Overview of Childrens Oral Health in Wisconsin

1
Overview of Childrens Oral Health in
Wisconsin
2
Wisconsin Youth Oral Health Data Collection Report

• Factors Affecting Youth Oral Health In Wisconsin

3
Purpose

• Share information on oral health of Wisconsin
  children
• Identify key data elements, existing data and
  studies
• Describe factors affecting youth oral health
• Provide regional summaries
• Describe available resources
• Serve as baseline for monitoring factors
  affecting youth oral health

4
Demographics of Wisconsin
5
Wisconsin Population

• Total population 5,363,675
• 72 counties, predominantly rural
• Milwaukee County (Southeast Region), 3,953
  people/square mile
• Iron County (Northern Region), 8 people/square
  mile
• Average family income is 44,032
• Estimated poverty rate is 9.2 percent for all
  ages, 14.3 percent for children ages 0-17.
• 2000 Health Data Profile, DHFS

6
Wisconsin Race/Ethnicity

• Non-Hispanic whites, 87
• Hispanic origin of any race, 3.6
• African American, 5.7
• American Indian/Alaska Native, 0.9
• Asian, 1.7
• Native Hawaiian/Other Pacific Islander, 0.3
• Other Races, 1.6
• US Census Bureau 2000

7
Wisconsin Children Demographics

• Of 1,532,093 children aged 0 to 19 years, 14
  live below 100 of poverty
• 278,152 children aged 0-19 are enrolled in
  Medicaid
• 22 of children live in single-parent households
• 112,684 children are enrolled in the
  Women-Infants-Children Program (WIC)
• 34 percent of all elementary school children are
  eligible for the federal free and/or reduced
  lunch rate
• DHFS MCH Title V Block Grant Application 2003
• DPI, 2002

8
Make Your Smile Count Survey

• Third-Grade Children

9
Acknowledgements

• Project Direction
• Warren LeMay, DDS, MPH
• Nancy McKenney, RDH, MS
• Kathy Phipps, DrPH
• Screeners
• Kathleen Endres, RDH, CDHS
• Midge Pfeffer, RDH, BS, CDHS
• Nancy Rublee, RDH, CDHC
• Wendy Ruesch, RDH, CDHC
• Shirley Arneson Waite, RDH, MPH
• Data Entry
• Rachel Uttech

10
Purpose

• To establish a baseline for monitoring
  childrens oral health status
• To assess the extent of childrens oral health
  needs
• To describe risk factors

11
(No Transcript)
12
Sampling

• Self-weighting stratified sample of elementary
  schools for each of five DHFS regions
• Third-grade children
• Combination of positive and passive consent
• Statewide response rate was 67 percent

13
Methods

• Basic Screening Surveys An Approach to
  Monitoring Community Oral Health (ASTDD)
• 5 dental hygienists - trained and calibrated

14
(No Transcript)
15
Methods

• Information
• Childs grade, date of birth, gender, race, and
  ethnicity
• Untreated cavities (yes, no)
• Caries experience in both the primary and
  permanent dentition (yes, no)
• Sealants on permanent molars (yes, no)
• Treatment urgency (urgent need for dental care,
  early dental care is needed, no obvious problems)

16
Methods

• Treatment Urgency
• Criteria for urgent care signs or symptoms that
  include pain, infection, swelling, or soft tissue
  ulceration of more than two weeks duration.
• Criteria for early dental care caries without
  accompanying signs or symptoms, individuals with
  spontaneous bleeding of the gums, or suspicious
  white or red soft tissue areas.
• Criteria for no obvious problems any patient
  without the above problems.

17
Make Your Smile Count

• 3,307 third-grade children screened (67 response
  rate)
• Age range 7-10 years (mean 8.38)
• 50 female
• 75 white non-Hispanic

18
Make Your Smile CountKey Findings - Statewide
Key Finding 1 39.9 percent of the children
were caries-free. Key Finding 2 60.1 percent
of the children had a history of dental caries -
at least one primary or permanent tooth with a
filling and/or an untreated cavity.
19
Make Your Smile CountKey Findings - Statewide

• Key Finding 3 30.8 percent of the children had
  untreated decay - at least one primary or
  permanent tooth with an untreated cavity.

20
Make Your Smile CountKey Findings - Statewide

• Key Finding 4 47.0 percent of the children had
  at least one permanent first molar with a dental
  sealant.

21
Make Your Smile CountKey Findings - Statewide

• Key Finding 5 31.1 percent of the children
  screened needed dental care - 27.1 percent were
  in need of early dental care while 4.0 percent
  needed urgent dental care.

