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Young chidren's oral health status in the saskatoon health region: 2006 2015
1. Saskatoon Health Region
Young Children’s Oral Health Status: 2006-2015
Maryam Jafari
School of Public Health, U of S
Ms. Leslie Topola
Manager, SHR, Population and Public Health
2. Overview
• Oral Health Program-Population and Public Health
• Background Information: Oral Health in Young Children
• The Current Report
3. Oral Health Program, Population and Public Health
Primary Health Services
• School Services
Dental Screening
• Fluoride Services
Fluoride Varnish Clinics
Public Health Dental Clinic
4. Tooth Decay: 5 times more common than asthma
• 57% of 6–11 years old (Canadian Health Measure Survey 2007-2009)
Early Childhood Tooth Decay (ECTD)
• Younger than 6 year old (primary teeth)
• No national information
• More than one fourth of children ( Ontario)
• Heath Impact:
• Economic Impact: Day surgery
$3.4 million (Saskatchewan)
$1.9 million (Saskatoon Health Region)
ECTD
Severe ECTD
Background
6. Prevention Strategies
• Reduce the bacteria of mother
Prevention and Treatment
• Minimize the transmission of bacteria of mother
• Fluoride
Community (Water, Milk, Salt)
Individual (Fluoride Varnish,…)
• Antibacterial agents
• Fissure sealants
NO Saliva Sharing!
7. Objectives
• Monitor the trends of oral health status children 0-6year olds
• Provide baseline for future screening/analysis for children 0-5 year old
• Assess oral health of 6 year old against Canadian Oral Health Framework
2013-2018
• Establish oral health target for 0-5 year old
• Determine disparities in the oral health status
• Child’s Residence, Neighborhood Income Status
8. Methods
• Data Collection (already done)
• Dental Assistants
• Dental Therapists
• Public Health Nurses
• Nurse Practitioners
9. Methods
• Data Analysis
• Oral Health Indicators
• “deft”, “DMFT”, “deft+DMFT”
• Early Childhood Tooth Decay
• Severe Childhood Tooth Decay
• Caries-Free
• Untreated Cavities
• No Evidence of Care
• Priority
deft : decayed, extracted, filled teeth
DMFT: Decayed, Missing, Filled Teeth
10. Results
1- Trend of oral health status
(in general):
2- Trend of oral health
(Urban vs. Rural ; Non-low Income vs Low Income Neighborhoods)
12. • N=23,787
• Age groups:
• Younger than 1 Year Old ( 2006-2014)
• 1 Year Old
• 2 Year Old
• 3 Year Old
• 4 Year Old
• 5 Year Old
• 6 Year Old ( 2008-2014)
14. Early Childhood Tooth Decay+ Severe-ECTD : 0-2 Year Old Children
0.00%
2.00%
4.00%
6.00%
8.00%
10.00%
12.00%
14.00%
16.00%
2006 2007 2008 2009 2010 2011 2012 2013 2014
%S-ECTD
15. Early Childhood Tooth Decay and Severe-ECTD: 3-5 Year Old Children
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
2006 2007 2008 2009 2010 2011 2012 2013 2014
%ECTD+S-ECTD
16. Early Childhood Tooth Decay and Severe-ECTD: 3-5 Year Old Children
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
2006 2007 2008 2009 2010 2011 2012 2013 2014
%ECTD
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
35.00%
2006 2007 2008 2009 2010 2011 2012 2013 2014
%S-ECTD
17. Canadian Oral health Framework (COHF) 2013-2018 Target:
6 Year Old Children
# Objective Indicator
1.a Reduce the number of teeth affected
by cavities in 6-Year Olds
deft +DMFT of <2.5
1.b Reduce the percentage of 6 year old
children who experienced cavities
55% of 6 year old children
have deft +DMFT=0 (Cavity-Free)
1.c Reduce the percentage of 6 year old
children with untreated cavities
<15% of 6 year old children
have d+D>0 (Untreated Cavities)
21. Saskatoon Health Region Recommended Target: 0-5 Year Old Children
# Objective Indicator
1.a Reduce the percentage of 5 Year Olds
who experienced cavities.
64% of 5 Year Olds have deft +DMFT=0
1.b Reduce the percentage of 4 Year Olds
who experienced cavities.
73% of 4 Year Olds have deft +DMFT=0
1.c Reduce the percentage of 3 Year Olds
who experienced cavities.
82% of 3 Year Olds have deft +DMFT=0
1.d Reduce the percentage of 2 Year Olds
who experienced cavities.
91% of 2 Year Olds have deft +DMFT=0
1.e Reduce the percentage of ≤1 Year Olds
who experienced cavities.
