20ll Oral Health Summit St. Paul, Minnesota Barbara Hann Ayo Adeniyi Merry Jo Thoele Jon Roesler...

20ll Oral Health Summit20ll Oral Health SummitSt. Paul, MinnesotaSt. Paul, Minnesota

Barbara HannBarbara Hann

Ayo AdeniyiAyo Adeniyi

Merry Jo ThoeleMerry Jo Thoele

Jon RoeslerJon Roesler

Minnesota Department of HealthMinnesota Department of Health

Oral Health UnitOral Health Unit

Minnesota BSS Minnesota BSS Baseline Data CollectionBaseline Data Collection

February – May 2010February – May 2010

Across MinnesotaAcross Minnesota

Third grade studentsThird grade students 40 schools40 schools 27 counties27 counties 40 school districts40 school districts 17 weeks17 weeks 3 pilot sites3 pilot sites

Basic Screening SurveyBasic Screening Survey

LocationsLocations

CollaboratorsCollaborators School Nurses of Minnesota School Nurses of Minnesota Minnesota Department of HealthMinnesota Department of Health

– Minnesota Obesity GrantMinnesota Obesity Grant– Oral Health UnitOral Health Unit– Maternal and Child HealthMaternal and Child Health– Steps and Coordinated School HealthSteps and Coordinated School Health

Minnesota Department of EducationMinnesota Department of Education Children’s Dental ServicesChildren’s Dental Services Apple Tree DentalApple Tree Dental University of MinnesotaUniversity of Minnesota Dental Hygienists of MinnesotaDental Hygienists of Minnesota VolunteersVolunteers

Data Collection Form/Data Collection Form/Active ConsentActive Consent

Process had transparencyProcess had transparency– data was recorded on the lower part of the data was recorded on the lower part of the

form so parents could see what was form so parents could see what was collectedcollected

– upper part of the form was for parental upper part of the form was for parental consent. consent.

– consent for both parts of the screening or consent for both parts of the screening or just one partjust one part

Identifying data was left at the schoolIdentifying data was left at the school

Keys to successKeys to success

Communication Communication

IncentivesIncentives

CommunicationCommunication

School district superintendentsSchool district superintendents

Elementary school principalsElementary school principals

School health professionalsSchool health professionals

School contact personSchool contact person

Parents/GuardiansParents/Guardians– Intro letter, consent data form, results letter, referral as Intro letter, consent data form, results letter, referral as

neededneeded

IncentivesIncentives

For Students:For Students:

Each student in third grade at each schoolEach student in third grade at each school

received a self-closing plastic bag received a self-closing plastic bag with a new toothbrush with a new toothbrush pedometerpedometer Five-a-Day Activity Book, Five-a-Day Activity Book, brushing and flossing flyer brushing and flossing flyer child and nutrition brochurechild and nutrition brochure

Incentives Incentives For Schools:For Schools:

The principals, teachers, and school coordinator receivedThe principals, teachers, and school coordinator received a “thank you” bag with food safety information a “thank you” bag with food safety information nutrition and activity informationnutrition and activity information cookbook and recipe cards cookbook and recipe cards pencils pencils fruit and vegetable tracking paper fruit and vegetable tracking paper pedometerpedometer

Teachers also received posters for the classroom for dental Teachers also received posters for the classroom for dental health and nutritionhealth and nutrition

BSSBasic Screening Survey

Association of State & Territorial Dental Directors

Representative Sample of Schools

3rd Graders Statewide

Non-invasive Oral Health Survey:

Caries, Fillings, & Sealants

Estimate Treatment Urgency

Sample is representative

• Public schools with 3rd grade classes

• Classroom size: 10 or more students

• Sample frame: 837 schools

• Simple random sample – Needed 40 schools; over-sampled 50

• ASTDD screening protocol used

MN2010 3rd Grade BSS

MN2010 BSS Facts

• Visited 40 schools across Minnesota– Eligible students: 3,054 (2008/09 school enrollment)

– Consented: 1,821– Screened: 1,766

• Response rate (active consent): 58% – Ohio 53% (active consent; 2005-2006)– Wisconsin 89% (passive consent; 2007-2008)

• Participation rate: 97%

BSS Data Summary

Oral Health Variable Estimate 95% C.I.*Dental sealants on molar** 64.1% 60.0 – 68.2%