22
Make Your Smile CountKey Findings - By Race

• Key Finding 6 Compared to white children, a
  significantly higher proportion of minority
  children had caries experience and untreated
  decay.

23
Make Your Smile CountKey Findings - By Race

• Key Finding 7 White and American Indian
  children were more likely to have dental sealants
  compared to both African American and Asian
  children.

24
Make Your Smile CountKey Findings - By Race

• Key Finding 8 More than 11 percent of the
  African American and 13 percent of the Asian
  children were in need of urgent dental care.

25
Make Your Smile CountKey Findings - By Ethnicity

• Key Finding 9 Compared to white non-Hispanic
  children, a significantly higher proportion of
  Hispanic children had caries experience and
  untreated decay.

26
Make Your Smile CountKey Findings - By Ethnicity

• Key Finding 9 (continued) Compared to white
  non-Hispanic children, a significantly lower
  proportion of Hispanic children had dental
  sealants.

27
Make Your Smile CountKey Findings - By
RegionDepartment of Health and Family Services
Regions
28
Make Your Smile CountKey Findings - By
Socioeconomic Status

• Oral health status is highly associated with
  socioeconomic status. The data was stratified
  into the following three income levels based on
  the proportion of children eligible for the free
  and/or reduced price meal program
• Higher income schools - less than 20 of the
  children are eligible
• Middle income schools - 20 to 39 of the
  children are eligible
• Lower income schools - 40 or more or the
  children are eligible

29
Make Your Smile CountKey Findings - By
Socioeconomic Status

• Key Finding 13 Children surveyed who attended
  lower income schools had significantly more
  untreated decay (44.5) compared to children in
  both middle (31.7) and higher income schools
  (16.6)

30
Make Your Smile CountKey Findings - By
Socioeconomic Status

• Key Finding 14 Children attending lower income
  schools were less likely to have dental sealants
  (33.5) compared to children in both middle
  (49.9) and higher income schools (56.6).

31
Make Your Smile CountKey Findings - By
Socioeconomic Status

• Key Finding 15 Eight percent of the children
  in lower income schools were in need of urgent
  dental care.

32
Make Your Smile CountEstimate of Disease
Prevalence

• Key Finding 16 Approximately 18,310 third-
  grade children in Wisconsin have untreated decay.
• Key Finding 17 Approximately 2,329 third-
  grade children in Wisconsin are in need of urgent
  dental care because of pain and or infection.
• Key Finding 18 If the estimated percentages
  obtained from the survey are applied to all
  elementary school children in Wisconsin, then
  approximately 14,376 elementary school children
  are in need of urgent dental care.

33
Make Your Smile CountComparison to Federal
Healthy People 2010 Objectives

• Decrease the proportion of children who have
  experienced dental caries in permanent or primary
  teeth to 42.
• Decrease the proportion of children with
  untreated dental caries in permanent or primary
  teeth to 21.
• Increase the proportion of 8-year-olds receiving
  protective sealing of the occlusal surfaces of
  permanent molar teeth to 50.

34
Make Your Smile CountComparison to Federal
Healthy People 2010 Objectives

• Wisconsin does not yet meet the Healthy People
  2010 objectives for caries experience and
  untreated decay.
• In terms of dental sealants, Wisconsin is very
  close to meeting the Healthy People objective.

35
Healthy Smiles for Wisconsin Survey of Public
School Systems

• Two surveys conducted in 1999 by Wisconsin Survey
  Research Lab in cooperation with DPI and DHFS.
• Follow-up surveys conducted in 2002-03 by UW
  Center for Health Policy and Program Evaluation.

36
Key Findings Oral Health Service Delivery
Programs in Public and Private Schools

• Oral health service delivery programs
• were defined as school-based or
• community-based programs such as
• screening and referral, fluoride mouth
• rinse,and dental sealants.

37
Key Findings Oral Health Service Delivery
Programs in Public and Private Schools

• 14 of schools overall had oral health service
  delivery programs.
• 12 of urban schools and 16 of rural schools had
  oral health service delivery programs.
• 18 of public schools and 8 of private schools
  had delivery programs.

