Overview: Pediatric Oral Health Burton L. Edelstein DDS MPH Children’s Dental Health Project

Claim “ Parents Report More Unmet Dental Need than Any Other Health Care Need for their Children”

Problem Statement Oral Concerns Are –Prevalent –Significant –Consequential Oral Health Is Sentinel to MCH

NHIS

Dental Unmet Need is #1 –3.3 Times > Medical –4.4 Times > Eyeglass –4.8 Times > Rx

NHIS One-in-18 Children With Dental Need Substantiation: –Urban Institute, Survey of America’s Families: –one-in-13 Children

NHIS - CSHCN Unmet Need Insured Medical2.2 Dental6.2 Mental0.9 Eye, RX3.1 Uninsured

NHANES III Tooth Decay Most Prevalent Chronic Disease of Children –5 Times More Common than Asthma

NHANES - HP 2000

Oral Health Issues Caries –Most Common Chronic Disease Cleft Lip/Palate –4th Leading Birth Defect Trauma & Abuse –75% Involve Face, Head, Neck

Oral Health Issues Tobacco –Smoking –Smokeless Dental Arch - Facial G & D –Orthodontics –Compromising Malocclusions

Dental is Sentinel Unmet Need Coverage Enrollment Access Disparities Safety Net

Dental & CSHCN Workforce Capacity Coverage Rampant Dental Disease Lack of Priority –Compromised Medical Care

Dental & Families Biology –Caries is Infectious & Transmissible -- from Mothers! Behavior –Dental Pain Changes Children’s Behavior & Performance

MCH Pyramid Infrastructure Population Based Services –Dental Enabling Services Direct Health Care

Federal Activities Healthy People 2000/2010 –Goal Statement Surgeon General’s Activities –Report, “Oral Health in America” –Workshop/Conference Departmental Initiatives

DHHS HRSA-HCFA Oral Health Initiative MCHB - HS - WIC Project NIH - HRSA Disparity Grants HCFA-HRSA Medicaid Grants Secretary’s Initiative

AMCHP Publication “Putting Teeth in Children’s Oral Health Policy & Programs: the State of Children’s Oral Health & Role of State Title V Programs” AMCHP December 1999