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1378 words by aspurloc
The problem that I decided to focus on was healthcare, particularly oral health care. I find that oral health is not as big of a concern to Americans as general health care. This issue is dear to me because I aspire to be a dentist. The 2003 Oral Health Report Card published by the Oral Health America National Grading Project to call greater policy attention to oral health needs. From this problem, I decided to focus on something that I could contribute to oral health. I researched and found that there is a program that helps children receives dental sealants. A dental sealant is a cover that is placed on the tooth to protect it from tooth decay. The U.S. Surgeon General was the first to focus and report on oral health and the effectiveness of sealants and the strategies to provide sealants to children in community setting. In 2001, the dental sealant program was recommended and strongly endorsed by the Task Force on Community Preventive Services. The Journal of Dental Research did a study that showed placing sealants over early tooth decay would cause the decay to become a cavity. Also the Journal of the American Dental Association has done numerous studies that show the benefits of the sealants. One study showed that sealants placed over tooth decay would lower the amount of cavity bacteria. The sealants must stay in place on the tooth in order for them to work efficiently. Using a toothbrush to clean the surface of the tooth before applying the sealants result in higher sealant retention than using a hand piece. The school-based dental sealant program seeks to provide a dental prevention service to children that would normally not receive dental care on their own. Children that would qualify for this service would be the students that receive reduced or free lunch, or those from areas that would include urban neighborhoods or rural parishes. However children from low income families have been shown to be less likely to receive dental care than children that do not meet the lunch program criteria. The local standards will determine the acceptability of targeting children rather than schools. The program targets schools based on the amount of lunch eligible children. The common benchmark for eligibility is 50 percent. This program is funded with grants or contracts by the state; therefore there are some things that must be done. The program reexamines children within one year after initial sealant placement. This assures that newly erupted teeth and previously placed sealants may be sealed, repaired, or reapplied (as necessary).
“Healthy People 2010 Oral Health Objective 21-8 calls for 50 percent of eight and 14 year-old children to have sealants on their permanent molar teeth. The Healthy People 2010 sealant objective and sealant programs focus on permanent molars because caries risk on other teeth with pits and fissures is considerably lower. Although sealants can be placed on children’s premolars, maxillary incisors and primary molars, the situations in which such use would be appropriate are limited. The Surgeon General’s Report on Oral Health found that studies suggest that sealants are an efficient use of resources when used in populations with higher-than-average disease incidence rates and when sealants are placed on teeth at highest risk for caries. The 1995 Workshop on Guidelines for Sealant Use distinguished community-based sealant programs (including school-based and school-linked programs) from individual care programs (private practice and public clinics). People treated in community programs are more likely to be episodic users of primary dental care services. Furthermore, community sealant programs do not provide continuous care nor do they have access to a full array of caries diagnostic and treatment options. (Center for Disease Control)” The Task Force on Community Preventive Services (2002) found that school sealant programs are effective in reducing tooth decay. The decrease in caries on the chewing surfaces of posterior teeth in children was 60 percent. Based on the information or results that they found, the Task Force strongly recommended that school sealant programs be included as part of a dental prevent strategy. A literature review of pit and fissure sealant in 2002 included 1,465 peer-reviewed publications from that reported that sealants are clearly safe, effective, and underused in the United States. An analysis of nine clinical studies with a randomized, half-mouth, clinical trial design and seven studies with observational study designs found good evidence that sealants effective in high-caries-risk children as long as the sealant is retained . Sealants are more effective in preventing further caries and providing cost savings in a shorter time span if placed in children who have high rather than low caries risk. The Oral Health America National Grading Project is a breakdown of the 51 states based on the percentage of the population of caries-risk children. Four states have a statewide sealant program targeting and received an A for serving over 35% of a distinct population of caries-risk children. Twelve states have a statewide sealant program targeting and received a B for serving 20-35% of a distinct population of caries-risk children. Nine states have a statewide sealant program targeting and received a C for serving 5-19% of a distinct population, or a substantial targeted regional program exists and is reaching over 30% of the caries-risk population. Twelve other states have a statewide sealant program targeting and received a D for serving less than 5% of a distinct population of caries-risk children. Twelve more states have no existing statewide sealant program, therefore receiving an F for the lack of dental prevention services (compared to the other states). Two states received no grade because they were without information about dental prevention services, particularly school based dental sealant programs. I am not particularly sure where Louisiana falls in this grading scale, but it did have four parishes that piloted the dental sealant program. The dental sealant program in Louisiana has served 1,739 children, so it has to be in the grade A or B category.
The following are a list of sources that I used:
http://www.cdc.gov/oralhealth/topics/dental_sealant_programs.htm
http://apps.nccd.cdc.gov/synopses/StateDataV.asp?StateID=LA&Year=2008
http://www.cityofno.com/Portals/Portal48/portal.aspx =
http://www.astdd.org/index.php?template=sactnav_temp.php&state=LA
December 10th, 2009 at 2:15 pm
Here is the page I promised.