38
Healthy Smiles for a Head StartAn Oral Health
Needs Assessment of Wisconsins Head Start
Children2003

• Warren LeMay, DDS, MPH
• Chief Dental Officer
• Division of Public Health
• Department of Health Family Services

39
Acknowledgements

• Project Direction
• Warren LeMay, DDS, MPH
• Chief Dental Officer
• Nancy McKenney, RDH, MS
• State Oral Health Consultant
• Kathy Phipps, DrPH
• Epidemiologist
• Screener
• Kathleen Endres, RDH, CDHC
• Regional Oral Health Consultant

• Head Start Program
• Survey Facilitators
• Barb Knipfer, BS
• Dane County Parent Council
• Carla Melvin, MPH
• Social Development Commission
• Diana Aronson, RN, BSN
• UW Oshkosh Head Start
• Pat Carlson, RN
• Western Dairyland EOC
• Valerie Bradley
• Wood County Head Start

40
Purpose of Survey

• Establish a baseline for monitoring oral disease
  status
• Establish a baseline for monitoring oral disease
  trends
• Policy development
• Program planning
• Targeting of programs

41
Sampling

• Random sample of Head Start grantees within each
  DHFS geographic region
• Number screened proportional to the number of
  children in that region enrolled in Head Start
• Representative of Head Start children, not all
  preschool children in Wisconsin
• Needed positive consent form

42
(No Transcript)
43
Head Start Programs Participating in Survey

• Southern Region Dane County Parent Council,
  Inc. Madison
• Southeastern Region Social Development
  Commission (SDC) Milwaukee
• Northeastern Region UW- Oshkosh Head
  Start Oshkosh
• Western Region Western Dairyland EOC,
  Inc. Independence
• Northern Region Wood County Head Start,
  Inc. Wisconsin Rapids

44
(No Transcript)
45
Methods

• Methods outlined in Basic Screening Surveys An
  Approach to Monitoring Community Oral Health
  (ASTDD)
• Trained and calibrated screeners
• Information collected
• Childs date of birth, age, gender, race, and
  ethnicity
• Caries experience in the primary dentition (no,
  yes)
• Untreated cavities (no, yes)
• Early Childhood Caries decay and/or fillings in
  the upper anterior teeth (no, yes)
• Treatment urgency (urgent need for dental care,
  early dental care is needed, no obvious problems)

46
Methods

• Treatment urgency (urgent need for dental care,
  early dental care is needed, no obvious problems)
• Criteria for urgent care signs or symptoms that
  include pain, infection, swelling, or soft tissue
  ulceration of more than two weeks duration.
• Criteria for early dental care caries without
  accompanying signs or symptoms, individuals with
  spontaneous bleeding of the gums, or suspicious
  white or red soft tissue areas.
• Criteria for no obvious problems any patient
  without the above problems.

47
Key Findings - Statewide

• 456 children screened
• Age range 3 to 6 years
• Mean age 4.4
• 32 white, non-Hispanic
• 22 black, non-Hispanic
• 32 Hispanic
• 7.7 Asian

48
Key Findings - Statewide
Key Finding 1 52 percent of the children were
caries (cavity) free.
49
Key Findings - Statewide
Key Finding 2 48 percent of the children had a
history of dental caries at least one primary
tooth with a filling and/or an untreated cavity.
50
Key Findings - Statewide
Key Finding 3 24 percent of the children had
untreated decay at least one primary tooth
with an untreated cavity.
51
Key Findings - Statewide
Key Finding 4 22 percent of the children had
Early Childhood Caries (any child age 3 or under
with at least one of six upper front teeth
either decayed, filled or missing due to
cavities).
52
Key Findings - Statewide
Key Finding 5 23.5 percent of the children
screened needed dental care 20.4 percent were
in need of early dental care while 3.1 percent
needed urgent dental care.
53
Key Findings - By Age
Key Finding 6 As expected, caries experience
increases with the age of the child. At three
years of age, 34.7 percent of the children had a
history of dental caries, while at six years of
age, 56.7 percent of children had dental caries.
54
Key Findings - By Age
Key Finding 7 The percentage of children with
untreated decay remained stable with age at
about 25 percent.
55
Key Findings - By Age
Key Finding 8 As early as 3 years of age, 18
percent of Head Start children have Early
Childhood Caries. By 6 years of age, over 26
percent experience Early Childhood Caries.
56
Key Findings - By Age
Key Finding 9 In each Head Start age group,
approximately 23 of the children require early
or urgent treatment.
57
Key Findings - By Race and Ethnicity
Key Finding 10 The highest proportion of
children with caries history were white
non-Hispanics.
58
Key Findings - By Race and Ethnicity
Key Finding 11 The highest proportion of
children with untreated decay were Hispanics.
59
Key Findings - By Race and Ethnicity
Key Finding 12 Compared to white and Hispanic
children, black Head Start children tend to have
a lower prevalence of Early Childhood Caries.
60
Key Findings - By Race and Ethnicity
Key Finding 13 Hispanic Head Start children
were more likely to require early or urgent
dental treatment.
61
Key Findings - By Region
Key Finding 14 Caries experience in Head Start
children was lowest in the Southeastern and
Western Regions.
62
Key Findings - By Region
Key Finding 15 Children in the Southern
Region tended to have less untreated decay than
children from the other regions, while having a
similar or greater level of decay experience.
This suggests that access to restorative care
may be easier for Head Start children in the
Southern Region.
63
Key Findings - By Region

