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Judith A. Feinstein, MSPH Director, Maine Oral Health Program ME Center for Disease Control & Prevention (Bureau of Health) Maine Department of Health & Human Services. Oral Health in Maine: Facts & Figures, August 2005.

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oral health in maine facts figures august 2005
Judith A. Feinstein, MSPH

Director, Maine Oral Health Program

ME Center for Disease Control & Prevention (Bureau of Health)

Maine Department of Health & Human Services

Oral Health in Maine: Facts & Figures, August 2005
slide2

“…Oral health is integral to general health. You cannot be healthy without oral health.”

Oral Health in America: A Report of the Surgeon General, 2000

oral health in maine
1999 Maine Smile Survey: 20%

of children in grades K & 3 needed

treatment.

47% of 3rd graders had at

least one sealant, and 56.8% needed

at least one more.

About 31% of grade K and 45% of grade 3 had a history of decay.

Oral Health in Maine
oral health in maine1
2002 Maine Child Health Survey

Kindergarten

– 18.4%: untreated caries.

2003 Youth Risk Behavior Survey:

77% of middle school students reported a dental visit in past year – compared to 87% in 2001.

Oral Health in Maine
oral health in maine 2004 maine child health survey preliminary data
Of the children screened, 15% of kindergarten and 17% of the 3rd graders had untreated dental decay.

Of the kindergarten children screened, 11% hadn’t had a dental visit.

Of the 3rd graders screened, 57% had at least one dental sealant, but 50% of them needed at least one more.

15% of the kindergarten children and 41% of the 3rd graders who were screened have decay experience (fillings and/or decay).

In 1999, 38% of lower income children had sealants; in 2004, 53% of the lower income children screened have them – a level similar to higher income children.

Oral Health in Maine2004 Maine Child Health Survey, Preliminary Data
oral health in maine2
~ half of women who had a baby that year visited a dental office or clinic during their pregnancy.

Women 35 or older were more likely, and women 25 or younger less likely to have had a dental visit.

Oral Health in Maine

PRAMS – 2000 Survey

oral health in maine3
Nearly 25% of new moms said they needed a dental visit during pregnancy; but of these, 35% did not go.

The women who did not obtain needed care were more likely to be 20-24 years old, enrolled in WIC, or have annual incomes of less than $16,000.

Oral Health in Maine

PRAMS – 2000 Survey

oral health in maine4
Oral Health in Maine
  • BRFSS data for 1995-97 indicated that for people age 65 and over, Maine was the 5th most edentulous (toothless) state in the country (1999)
  • 2002: 30.4% of adults aged 65 and older reported loss of all their natural teeth and 43.8% reported retention of most of their natural teeth.
  • 2002: 4.8% of the 25-34 age group and 11.8% of those aged 35-44 had lost six or more teeth.
  • 2004: Of Maine adults, 12.7% had lost six or more teeth; 2.1% of those aged 35-44 and 24.3% of those 65 and older had lost all of their teeth.
water fluoridation
Exposure to optimally fluoridated water can reduce dental decay by 20 to 40%.

Close to half of Maine’s cities & towns do not have public water supplies.

Of communities with public water supplies, 84% of the population has fluoridated drinking water; but for the state as a whole, about 38%.

Water Fluoridation
oral health infrastructure in maine
Oral Health Infrastructure in Maine
  • Most dental care in Maine is delivered via

small, independently operating private practices.

  • Maine’s oral health safety net:
    • One municipal children’s clinic (Bangor)
    • 12 Federally Qualified Health Centers
    • 4 private non-profit children’s clinics
    • Three private non-profits with dental centers in 7 locations
    • State clinics: Portland, Augusta, Bangor
infrastructure
Infrastructure
  • Volunteer and voucher programs
  • Dental Hygiene Schools – Preventive services
  • Preventive Dental Hygiene Programs & Agencies
  • Mobile Programs: Miles for Smiles and The Tooth Ferry
issues for oral health in maine
Workforce concerns: numbers, age and

distribution of dentists (2002)

589 dentists, net gain of 8 since 1998 (actively practicing vs. 630 licensees)

465 (~80%) were general practice dentists.

Dentist to population ratio was one per 2,165, compared to national ratio of one per 1,656. Maine was 28th in the 50 states.

Only 30% of Maine dentists were 45 or younger; average age was 50.5.

Issues for Oral Health in Maine
issues in maine
Issues in Maine

Workforce concerns: numbers, age and distribution of dental hygienists (2004)

  • 739 hygienists, compared to 715 in 1999 (actively practicing); 90% employed in private dental offices.
  • Hygienist to population ratio is one RDH per 1,752 residents. Cumberland County’s ratio was significantly lower (better) than the state’s ratio; Washington & Somerset were significantly worse.
  • About 64% of Maine’s hygienists are 45 or younger (compared to 75% in 1999).
mainecare
MaineCare
  • In 2002, 57% of both general practice dentists and specialist dentists treated MaineCare patients in their practices.
  • When asked if they were accepting new MaineCare patients, more than 60% of specialists reported that they were, compared to 23% of general practitioners.
mainecare1
MaineCare
  • MaineCare reimbursement is well below market rate – estimated at 40% of “usual & customary.” Current payment levels fall below the 10th percentile of fees charged by general dentists in New England.
  • About 45-48% of Maine dentists were paid by MaineCare in 2004, and about 65,000 clients received at least one service. Total paid: over $20 million (compared to $13 million 2 years earlier).
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