mississippi state oral health plan building bridges to improve oral health dr. nicholas mosca dental...

Mississippi State Oral Health PlanBuilding Bridges to Improve Oral Health

Dr. Nicholas MoscaDental Director, Mississippi Department of Health

Mississippi State Oral Health PlanBuilding Bridges to Improve Oral Health

Dr. Nicholas MoscaDental Director, Mississippi Department of Health

Government Protects HealthGovernment Protects Health

Traditional government view of ‘filling a cavity’

Most oral diseases are completely preventable at low cost

Governor Musgrove by executive order formed task force to develop a plan.

Most oral diseases are completely preventable at low cost

Governor Musgrove by executive order formed task force to develop a plan.

Preventable Oral DiseasesPreventable Oral Diseases

Tooth decay or ‘dental caries’ Gingivitis / periodontal disease Cleft lip / cleft palate

(folic acid deficiency) Oral cancer (tobacco use)

Tooth decay or ‘dental caries’ Gingivitis / periodontal disease Cleft lip / cleft palate

(folic acid deficiency) Oral cancer (tobacco use)

High Prevalence in MississippiHigh Prevalence in Mississippi

7 in 10 school-age children in public schools have tooth decay experience (fillings or cavities)

1 in 3 school-age children have untreated decay (cavities)

1 in 10 school-age children have urgent need for dental care due to pain or infection

Nationally, unmet need for dental care is 3 times greater than for medical care

7 in 10 school-age children in public schools have tooth decay experience (fillings or cavities)

1 in 3 school-age children have untreated decay (cavities)

1 in 10 school-age children have urgent need for dental care due to pain or infection

Nationally, unmet need for dental care is 3 times greater than for medical care

Diagnosis and Treatment

(Repair)

Solutions balance costs?Predict and

manage people at-risk

Implement disease prevention

New View of an Old ProblemNew View of an Old Problem

Tooth decay is 5 x more common than asthma Infectious Transmissible Predictable Culturally dependant Highly prevalent and consequential

The ‘cavity’ is the disease manifestation

Tooth decay is 5 x more common than asthma Infectious Transmissible Predictable Culturally dependant Highly prevalent and consequential

The ‘cavity’ is the disease manifestation

Dental caries is well-understoodDental caries is well-understood

Caused by acid producing bacteriain dental plaque

Caused by acid producing bacteriain dental plaque

Streptococcus mutans

White Spot Lesions

White Spot Lesions

Cavitated Enamel

Dental caries is transmissibleDental caries is transmissible

Vertical transmission from kissing, feeding and playing

Window of infectivity during first 2 years of life

Prevention should begin before age 2

Vertical transmission from kissing, feeding and playing

Window of infectivity during first 2 years of life

Prevention should begin before age 2

State Medicaid EPSDTState Medicaid EPSDTFY 2003 Total

eligiblesAges 1-2 Ages 3-5

Receiving any dental srvcs

28%

(118,424)

1.6%

(8,784)

49%

(29,490)

Receiving preventive dental srvcs

24%

(101,726)

0.1%

(6,617)

44%

(26,415)

New View of an Old ProblemNew View of an Old ProblemTooth

Mouth

ChildFamily

Community

Society

Health DISEASE

Dental caries is manageable (like diabetes)

Mobilizing Partnerships for Oral Health

Partner with Extension Service to utilize area health agents to deliver oral health education and prevention

Promote local community water fluoridation programs

Partner with Extension Service to utilize area health agents to deliver oral health education and prevention

Promote local community water fluoridation programs

KY Land Grant Mission and the Cooperative Extension ServiceKY Land Grant Mission and the Cooperative Extension Service

Although not directly funded by the Department for Public Health, one more partner emerges in the fight to improve oral health

The Cooperative Extension Service develops “Health Education Through Extension Leadership” using the extensive infrastructure available to provide community based partners to enhance health. Funding from state Department of Agriculture

August 2005, UK Colleges of Agriculture and Dentistry sign an agreement. Dentistry faculty becomes coordinator for oral health educational materials and training programs for extension agents.

Although not directly funded by the Department for Public Health, one more partner emerges in the fight to improve oral health

The Cooperative Extension Service develops “Health Education Through Extension Leadership” using the extensive infrastructure available to provide community based partners to enhance health. Funding from state Department of Agriculture

August 2005, UK Colleges of Agriculture and Dentistry sign an agreement. Dentistry faculty becomes coordinator for oral health educational materials and training programs for extension agents.

Plan provides opportunitiesPlan provides opportunities

“Creates interagency initiatives”

“Assures synergy” “Convenes strategic

alliances” “ Supports CSHCN

projects (i.e. Special Olympics)”

“Disease surveillance” (e.g. BRFSS, YRBS)

“Creates interagency initiatives”

“Assures synergy” “Convenes strategic

alliances” “ Supports CSHCN

projects (i.e. Special Olympics)”

“Disease surveillance” (e.g. BRFSS, YRBS)

“Obtain and share federal dollars” HRSA, CDC, USDA

“Addresses licensing and regulatory issues”

Oral health plan sets “clear expectations”

“Obtain and share federal dollars” HRSA, CDC, USDA

“Addresses licensing and regulatory issues”

Oral health plan sets “clear expectations”

Areas of collaborationAreas of collaboration Agreements for preventive services

Oral disease surveillance Community or population-level prevention (public water

fluoridation, dental sealants, fluoride rinse programs) Planning

Coalition / Summit Meeting / Collaborations Consultation

Education Continuing education / extramural training Student projects (i.e. community-based education

or outreach services)

Agreements for preventive services Oral disease surveillance Community or population-level prevention (public water

fluoridation, dental sealants, fluoride rinse programs) Planning

Coalition / Summit Meeting / Collaborations Consultation

Education Continuing education / extramural training Student projects (i.e. community-based education

or outreach services)

Key BarriersKey Barriers

“Administrative “red tape” & “bureaucracy” “Tight budget” or “cuts” “Insufficient staff to get involved” “Time constraints” “Dentists won’t treat the kids that need care” “Restricted auxiliary staff practice laws” “Few elderly care initiatives”

“Administrative “red tape” & “bureaucracy” “Tight budget” or “cuts” “Insufficient staff to get involved” “Time constraints” “Dentists won’t treat the kids that need care” “Restricted auxiliary staff practice laws” “Few elderly care initiatives”

Collaborations for Oral HealthCollaborations for Oral Health

Community water fluoridation program Community-based Dental Partnership for

those with HIV infection Weekly school-fluoride mouthrinse School-based dental sealant program Head Start Oral Health Advisory Committee State Comprehensive Cancer Control Plan Regional oral health consultants

Community water fluoridation program Community-based Dental Partnership for

those with HIV infection Weekly school-fluoride mouthrinse School-based dental sealant program Head Start Oral Health Advisory Committee State Comprehensive Cancer Control Plan Regional oral health consultants

School fluoride rinse programSchool fluoride rinse program

School-based Dental SealantsSchool-based Dental Sealants

UMMC School of Nursing Mercy Delta Health Express

Consumer / Professional EducationConsumer / Professional Education

Contact InformationContact Information

Phone: 601-576-7500 Email: nicholas.mosca@msdh.state.ms.us Website:

http://www.healthyMS.com/dental

Phone: 601-576-7500 Email: nicholas.mosca@msdh.state.ms.us Website:

http://www.healthyMS.com/dental