• Key Finding 16
• Early Childhood Caries experience in Head Start
  children was similar in the five Regions.

64
Key Findings - By Region

• Key Finding 17
• The need for early or urgent treatment was lowest
  in the Southern Region.

65
Comparison toHealthy People 2010 Objectives and
National Data
66
Comparison toHealthy People 2010 Objectives and
National Data
67
Comparison toHealthy People 2010 Objectives and
National Data
Third National Health and Nutrition Examination
Survey (NHANES III) (1988 - 1994)
68
Thank you!!
69
Community-Based Prevention Programs
70
Integrating Preventive Oral Healthcare Measures
into Healthcare Practice
71
(No Transcript)
72
Early Childhood Oral Health

• Transmissible, bacterial infection
• Unique characteristics and risk factors
• DHFS oral health consultants train medical/
  dental personnel, health dept., rural clinics
• Training
• Basic screening survey
• Anticipatory guidance
• Fluoride varnish application
• Referral

73
Maternal Oral Health

• Preconceptional, prenatal and postnatal oral
  health
• Educate primary healthcare providers
• Promote healthy birth outcomes

74
Other Fluoride Programs
75
Community Water Fluoridation Programs

• Evidence-based prevention program
• Reduces health disparities, benefits all ages and
  socioeconomic status
• Reaches 63 of total Wisconsin population
• 90 of Wisconsin population is on community water
  supplies
• Wisconsin is 12th highest in nation

76
(No Transcript)
77
Dietary Fluoride Supplement Programs

• Used since 1940s
• Children living in households with inadequate
  levels of fluoridated water
• Prescribed for children six months - six years
• Water supplies must be tested
• Other water sources taken into consideration
  (example day care)
• DHFS-supported programs served 2,245 children in
  2001.

78
School-based Fluoride Mouthrinse Programs

• Supervised, weekly, school-based program
• Children over age six in non-fluoridated
  communities
• DHFS provides funding and technical assistance
• DHFS-supported programs
• 66 schools
• More than 10,000 children

79
Dental Sealant Programs
80
(No Transcript)
81
Healthy Smiles for WisconsinSeal-a-Smile Program

• Dental sealants are a thin resin coating
• Covers chewing surfaces (permanent molars)
• Provides a physical barrier to cavity-causing
  bacteria and carbohydrates
• Pits and fissures are most susceptible
  (morphology)
• Evidence-based prevention strategy
• MA cost expenditure savings
• Target high-risk children with low access (high
  free and reduced lunch school)

82
Healthy Smiles for WisconsinSeal-a-Smile Programs

• 47 of Wisconsin third-grade children have
  dental sealants
• Significantly fewer sealants in children enrolled
  in higher free and reduced lunch schools
• 2001-02 hosted 104 events in 18 communities
• 3,919 children screened
• 2,918 found to need sealants
• 10,701 dental sealants placed

83
Seal-A-Smile Program

• Available GPR Funds to Distribute - 60,000
• Children
• Program Children Receiving Sealants
• Year Screened Sealants Placed
• 2000-01 2,057 1,548 5,571
• 2001-02 3,320 2,366 8,823
• 2002-03 4,367 2,670 10,681

84
Guardcare Sealant Program

• National initiative, part of clinical training
• Collaborative effort with Wisconsin Army National
  Guard, 13th Medical and Dental Detachment, DHFS,
  LHDs, health professional education, community
  organizations, agencies
• Free sealants to underserved
• Since 1995
• 3,074 children served
• 15,070 teeth sealed

85
Spit Tobacco Program
86
Spit Tobacco Program

• Smokeless tobacco associated with oral cancer
• Use often begins in adolescence
• 20 reported ever using
• 9 of all students reported using in the past 30
  days
• 14 of males
• 4 of females

87
Spit Tobacco Program

• Wisconsin Tobacco Control Board funded, DHFS
  contracts with WDA
• Partners include Milwaukee Brewers Baseball
  Club and Department of Public Instruction
• Five-day curriculum comic book with health
  messages, integrates math, science, geography
• In 2001-02, served 150 schools, 80,000
  fifth-grade students including Brewers Day in
  the Park.
• 2002 evaluation indicates teacher satisfaction
  with curriculum and improved child learning and
  attitude.

