Transcript Helping To Heal

Helping To Heal
Understanding How Pediatric Dentists
Can Impact Oral Health Poverty
Helping to Heal: Understanding How Pediatric Dentists
Can Impact Oral Health Poverty
Outline
I.
I.
II.
III.
Objectives
Introduction
What is poverty?
Why is poverty a challenge for public health
and for the profession of dental medicine?
IV. Problem Analysis: Oral Health
V. The Pediatric Dentist defined
VI. AAPD Mission & Vision
VII. The Business Rational
A Fee Schedule Comparison
VII. The Moral Rational
a. The Oral Health Crisis in the Classroom
b. Signs & Symptoms
c. A Cycle of Pain: Consequences of untreated
tooth decay
d. From Maryland to Mississippi and Abroad
e. A BOY’S SILENT PLEA STIRS
CHANGE IN MARYLAND
f. GIRL STARVES AFTER TEETH
PULLED
VIII. Socially-sensitive Practice Management
Knowledge
XI. Conclusion: Looking toward the future
Objectives
• Inform and update oral health care professionals
about poverty.
• Describe the challenges poverty represents for
public health and for health professionals.
• Provide socially-sensitive practice management
knowledge.
Introduction
This Miniclinic presentation emphasizes the moral rationale for pediatric
dentists to take the lead and empower the profession of dental medicine and
help to relieve the oral health poverty that exists among millions of children.
Participants will gain invaluable, socially-sensitive practice management
knowledge. This presentation will better enable dental professionals to
provide the much needed restorative treatment for children who live day after
day with the overwhelming suffering of untreated tooth decay.
Put a feather in your cap!
What is poverty?
The United Nations defines poverty as a human
condition characterized by the sustained or
chronic deprivation of the resources, capabilities,
choices, security and power necessary for the
enjoyment of an adequate standard of living and
other civil, cultural, economic, political and
social rights.
Why is poverty a challenge for public health and for
the profession of dental medicine?
There is considerable evidence that low
socioeconomic status and poverty constitute the
main determinants of poor health in
industrialized societies. The poorer people are,
the more they are at risk of developing diseases,
and ultimately, of dying prematurely.
Problem Analysis: Oral Health
Societal/ Policy Level/
Tertiary Precursors
Poverty
Cultural/Ethnic Issues
Lack of Medical Provider
training about oral health
Lack of fluoridation in water systems
Low Medicaid Reimbursement Rates
Family/ Institutional Level/
Secondary Precursors
Lack of Providers that take
Medicaid
Lack of education concerning oral health issues
Candy and Soda Pop in Schools
Lack of Nutrition
Knowledge
Lack of SpecialtyTreatment Resources
Lack of Insurance
Lack of training of allied health providers to address oral
health issues
“They’re Only
Baby Teeth”
Medicaid Reimbursement
Lack of Transportation
Lack of Fluoride rinse
campaign in schools
Individual Level/ Primary Precursors
Poor Nutrition
Lack of Parental Education concerning
the importance of oral health care
Fear of Dentistry
Parent may have transmitted bacteria to child
that could cause early childhood caries
Targeted Indicator :
Consequences:
Poor Oral Hygiene
Unmanageable behavior in dental office
Oral Health
Pain and suffering, potential for poor nutrition, cosmetic disfigurement, lowered self-esteem,
potential for chronic infection including periodontal disease, and ultimate increased treatment costs.
Why poverty is a challenge for the profession
of dental medicine?
•
Dental caries is the single most common chronic
•
Childhood disease 5 times more common than asthma
•
Over 50 percent of 5 - 9 year old children have at least
•
One cavity or filling, and that proportion increases to 78
•
Percent among 17year olds
•
Unintentional and intentional injuries commonly affect
•
Craniofacial tissues
•
Poor children suffer twice as much dental carries as their more affluent peers, and their disease
is more likely to be untreated
•
For each child without medical insurance, there are at least 2.6 children without dental insurance
•
Uninsured children are 2.5 times less likely than insured children to receive dental care
The Pediatric Dentist defined
Pediatric dentists are the pediatricians of dentistry,
exclusively trained to address the unique oral health
needs of children. The specialized education in child
psychology, growth and development, management
of oral-facial trauma, sedation and general
anesthesia places us at the forefront of leading the
charge in providing equal access to dental care for
all children.
·
·
Pediatric Dental Practices are High Patient Volume Practices that are Prevention-Oriented
Pediatric dentists and orthodontists have 2-3 times as many scheduled visits per week as do general dentists or
other specialists.