100% of ≤1 Year Olds have deft
+DMFT=0
22. • Oral health in 1, 2, 3, 4, 5 year old children has improved.
• Oral health in children younger than 1 has declined.
• Oral health in 6 year old children has declined
• The best measurements were seen in 2008
• The best measurements in recent year were seen in 2013
24. LIM vs. Non-LIM Neighborhoods:
• Low Income Measure (LIM)
• Low Income: 30% of families in the neighborhood meet the
definition of LIM (Statistics Canada)
• Age groups:
• 0-2 Year Old
• 3-5 Year Old
• 6 Year Old
25. Average “ deft+DMFT”: 0-2 Year Old Children
0
0.2
0.4
0.6
0.8
1
2006 2007 2008 2009 2010 2011 2012 2013 2014
Average“deft+DMFT”
Non-LIM LIM
26. Urban vs. Rural areas:
• Urban: Saskatoon, Humboldt
• Age groups:
• 0-2 Year Old
• 3-5 Year Old
• 6 Year Old
27. Average “ deft+DMFT”: 3-5 Year Old Children
0
0.5
1
1.5
2
2.5
3
3.5
4
2006 2007 2008 2009 2010 2011 2012 2013 2014
Average“deft+DMFT”
Urban Rural
28. Summary
• Oral health in Non-Low Income Neighborhoods has improved.
• Oral health in Low Income Neighborhoods has remained stable/showed unfavorable trend.
• Children in Non-Low Income Neighborhoods had better health compared to Low Income Neighborhoods.
• Oral health in both Urban and Rural children has improved.
• Rural children had better oral health compared to Urban children
29. Discussion
Improvements of oral health in Rural areas
• Involvement of Nurse Practitioners/Public Health Nurses in rural areas
• Possible confounders (Aboriginal status, dental insurance) wasn’t assessed
• Role of water fluoridation wasn’t assessed
Fluoride water content has not improved over the years.
No significant differences in oral health in Fluoridated vs non- Fluoridated areas
(SHR Dental Screening Program Report 2013-2014)
• Fluoride Varnish Program wasn’t evaluated
• Changes in lifestyle and habits in urban areas
30. Recommendations
• Involve Nurse Practitioners/Public Health Nurses in Fluoride Varnish Programs in
Urban areas (Low Income Neighborhoods)
• Conduct data entry the same day (web-based in real time)
• Conduct a national dental survey for children younger than 6 year old.
• Canadian Health Measure Survey 2007-2009 ( 6-11 year old children)
• Provide free consultation/checkup for the children 1 year old (Canadian Dental Association)
• Incorporate oral preventive health care in the universal health care system
• Incorporate oral exam as a part of routine prenatal care
• Improve training in pediatric dental care and pregnant women dental care in dental
school
31. Acknowledgments
Dental Health Screening Advisors
• Leslie Topola
• Julie Laberge-Lalonde
• Cynthia Ostafie
Examiners and Data Collection
Nurse Practitioners and Public Health Nurses
Oral Health Professional
• Leah Abrook
• Julie Laberge-Lalonde
• Linda O’Keefe
• Cynthia Ostafie
• Gwen Sawicki
• Diane Schitka
• Chris Vandale
• Leanne Ziolkowski
Office Administration
• Barbara Anderson
• Joyce Birchfield
• Terry Dunlop
• Josh Marko
• Bob Toso
32.
33. References:
King A. Oral health – more than just cavities: a report by Ontario’s Chief Medical Officer of Health.
Ontario: Queen’s Printer for Ontario; 2012. Available from:
http://www.health.gov.on.ca/en/common/ministry/publications/reports/oral_health/oral_health.pdf
Oral health during pregnancy and early childhood: evidence-based guidelines for health professionals.
J Calif Dent Assoc. 2010; 38(6):391. Available from:
www.cdafoundation.org/Portals/0/pdfs/poh_guidelines.pdf
Saskatoon Health Region. Oral Health Program Population and Public Health. Dental Health Screening
Program Report 2013-2014. Saskatoon, Saskatchewan: Saskatoon Health Region; 2014. Available from:
https://www.saskatoonhealthregion.ca/locations_services/Services/OralHealth/Documents/SHR%20FI
NAL%20Dental%20Screening%20Report%202013-2014.pdf
Saskatoon Health Region. Saskatchewan Dental Health Screening Program report 2013-2014; 2014.
Available from: https://www.saskatoonhealthregion.ca/locations_services/Services/Oral-
Health/Documents/Saskatchewan%202013 14%20Dental%20Screening%20Report.pdf