Caries experience** 54.9% 50.3 – 59.5%

Untreated tooth decay** 18.1% 14.9 – 21.4%

Treated tooth decay 47.8% 43.1 – 52.4%

Treatment Urgency: None 81.5% 78.3 – 84.8%

Treatment Urgency: Early 16.8% 14.1 – 19.4%

Treatment Urgency: Urgent 1.7% 0.9 – 2.5%*95 percent confidence interval

** Natl. Oral Health Surveillance System Indicators


Dental Sealants

Percentage of 3rd Grade studentswith dental sealants on at least

one permanent molar tooth

MN2010 BSS: Dental Sealants

Minnesota 64.1% (#2)U.S. 23.0%

High: Vermont 66.1%South Dakota 61.1% North Dakota 52.7%

Wisconsin 47.0%Iowa 45.5%Ohio 43.3%

Illinois 26.9%Low: South Carolina 20.3%

Minn, 64.1% USA, 23.0%

0%

10%

20%

30%

40%

50%

60%

70%

Sealants on Molar

Healthy People 2010: 50%


Caries Experience

Percentage of 3rd Grade students with history of dental caries (treated or untreated caries)


MN2010 BSS:

Caries Experience

Minnesota: 54.9% (#11)U.S.: 52.0%

Low: Connecticut 40.6%Iowa 42.8%Ohio 55.0%

Illinois 55.4%North Dakota 55.6%

Wisconsin 60.1%South Dakota 65.6%

High: Arkansas 72.2%

Minn, 54.9% USA, 52.0%

0%

10%

20%

30%

40%

50%

60%

Caries Experience

Healthy People 2010: 42.0%


Untreated Tooth Decay

Percentage of 3rd Grade students with untreated tooth decay



Minnesota: 18.1% (#4)U.S.: 29.0%

Low: Iowa 13.2%North Dakota 16.9%

Ohio 25.7%Illinois 30.2%

Wisconsin 30.8%South Dakota 32.9%

High: Arkansas 42.1%


Minn, 18.1% USA, 29.0%

0%

10%

20%

30%


Healthy People 2010: 21.0%


Socioeconomic Status

School’s Free & Reduced Lunch (FRL) Eligibility Status

Proxy for community socioeconomic status

0% 10% 20% 30% 40% 50% 60% 70% 80%

<= 25%

26-49%

50-74%

>= 75%

Fre

e &

re

du

ce

d lu

nc

h e

ligib

ility

sta

tus

Percent Sealants on Molar


0% 10% 20% 30% 40% 50% 60% 70% 80%

<= 25%

26-49%

50-74%

>= 75%

Fre

e &

re

du

ce

d lu

nc

h e

ligib

ility

sta

tus

Percent Caries Experience


0% 5% 10% 15% 20% 25% 30%

<= 25%

26-49%

50-74%

>= 75%

Fre

e &

re

du

ce

d e

lig

ibil

ity

sta

tus

Percent Untreated Tooth Decay


0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

<= 25%

26-49%

50-74%

>= 75%

Fre

e &

re

du

ce

d lu

nc

h e

ligib

ility

sta

tus

Percent Treatment Urgency

Treatment Urgency: Urgent

Treatment Urgency: Early

Treatment Urgency: None


Race & Ethnicity

0%

10%

20%

30%

40%

50%

60%

70%

80%

Sealants on Molar Caries Experience Untreated Caries Treated caries

White, non-Hispanic, n=1,345 Non-white, non-Hispanic, n=252

Hispanic, n=90 Unknown/missing, n=79


Location: Urban vs. Rural

57.0%

19.9%

49.5%

63.9%

44.8%

15.3%

51.3%

64.4%

0%

10%

20%

30%

40%

50%

60%

70%


Rural, student n=1,103

Urban, 7-County Metro, student n=663


Gender: Male vs. Female

62.2%

58.2%

20.5%

51.1%

20.0%

49.4%

66.3%

57.1%

0%

10%

20%

30%

40%

50%

60%

70%


Male, n=869

Female, n=826


Conclusion: Mixed findings

• Overall good preventive strategies & treatment – restorative services and treatment need on par with

nation

• Caries experience higher than national targets – ~ 20% attend school with cavities in their mouths

• Disproportionate burden of oral disease – minority populations – lower income families


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20ll Oral Health Summit St. Paul, Minnesota Barbara Hann Ayo Adeniyi Merry Jo Thoele Jon Roesler...

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