88
(No Transcript)
89
Oral Health Professional Workforce
90
Dentist Workforce

• 3,432 licensed dentists living in Wisconsin
  (2002)
• Survey by DHFS, Bureau of Health Information,
  2001
• Of 2,842 dentists practicing in Wisconsin, 57
  had practiced more than 20 years
• Work a median of 35 hours per week
• 56 new dentists expected to enter practice each
  year between 2000-2010 higher numbers of
  dentists expected to leave practice in the same
  period
• Report details dentists by DHFS region

91
Dentist Workforce

• 81 general practice
• 57 solo practice
• 53 dentists/100,000 population
• 44 primary care dentists/100,000 population
• 59 dentists/100,000 population (US ratio)

92
Dental Hygienist Workforce

• 3,901 licensed hygienists living in Wisconsin
  (2002)
• Dental Hygiene Association of Wis. Survey, 2000
• 3,364 dental hygienists were sent surveys
• 51.1 (1,714) responded
• 6.8 per 10,000 population in state metropolitan
  counties
• 4.7 per 10,000 in state-designated
  non-metropolitan counties
• 1 out of 4 do not feel there are enough dental
  hygiene job opportunities available to them.

93
Dental Health ProfessionalShortage Areas (HPSAs)

• Federal designation reflecting a shortage of
  dental professionals for
• Geographic (rural or urban) areas, or
• Specific populations (mainly low income)
• There are 50 dental HPSAs in Wisconsin

94
(No Transcript)
95
National Health Service Corps (NHSC)

• Scholarship program for 3rd and 4th year dental
  students
• In return for work obligation in a dental HPSA
• Student loan repayment program for dentists and
  dental hygienists
• In return for work obligation in a dental HPSA

96
Health Professional Loan Assistance Program
(HPLAP)

• Established 1990, Dept. of Commerce in
  cooperation with Wisconsin Office of Rural Health
• Recruit and retain primary care medical and
  dental professionals
• Dentists and dental hygienists may apply to
  receive education loan assistance for practicing
  in dental HPSA

97
Oral Health Delivery in Wisconsin
98
Introduction

• Wisconsin Family Health Survey 2000, self-
• reported
• 74 of residents saw a dentist in last year
• 56 of all low-income reported seeing a dentist
• 77 of low-income children ages 3-17 were
  reported to have seen a dentist in the last year

99
Private Practice

• In the US, private practice dentistry accounted
• for 96 of estimated 53.8 billion spent on
• dentistry in 1998.

100
Rural Dental Clinics

• Federal Office of Rural Health Outreach Grant
• North-central Wisconsin, Langlade, Lincoln,
  Oneida, Forest counties
• Sliding-fee scale, Medicaid, BadgerCare
• Scheduled in community settings
• Regular schedule with portable equipment

101
Rural Dental Clinics

• State funding supports three rural dental clinics
• Cooperative Education Service Area (CESA 11)
  manages Menominee project
• Marshfield Family Health Center (federally
  qualified health center) manages Ladysmith
  project, strengthening coordination of care
  between medical/dental clinics
• Tri-County Community Dental Clinic serves
  Winnebago, Calumet and Outagamie counties

102
Community Clinics Federally Qualified Health
Centers (FQHC)

• FQHCs serve underserved populations
• Eligible for higher Medicaid reimbursement
• Located in a federally designated shortage area
• Serve all patients regardless of insurance status
• Eligible for NHSC loan repayment and scholarship
  placement
• Be a nonprofit corporation and have a community
  governing board

103
Community Clinics Federally Qualified Health
Centers (FQHC)

• Eight of 15 Wisconsin FQHCs have on-site
  comprehensive dental programs
• Bridge Community Clinic
• Family Health Medical and Dental
• Kenosha Community Health Center, Inc.
• Milwaukee Health Services
• Northern Health Centers
• Scenic Bluffs Community Health Centers
• Sixteenth Street Community Health Center
• Marshfield Clinic