Celeste F. Terry
—–Original Message—–
From: Celeste Terry
Sent: Tuesday, December 08, 2009 5:13 PM
To: Celeste Terry
Subject: Emailing: Synopses by State Louisiana - 2008 - Synopses.htm
National Center for Chronic Disease Prevention and Health Promotion
Oral Health Resources
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The Synopses Web site is a product of a cooperative agreement between the Centers for Disease Control and Prevention (CDC) and the Association of State and Territorial Dental Directors (ASTDD).
Synopses of State and Territorial Dental Public Health Programs
Synopses by State
Louisiana—2008
Using and interpreting the Synopses
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Louisiana Contact Information
Ms. Susan Jeansonne, Interim Director
susan.jeansonne@la.gov
(225) 342-7973
http://www.dhh.louisiana.gov/offices/?ID
=79*
On this page
Demographics
Infrastructure
Workforce
Administration
Programs
Demographics — Display Trend
State Population
4,293,204
School-aged children (grades K–12, 5–17 years)
788,626
Children enrolled in Medicaid — enrolled at least 1 month of the year
777,212
Children eligible for SCHIP 1
145,460
Children (K–12) on free/reduced-cost school lunch program
64.6%
Percent of total population that are between 5-17 years
18.4%
Type of SCHIP program - Medicaid expansion, separate, combination
Combination
SCHIP Eligibility Limit
200
Number of children under 18 in families earning less than 125% FPL
308,000
Percent of children under 18 in families earning less than 125% FPL
29.2%
Number of children under 19 at or below 200% FPL
503,000
Percent of children under 19 at or below 200% FPL
44.7%
Number of children under 19 at or below 200% FPL without insurance
123,000
Percent of children under 19 at or below 200% FPL without insurance
10.9%
Percent of total population that are 65 years and older
12.2%
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Infrastructure — Display Trend
Population served by public water system
4,287,768
Percentage of people on public water systems that receive fluoridated water 2
40.4%
Population served by fluoridated water system
1,731,807
Number of dental schools
1
Number of dental hygiene schools
3
Number of community-based low-income dental clinics 2
238
Number of tribal, state, or local agencies with service populations of 250,000 or more 2
2
Number of agencies with a dental program 2
2
Number of dental programs directed by a dental professional 2
1
Number of directors with an advanced public health degree 2
1
Number of local health departments that had a dental program for education services only.
0
Number of local health departments that had a dental program for preventive services only.
2
Number of local health departments that had a dental program for preventive & restorative services.
1
Number of mobile dental clinic programs that had a program for education services only.
0
Number of mobile dental clinic programs that had a program for preventive services only.
0
Number of mobile dental clinic programs that had a program for preventive & restorative services.
0
Does your state have Medicaid adult dental benefits?
No
Does your state have Medicaid adult dental benefits for pregnant women?
Yes
None, Emergency, Limited, Comprehensive
Limited
Does your state have SCHIP adult dental benefits?
No
Does your state have policies designed to increase access for nursing home residents?
No
Does your state have policies designed to increase access for developmentally disabled adults?
No
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Workforce — Display Trend
Number of dentists licensed by state
2,460
Number of dentists in the state
2,212
Number of dental hygienists in the state
1,658
Number of dental hygienists licensed by state
1,918
Number of counties in state
64
Total population of counties in state without an enrolled Medicaid dentist
5,865
Number of counties in state without an enrolled Medicaid dentist
1
Number of billing dentists with at least 1 claim - combined providers
593
Number of treating dentists with at least 1 claim - combined providers
663
Number of billing providers with paid Medicaid or SCHIP claims >= $10,000
365
Number of billing providers who saw 50 or more beneficiaries < 21 years - Combined
342
Number of billing providers who saw 100 or more beneficiaries < 21 years - Combined
299
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Administration — Display Trend
State dental director devotes full time to his/her duties
Yes
Full-time equivalents (FTEs) 3
2.00
Contracted full-time equivalents (FTEs) 3
2.00
Percentage of time dental director spends on Medicaid/SCHIP issues
10%
Percentage of time dental director spends on Medicaid/SCHIP issues that is paid for by Medicaid/SCHIP
0%
As of January 1st of this year, how many full years has the current dental director been in this position?
3
Percent of dental budget from HRSA State Oral Health Collaborative Systems
0%
Percent of dental budget from HRSA Integrated Systems Development
0%
Percent of dental budget from Bureau of Health Professions (Oral Health Workforce)
0%
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Programs - Display Trend
Behavioral Risk Factor Surveillance System
7,084 people surveyed
Dental Screening
—
Dental Sealants
1,739 children served
Fluoridation Program
—
Medicaid Dental Claims Data
—
Oral Health Education/Promotion
—
Oral Health Programs for Pregnant Women
3,994 pregnant women served
Oral Health Surveys
—
Pregnancy Risk Survey
2,384 women surveyed
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1
SCHIP is the State Children’s Health Insurance Program.
2
Item related to Healthy People 2010 oral health objectives. See sources page for more information.
3
FTE is full-time equivalent. The number of work hours budgeted per week divided by 40 hours per week equals the number of full-time equivalent workers.
* Links to non-Federal organizations are provided solely as a service to our users. This link does not constitute an endorsement of this organization by CDC or the Federal Government, and none should be inferred. The CDC is not responsible for the content of the individual organization Web pages found at this link.
Using and interpreting the Synopses
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This page last updated November 6, 2008
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