Oral health standards of care for children at risk saskatchewan ministry of health

Saskatchewan Ministry of Health
Oral Health Standards of Care for
Children at Risk
Oral Health Coalition
October 30, 2012

POPULATION HEALTH BRANCH

Building a Healthier Saskatchewan

• Provide update on enhanced services and
take time to reflect on the past year
• Provide an overview of the data being
collected provincially
• Share some early observations of services
in 2011-12

Goal:
• To reduce dental decay and contribute
to the healthy development of at risk
mothers, infants, preschool and school
age children.
• To reduce the need for hospital based
general anaesthesia treatment services

• Oral Health Assessment, referral and
follow-up
– Assessments will provided to all children from
2 months to 5 years of age
– Children with treatment needs are referred for
follow-up by appropriate oral health
professional
– Children who receive services under GA are
followed up in the community


• Fluoride Varnish
– Children from 6 months of age to 5 years who
are identified at risk will be provided 2 fluoride
varnish applications each year.

• Dental Sealants
– provided to all Grade 1 and Grade 7 students
attending schools identified as being high risk

Saskatchewan Surgical Initiative
2012-13
• $60.5M for SkSI
• 99% of surgeries completed within 18
months
• 97% within 12 months


• 2546 children under the age of six
received dental surgery under GA in
2010-12
• 2721 children were seen in 2011-12
• Total of 5267 children in the past 2 years

Surgical Procedure Rates
Figure 4: Five-year Average Oral Surgical Procedures Rates by RHA of Patient, 2007-2011.
Sun Country
Five Hills
Cypress
Regina Qu'Appelle
Sunrise
Saskatoon
Heartland
Kelsey Trail
Prince Albert Parkland
Prairie North
Mamawetan Churchill River
Keewatin Yatthe
Athabasca
Saskatchewan
0%

5%

10%

15%

20%

25%

Percentage (%) of Children 0-5


Waitlist
SK Surgical Patient Registry: Number Waiting at Month End

2000

1800

1600

1400

1200

1000

800

600

400

200

0
201004

201005

201006

201007

201008

201009

201010

201011

201012

201101

201102

201103

201104

201105

201106

201107

201108

201109

201110

201111

201112

201201

201202

201203


Waitlist
SK Surgical Patient Registry: Number Waiting at Month End by Time Already Waited

Wait > 12mth

Wait > 18mth

350

300

250

200

150

100

50

0
201004

201005

201006

201007

201008

201009

201010

201011

201012

201101

201102

201103

201104

201105

201106

201107

201108

201109

201110

201111

201112

201201

201202

201203


Average Monthly Procedures
Figure 2: Average Monthly Oral Surgical Procedures in Children 0-5 (x-bar control chart)
2 60

240

Number of Procedures per Month

220

2 00

1 80

1 60

1 40

1 20
Oct- Jan- Apr- Jul- Oct- Jan- Apr- Jul- Oct- Jan- Apr- Jul- Oct- Jan- Apr- Jul- Oct- Jan- Apr- Jul- Oct- Jan06 07 07 07 07 08 08 08 08 09 09 09 09 10 10 10 10 11 11 11 11 12
Quarter Beginning


SK Surgical Patient Registry: Summary of Surgery Performed by Region of Service and Children's Region 2011-12 Q4
Region of Service

Children Reside

400

350

300

250

200

150

100

50

0
Sun Country

Five Hills

Cypress

Regina
Qu'Appelle

Sunrise

Saskatoon

Heartland

Kelsey Trail

Prince Albert Prairie North Mamawetan
Parkland
Churchill
River

Keewatin
Yatthe

Athabasca

Unknown or
Out of
Province


Surgical Procedures
Figure 3: Saskatchewan Oral Surgical Procedures Rates by Year, Children 0-5
4.0%

3.5%

3.0%

Percentage (%)

2.5%

2.0%

1.5%

1.0%

0.5%

0.0%
Oral Surgery

2007

2008

2009

2010

2011

3.3%

3.3%

3.1%

3.2%

3.6%


Analysis and Recommendations
• 2010 incidence rate of 3.2% will be the
baseline.
• Consider options to increase surgical
activity in the summer.
• Consider implementation of additional
preventive measures to meet the high
needs of the north.


• Northern Proposal
– Support for two DT positions to work with pre
& postnatal mothers & preschool children.
– 3 northern RHA will work together to address
some of the remaining challenges in the north
to ensure the standard of care is met.
– Services will include and compliment
enhanced preventive services

Enhanced Preventive Dental Services
Evaluation Sections:
1. Child Health Clinics, Pre/postnatal services
and follow-up after dental treatment under
GA
2. Fluoride Varnish Applications
3. Dental Sealants
4. Overall program objectives



• Overall Evaluation Objectives
Target

Actual

90% of DT staff hired
100% of equipment/supplies in place
80% of Dental Assistants Hired*
100% of Eligible Schools Contacted

100%
100%
77%
100%

95% of at risk schools participating

95%


Target
•
•
•
•
•

Actual

50% of eligible Gr. 1 students consent to services
65% of enrolled Gr.1’s receive a fluoride varnish
65% of enrolled Gr.1’s received sealants
65% of Grade 1 receive OHI
90% of PHNs are oriented to updated CHC
Guidelines

63%
92%
66%
90%
89%



Target
• # of children assessed during child health
clinics – 32,000 per year
Actual
• 17,970
• 56% of our annual target

Target:
• # of children at risk receiving a fluoride
varnish - 15,000 per year
Actual:
• 10,411
• 69% of our goal.

Target:
• # of children receiving a sealant - 3,600
Actual:
• 2824 children received 7,096 sealants
• 78% of our goal



• Other goals to be measured:
– 5% reduction of Early Childhood Tooth Decay
– 5% reduction in the number of children who
require dental surgery under GA.



One smile at a time.


Oral health standards of care for children at risk saskatchewan ministry of health

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