104
Great Lakes Inter-Tribal Clinics

• Eight of eleven tribal clinics in Wisconsin have
  comprehensive dental services available
• Potawatomi Health and Wellness Center (Crandon)
• Ho Chunk Nation Health Department (Black River
  Falls)
• Lac Courte Oreilles Community Health Center
  (Hayward)
• Peter Christensen Health Center (Lac du Flambeau)
• Oneida Community Health Center (Oneida)
• St. Croix Health Services (Hertel)
• Stockbridge-Munsee Health Center (Bowler)
• Menominee Tribal Clinic (Keshena)

105
Other Safety Net Clinics

• According to Childrens Health Alliance of
  Wisconsin, Dental Care Access Programs for the
  Uninsured and Underinsured in Wisconsin, 2001,
  there were 20 counties with safety net clinics.
• Vary in structure
• Volunteer and paid staffs
• Variety of services

106
Marquette University School of Dentistry

• Provides comprehensive services to patients of
  all income levels
• Served 15,312 unduplicated patients during 47,509
  visits
• 65 paid out-of-pocket
• 18 Medicaid/BadgerCare
• 10 Medicare
• 7 private insurance

107
Marquette University School of Dentistry

• Clinics
• Marquette University School of Dentistry Clinic
  (Milwaukee)
• Isaac Coggs Community Health Center (Milwaukee)
• Johnston Community Health Center (Milwaukee)
• Oneida Community Health Center (Oneida)

108
Wisconsin Technical College System Dental Hygiene
Programs

• Eleven of the sixteen colleges offer Dental
  Hygiene clinical services
• Clinic fees are designed to be affordable for
  those unable to access preventive oral health
• Participate in public health programs
• (school and community-based dental sealant
  programs, ECC programs)

109
Wisconsin Technical College System

• Blackhawk Technical College (Janesville)
• Chippewa Valley Technical College (Eau Claire)
• Fox Valley Technical College (Appleton)
• Lakeshore Technical College (Cleveland)
• Madison Area Technical College (Madison)
• Milwaukee Area Technical College (Milwaukee)
• Moraine Park Technical College (Fond du Lac)
• Northcentral Technical College (Wausau)
• Northeast Wisconsin Technical College (Green Bay)
• Waukesha Area Technical College (Pewaukee)
• Western Wisconsin Technical College (LaCrosse)

110
Head Start Programs

• Head Start Program requires a dental examination
  for each child
• Of the 15,390 children enrolled in 2001
• 72.88 (11,216) received a dental examination
• Of those receiving examinations
• 28.6 (3,205) needed treatment
• 2,332 had or received treatment at the time of
  the report

111
Financing Oral Health
112
Self-Pay

• Self-pay represents 47 of total dental
  expenditures.
• Dental Insurance
• In the US, private dental insurance covered 40
  of the population.
• Accounts for 47 of total dental expenditure
• Same percentage as self-pay

113
Wisconsin Medicaid/BadgerCare Fee-for-Service

• Wisconsin Medicaid Measures of Dental Services
  Fiscal Year 2001 Report
• 22.5 of all fee-for-service Medicaid/BadgerCare
  recipients
• 24.7 of fee-for-service Medicaid/BadgerCare
  recipient children

114
Medicaid/BadgerCare Health Maintenance
Organization

• Wisconsin Medicaid Program contracts with HMOs
  to provide services
• Serves four counties Milwaukee, Racine,
  Waukesha, Kenosha
• 21.1 of Wisconsin Medicaid enrollees in
  Milwaukee County saw a dentist for any reason in
  2000

115
HealthCheck Early and Periodic Screening,
Diagnosis, and Treatment (EPSDT)

• 357,339 children were eligible for HealthCheck in
  2001
• 65 of children received all initial or periodic
  screenings
• 19.5 of children received any dental service
• 8.6 of children received treatment

116
HealthCheck Early and Periodic Screening,
Diagnosis, and Treatment (EPSDT)

• Wisconsin Medicaid covers dental sealants
  provided by certified HealthCheck nursing
  agencies to all Medicaid recipients under 21,
  regardless of whether the recipient is covered by
  Medicaid fee-for-service or enrolled in a
  Medicaid HMO.

117
Donated Dental Services

• The Foundation for the Handicapped
• National charitable organization
• Started to assist medically compromised, aged,
  indigent, and people with disabilities
• Wisconsin Foundation for the Handicapped is an
  affiliate
• Wisconsin provides state funds annually for a
  program coordinator at WDA
• Dentists provide donated services
• DHFS monitors contract

118
Thank you for your interest in oral health.