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Bureau of Dental Health: An Overview of Programs

Bureau of Dental Health: An Overview of Programs. Timothy Cooke, BDS, MPH Bureau of Dental Health Albany, NY. (518) 474-1961 tlc06@health.state.ny.us. Vision & Mission.

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Bureau of Dental Health: An Overview of Programs

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  1. Bureau of Dental Health: An Overview of Programs Timothy Cooke, BDS, MPH Bureau of Dental Health Albany, NY. (518) 474-1961 tlc06@health.state.ny.us

  2. Vision & Mission • The Bureau of Dental Health will provide an environment to encourage all New Yorkers to develop an awareness of the importance of oral health, and to assure it’s inclusion in public health programs targeted toward the building of healthier communities. • Our mission is to improve the oral health of all New Yorkers. We design and implement public health initiatives to prevent and control oral diseases and other adverse conditions, promote healthy behaviors, and improve the skills of all dental care providers. We partner with local health departments, health care providers, community organizations, and residents of the state to build healthier communities.

  3. Functions • Assess and monitor oral health status • Provide guidance for planning policy development to support community efforts directed toward assuring oral health • Mobilize community partnerships to design and implement programs directed toward prevention and control of oral diseases and conditions • Inform and educate the public regarding issues related to healthy lifestyle, health plans, and availability of care

  4. Functions continued…………. • Integrate oral health programs and policies into other health care programs • Assure the capacity and promote the competency of public health dentists, general practitioners, and dental hygienists • Evaluate the effectiveness, accessibility, and quality of population-based and personal service • Promote research and demonstration programs to develop innovative solutions to problems

  5. Organizational chart

  6. Technical Support Rural Health School Health Indian Health Local Health Migrant Health Investigation of disease transmission BUREAU OF DENTAL HEALTH Office of Children and Families Community Health Centers Child Health Plus Dental Care for persons with HIV Medicaid Managed care

  7. Oral Diseases

  8. Dental Caries • Despite improvements in overall disease levels, dental caries remains the commonest childhood disease* • 7x as common as asthma • Responsible for children missing 52m school days annually • 54% of 3rd grade children in NY have suffered dental caries, 33% have active disease+ • Caries can affect teeth soon after eruption: Early Childhood Caries • 3000 children annually in NY are hospitalized for treatment • Cost close to $1m • Major disparities in caries experience by income *Oral Health in America: A Report of the Surgeon General ~ DHHS 2000 + NY surveillance 2002-04, unpublished data

  9. Early Childhood Caries

  10. Periodontal Disease • Severe periodontal disease (measured as 6 millimeters of periodontal attachment loss) affects about 14 percent of adults aged 45 to 54 • Twenty-three percent of 65- to 74-year-olds have severe periodontal disease • About 30 percent of adults 65 years and older are edentulous, compared to 46 percent 20 years ago • Potential link to pre-term/ low birth weight babies • Associated with heart disease • Two-way link with diabetes Oral Health in America: A Report of the Surgeon General ~ DHHS 2000

  11. Oral and Pharyngeal Cancer • Oral and pharyngeal cancers are diagnosed in about 30,000 Americans annually; 8,000 die from these diseases each year Oral Health in America: A Report of the Surgeon General ~ DHHS 2000

  12. TestisThyroidProstateMelanomas of SkinBreast (Females)Corpus & Uterus, NOS*Hodgkin’sUrinary BladderCervix UteriLarynxColonKidney/RenalRectumOral Cav & PhynxNon-Hodgkin’sOvaryLeukemiasBrain & NOS*Multiple MyelomaStomachLung and BronchusEsophagusLiver & IntrahepPancreas Five-year relative survival rates for select cancers for White and Black persons White Patients Black Patients *Note: NOS= not otherwise specified Source: Kosary, 1996 Five-year relative survival rates Oral Health in America: A Report of the Surgeon General ~ DHHS 2000

  13. Programs

  14. Fluoridation *http://apps.nccd.cdc.gov/MWF/Index.asp

  15. New York State Fluoride Supplement Program • Self Applied Fluoride Education and Rinse Program (SAFER) • 95,000 children in 300 schools • Fluoride tablets and drops • 5000 children in Head-Start, WIC, Migrants and County-based public health programs

  16. Public Insurance Medicaid: • About 1.6 m (23%) eligible children receive dental care • $76.7 million or 2% of all expenditures • Program has been enhanced substantially • Adult dental coverage always under threat Child health plus: • Approximately 450,000 are enrolled

  17. Municipal Health Services Plan • State supports local health units. Activities are: • Dental health education • Dental clinics • School-based programs • Assessment

  18. Orthodontic Program • Supports reimbursement for • Cleft lip, cleft palate or ankylosis • Severe deviations resulting from disease or trauma in either jaw • Malocclusions best described as: • Maxillary prognathism • Mandibular protrusion • Micro or macro development of jaws

  19. School-based Programs • Programs that do not need DOH oversight: • Dental health in school curricula • Dental note program in New York City • Fluoride rinse/tablet program • Screening & referral program • Providing clinical services requires approval by DOH: • Prophylaxis & dental sealant application • Treatment programs

  20. Clinical Service Provision • Mobile dental equipment • Fixed school site • Mobile Van

  21. Health Education Program • Fluoridation • Preventive Care • Early Childhood Caries • Pregnancy and oral health • Dental Sealants • Infection Control • Management of persons with HIV and AIDS • Oral Cancer

  22. Grants

  23. Preventive Dentistry Grants • Establish community partnerships • Identify effective intervention and mobilize resources • Facilitate linkages and assure quality systems of care • Expansion of the use of preventive services • Evaluate outcomes and monitor progress • Develop local coalition

  24. Innovative Services Grants • Innovative projects: • Try new approaches to meeting local oral health needs • Piloting potential “best practices” • Disseminate new ideas • Technical Assistance Center

  25. Recent Activities

  26. New York State Oral Health Plan • CDC funded project • Approach used for all chronic disease programs • Developed by 80-90 stakeholders • Outlines key Goals, Objectives and Strategies • Short and long term • Organizations and coalitions will select appropriate activities and interventions

  27. Statewide Oral Health Coalition • Will coordinate activities around State Oral Health Plan implementation • Core of members active in developing the plan • Will work with regional and local oral health coalitions

  28. Guidelines Project • Guidelines for the dental care of pregnant women and young children • No precedent for these guidelines • Convened expert panel: • OB/Gyns • Dentists • Pediatricians • Will (hopefully!) be released soon

  29. Burden Document • Uses CDC outline • Presenting all the available data on oral disease in NY in one place • Will be published later in 2006 Questions?

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