Kentucky Oral Health Program Overview

Dr. Julie Watts McKeeDental Director

2

Core Mission:To assure oral health for Kentucky.

2

3

Statistics: Decay Rates: 2011-2012

10% U.S. Children with decayKentucky rate: currently unknown

2001-200419.5% of 2-5 year olds in U.S. with untreated

decay2001

42.8% of Kentucky children with untreated decay

3

4

Statistics: Access and Utilization46% of all Medicaid/KCHIP children

One dental service60% of 6-9 year olds received services

40% of all received a preventive service54% of 6-9 year olds received preventiveOral Health Service by a non-dentist provider

PhysiciansHealth Departments

Nurses Hygienists

5

Statistics: Preventive ServicesFluoride Varnish

200440% reduction in smooth surface decay. Last year: 22,000 in local health deparmentsSmiling Schools: 17,000 this year

Public Health Hygiene7 sites30,000 services4,600 patients

6

Statistics: Behavioral Risk Factor Surveillance SystemHigh rate of extractions

7th highest in adults with an extractionDental Visits

42nd in the nation (not good)60% of adults with a dental visit

7th in edentulism in senior Kentuckians.This is an improvement over the years

7

Statistics: Dental WorkforceDeloitte Report

Rural areas need dentistsJefferson County needs 150 more dentists

Maldistribution435,000 newly covered mouthsFew new providers13 new dentist license in Appalachia

8

Statistics: Water FluoridationReduces decay between 40 and 50%99.8% of Kentuckians have optimally

fluoridated drinking water. Highest covered state

Washington, DC at 100%New regulations

0.7 Parts Per Million

9

Key Stakeholders: Health DepartmentsSpecific Funding VarnishSealantsHygiene ProgramsSpecial ProjectsMedicaid Reimbursements

10

Key Stakeholders: Dental SchoolsUniversity of Kentucky

OutreachVarnish SuppliesSpecial Projects

University of LouisvilleSpecial Projects

Collaboration is evident

11

Key Stakeholders: AppalachiaSmiling Schools

12

Key Stakeholders: Boards and Associations Kentucky Board of DentistryKentucky Dental Association

13

Key Stakeholders: Water PlantsRegulatory Responsibility

MonitoringReporting

Technical Assistance

14

Emerging Issues: Data CollectionUniversity of Kentucky

Prevalence StudyEarly Learners

Delta DentalPrevalence Study

Third and Sixth GradersUniversity of Louisville

On-Going Surveillance System

15

Emerging Issues: PH HygienistsSeven Pilot Programs

Start up fundingLooking for two more

Electronic Health RecordsDental is the Canary

16

Emerging Issues: Increased Decay Rates in Early ChildhoodPermanent Teeth Decay Rates (Nationally)

Dropping SlowlyPrimary Teeth Decay Rates (Nationally)

Slight, but significant increaseKentucky?

We’ll see

17

Emerging Issues: TeledentistryOral Health

Interested in developing networkInvolves dental schoolsInvolves private dentists

18

Emerging Issues: Workforce DistributionPossible maldistribution?Medicaid ExpansionLeads to delay or avoidance of care

19

Emerging Issues: Community Dental Health WorkersCommunity Dental Health Coordinator

Reduces careReduces impactProven in other areas of patient navigation

and education

20

Emerging Issues: Adult DenturesSignificant Increase in Medicaid ExtractionsPent Up Dental Need in Expansion PatientsDentures

EmployabilityBetter Nutrition

21

Program Cost Effectiveness:Community Water Fluoridation

Annual per-person cost savings$16-$19 a year

KentuckySaves $69 Million a year

22

Program Cost Effectiveness:Fluoride Varnish

20% reduction shown in Kentucky projectsVaries on the studied parameters

23

Program Cost EffectivenessSealants

Evidence Based ProcedureAfter two years

$53Oregon

1313% in 20 years$125 cost of filling-avoided

If avoided, PH RDH has avoided $987,164

24

The Future of Oral HealthNationally

Provider numbers StableDecreasingIncreasing

StateKeep on striving for the best oral health status

for all Kentuckians