The three most common pediatric dentistry procedures are prophylaxis, fluoride treatment, and a periodic oral
evaluation
Pediatric Dentistry Volume of Patients Treated and Services Rendered
160
144
138
140
120
104
107
100
80
80
60
50
40
20
0
Solo Pediatric
Dentists
Non-solo
Pediatric
Dentists
General
Dentists
Patients/Week
(Excluding Hygiene
Visits)
Patients/Week
(Including Hygiene Visits
Pediatric dentists report the highest percentage of patients insured through public
assistance, among all dentists
% of Patients w /Public Assistance
18.1%
2.7%
1.4%
1.3%
Prosthodontist
Orthodontist
General
dentist
Oral and
maxillofacial
surgeon
Pediatric
Dentist
3.2%
Periodontist
5.6%
Endodontist
6.9%
Updated, September 2007
The percentage of public assistance patients in a practice.
ADA 2007 Survey of Dental Fees
Updated, September 2007
The AAPD Mission
The mission of the AAPD is to advocate policies,
guidelines and programs that promote optimal oral
health and oral health care for children. The AAPD
serves and represents its membership in the areas of
professional development and governmental and
legislative activities. It is a liaison to other health care
groups and the public.
The AAPD Vision
The vision of the AAPD is optimal health and care for
infants, children, adolescents and persons with special
health care needs. The AAPD is the leader in representing
the oral health interests of children. The pediatric dentist is
a recognized primary oral health care provider and
resource for specialty referral.
The Business Rationale
A Fee Schedule Comparison: Private Pay versus Medicaid
Maryland
Medicaid vs. BCBS
Consultation
Initial Examination
Emergency Examination
Prophylaxis
Fluoride Treatment
Pulpotomy
Pulpectomy
Stainless Steel Crown
Resin Crown
Resin Restorations
Amalgam Restoration
Extraction
Illinois
Medicaid vs. MetLife
California
Medicaid vs. Aetna___
The Moral Rationale
Signs
&
Symptoms
From
Maryland
To
Mississippi
The Faces of the Oral
Health Crisis in the
Classroom
A Cycle of Pain:
Consequences of untreated tooth decay.
Signs & Symptoms
The Faces of the Oral Health
Crisis in the Classroom
From Maryland
to Mississippi
and Abroad
Deamonte Driver, Prince George’s County, MD
– January, 2007- Age 12
Alexander Collander, Bil0xi, MS
– March, 2007 – Age 6
Diamond Brownridge - Chicago, IL
- November, 2006 -Age 5
Sophie Waller, Truro, England
- December, 2005 - Age 8
A BOY’S SILENT PLEA STIRS CHANGE IN MARYLAND
PEDIATRIC DENTISTRY TODAY
March 2009 Volume XLV.Number 2
Deamonte Driver, sitting next to his mother, Alyce, shows the scars from
incisions for his brain surgery.
Photo Credit: By Linda Davidson -- The Washington Post
Related Article: For Want of a Dentist, page B01
British Girl Starves After Teeth Pulled
CBS News – London, February 10, 2009
A Cycle of Pain:
Consequences of untreated tooth decay
Could society have caused this end result
because of untreated tooth decay?
Socially-sensitive Practice Management
Knowledge
Community
Outreach
Outreach
to
Schools
Outreach
to
Professionals
Outreach to
Government
Community Outreach
Outreach
Professionals
Outreach
To Schools
Outreach
To Schools
Outreach To
Government
Conclusion: Looking toward the future
• Fighting poverty has been justified for reasons ranging
from human rights and social justice to economic,
political and even religious concerns.
• Oral health professions and their members must embark
on the national movement toward poverty reduction and
contribute to alleviating its consequences.
Efforts must aim to:
1) improve relationships with
underserved members of society
2) develop strategies for positive
and effective interactions
3) improve access to dental
services for poor populations
Pediatric Dentists Can Make The Difference
Thank you for being
a pediatric dentist
that cares enough to
help make a difference!
Special Thanks to:
American Academy of Pediatric Dentistry
Dr. George Acs, Department of Dentistry,
Children's National Medical Center
Dr. Burton Edelstein, Executive Director,
Children's Dental Health Project
Ms. Aqsaa Chaudhry, Franklin Senior High School
Dr. Caswell A.Evans, Project Director, Oral Health
In America: A Report of the Surgeon General
The End