4. Dental care operates as a private fee-for-service system
Private dental insurance
Out-of-pocket
Public dental insurance
Canadian Dental Health Care System
5. 62% private dental insurance
(usually an employee benefit)
32% no dental insurance
6% public insurance
Dental Health Care System
7. Publicly Funded Share of Total Expenditures
for Dental Services in Canada
Canadian Dental Association
8. Individuals with low income
Young children in low income families
Individuals with no employment-related
dental insurance
Elderly living in LTC or with low income
Indigenous people
Refugees and immigrants
Individuals with disabilities
People living in rural/remote areas
Vulnerable Populations in Canada
13. Provincial Oral Health Office
To provide leadership and strategic direction to
respond to Albertans’ oral health needs
14. Provincial Oral Health Office
• Every Albertan deserves good oral health as part of good health
• Access to oral health care improves health, well-being, and quality of life
• Partnership and collaboration create a supportive environment for oral health
• Evidence-based dentistry enables a cost-effective utilization of resources
• Oral health standards of care ensure quality services
• Leadership and communication improve capacity to meet public health needs
20. Health Promotion
• Community Water Fluoridation
• Oral Health Information
• Seniors’ Mouth Care
• Reporting Oral Health Indicators
Health
Promotion
21.
22.
23.
24. Community Water Fluoridation “It is the controlled adjustment of the natural
fluoride concentration in a public water supply up to the level recommended for
preventing tooth decay.” CDC (2005)
33. 18,470
10,585 9,974
6,498 6,067 5,789
0
5,000
10,000
15,000
20,000
25,000
EligibleChildren-Gr1&2
Children - Gr 1&2
Provincial School Dental Sealant (DS)
Sep 2015 - Jun 2016
Consent Forms Sent
Consent Forms Returned - 57%
Children Observed for DS - 94% of Consent Forms Returned
Children Referred for DS - 65% of Children Observed
Children Received DS - 93% of Children Referred Received at Least One DS
Children Completed All DS - 89% of Children Referred
Note: 9,974 children observed for DS represents 9% of the Gr 1&2 children population.
35. To standardize oral assessment for
daily oral hygiene needs
To provide training on oral hygiene
to health care providers
To promote oral health to patients living in Continuing Care
Designated Living Options
To prevent oral diseases resulting from poor oral hygiene
Seniors’ Program
36. Seniors’ Oral Health
Prevalence of Coronal Caries Dentate Adults 20.3%
Prevalence of Untreated Decay Higher Income
Middle Income
Lower Income
13.5%
21.9%
29.8%
Privately Insured
Publicly Insured
15.9%
35.8%
Prevalence of Root Caries Age 20-39
Age 40-59
Age 60-79
5.8%
24.9%
43.3%
Privately Insured
Publicly Insured
17.4%
31.4%
Report on the Findings of the Oral Health Component of the Oral Health Component Canadian
Health Measure Survey (CHMS) 2007-2009.
Edentulism: 1972–23.6% 2009–6.4%
39. Eligibility Criteria
Alberta citizens
No dental insurance
• Children not covered by the ACHB
• Adults not covered by Alberta Works,
AISH, FNIB, Blue Cross
Income under LICO limits
40.
41.
42. Dental Procedures
2013 2014 2015 2016
Dentist
Emergency exams 996 1,174 1,494 2,051
Exam of full mouth 572 526 588 754
Extractions 1,274 1,404 1,654 2,617
Fillings 2,908 2,482 2,827 3,857
Root canal 195 235 264 294
Dental Assistant
Panoramic radiographs 567 656 787 1,343
Sets of BWs and sets of PA
radiographs
3,287 3,775 4,382 4,800
Dental Hygienist
Oral hygiene education 1,193 1,262 1,108 1,039
Fluoride varnish application 476 448 439 480
Probing, scaling and root planing 3,419 3,498 2,807 2,180
Total Patients Seen 1,646 1,961 2,310 3,040
44. Age McLennan High Level La Crete Total
Group (yr) IC C IC C IC C IC C
0-8 yrs 54 53 41 23 89 30 184 106
9-15 yrs 89 83 69 20 154 73 312 176
16- yrs 586 531 591 110 345 185 1522 826
Totals 729 667 701 153 588 288 2018 1108
Table 1: Number of completed (C) and Incomplete (IC) treatment plans by age group from
April 1, 2015 to March 31, 2016
Procedures Types McLennan High Level La Crete Totals
(%)
Patient Exams/Radiographs 1535 1011 809 3355 (38)
Prevention/Periodontics 1440 830 682 2952 (33)
Restorative 851 338 591 1780 (20)
Oral Surgery 293 160 100 553 (6)
Endodontics 27 24 33 84 (1)
Prosthodontics 38 20 7 65 (1)
Other 39 25 20 84 (1)
Total Treatments 4223 2408 2242 8873(100)
Table 2: Number of procedures and procedure types from Apr. 1, 2015 to Mar. 31, 2016
45. Research & Surveillance
Research &
Surveillance
• Oral Health Dashboard
• Water fluoridation review
• Oral cancer research
• Caries prevalence rates
57. Year # %
2011 27,051 16.4%
2012 27,978 16.9%
2013 28,148 17.0%
2014 28,526 17.3%
2015 27,254 16.5%
2016 26,370 16.0%
Total Visits (2011-2016) 165,327 100.0%
Characteristics of ED Visits for Dental Problems not
Associated with Trauma by Year - Alberta 2011 to 2016
58. ED Visits for Dental Problems not Associated
with Trauma by Gender and Age 2011-2016
59. ICD-10-CA
Code
Code Description 2011 2012 2013 2014 2015 2016
2011-
2016
K04 Diseases of pulp and periapical tissues 12,267 12,551 12,599 12,844 12,263 11,713 74,237
K08
Other disorders of teeth and supporting
structures
5,125 5,144 5,345 5,407 5,128 5,094 31,243
K12 Stomatitis and related lesions 1,949 2,158 2,139 2,065 2,029 1,964 12,304
K11 Diseases of salivary glands 1,179 1,349 1,383 1,522 1,391 1,383 8,207
K02 Dental caries 1,266 1,362 1,345 1,348 1,313 1,213 7,847
K05 Gingivitis and periodontal diseases 1,294 1,360 1,305 1,320 1,296 1,248 7,823
K07 Dentofacial anomalies (including malocclusion) 1,086 1,044 1,070 1,054 1,025 1,012 6,291
K13 Other diseases of lip and oral mucosa 837 865 873 897 849 801 5,122
Other K00-
K14
All Other K00-K14 2,048 2,145 2,089 2,069 1,960 1,942 12,253
All K00-K14 All dental problems not associated with trauma 27,051 27,978 28,148 28,526 27,254 26,370 165,327
Frequency of ICD-10-CA Code Diagnoses of ED Visits for Dental
Problems not Associated with Trauma - Alberta 2011-2016
60. Emergency Department Visits for
Dental Problems in Alberta
1.2%
1.0%
0.8%
0.5% 0.5%
0.3%
0.0%
0.2%
0.4%
0.6%
0.8%
1.0%
1.2%
1.4%
Dental Pneumonia Asthma Diabetes Hypertension
Diseases
Ischemic Heart
Disease
PercentageofallEDVisits
Select Health Conditions
Percentage of all ED Visits for Select Conditions (2011-2016)
61. Fluoride Varnish as a Population Health Preventive Service in Alberta
C. Huber, S. Baran, C. de Graaff, R. Figueiredo. Submitted: Canadian Journal of Public Health
Articles
Submitted
Emergency department visits for dental problems not associated with trauma in Alberta,
Canada
Figueiredo R, Fournier K, Levin L. Submitted: International Dental Journal
Acute dental infections managed in an outpatient parenteral antibiotic program setting:
prospective analysis and public health implications
Connors WJ, Rabie H, Figueiredo R, Parkins MD. Submitted: Bio Med Central Infectious Diseases
Emergency Department Visits for Dental Problems in Alberta, Canada
R. Figueiredo*1, 2, D. Alabi1, L. Levin2
2016 CAPHD Oral
Presentations
Caries prevalence data for grade 1 students in Alberta, Canada by community deprivation index
level and geography
*Steven Patterson1, Lindsay McLaren2, Rafael Figueiredo3
Addressing Acute Dental Infections in Emergency Departments
H. Rabie1*, W. Connors2, D. Holton3, M. Parkins3, R. Figueiredo1
The Use of a Guideline for Safe Preventive Dental Service for Children with Asthma
S. Baran1*, C. Huber1, C. De Graaff1, R. Figueiredo1
2016 CAPHD Poster
Presentations
Fluoride Varnish as a Population Health Preventive Service in Alberta
C. Huber1*, S. Baran1, C. de Graaff1, R. Figueiredo1
Oral Health Framework for Residents in Long Term Care
C. De Graaff *1, C. Huber1, S. Baran1, R. Figueiredo1
Dental World Summit
2017 - Italy
Dental Health Surveillance of Emergency Departments in Alberta, Canada
