Geographic Differences in Tooth Decay Among Children in Texas

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Geographic Differences in Tooth Decay Among
Children in Texas

• Gita G. Mirchandani, PhD, MPH

A.Sayegh, B. Castrucci, G.Gossman, L.
Altenhoff Texas Department of State Health
Services
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Background

• Dental caries (tooth decay)--most common chronic
  childhood disease
• Healthy People 2010 oral health indicators
• 2 specifically address prevalence of dental
  caries

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Healthy People 2010 Objectives

• 21-1 Dental caries experience
• 21-1b. Reduce the proportion of children 6-8
  years with dental caries experience in their
  primary and permanent teeth

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Healthy People 2010 Objectives

• 21-2 Untreated dental decay
• 21-2b. Reduce the proportion of children 6-8
  years with untreated dental decay in primary and
  permanent teeth

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Dental Caries Experience
US
Target
Texas
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Untreated Caries (tooth decay)
Texas
US
Target
7

• METHODS

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Data

• Basic Screening Survey (BSS)
• August 2004-May 2006
• Sample of underserved children
• School-based 110 schools with 50 of students
  on free/reduced lunch program
• 17,344 Texas school children aged 2-14

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Sample
Age Age Age
Grade 6 7 8 Total
PRE K 2 1 0 3
K 751 26 1 778
1ST 1,980 1,389 96 3,465
2ND 30 1,813 1,408 3,251
3RD 0 19 1,995 2,014
4TH 0 4 11 15
5TH 0 0 1 1
missing 1 2 0 3
Total 2,764 3,254 3,512 9,530
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Outcome Measures

• Dental Carries Experience Proportion of children
  aged 6-8 years with caries experience (treated
  and untreated tooth decay)
• Untreated tooth decay  Proportion of children
  aged 6-8 years with untreated tooth decay.

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Explanatory Variables

• Socioeconomic status
• Not poor (Non-Free/Reduced lunch Non-Medicaid)
• Poor (Free/Reduced lunch, Non-Medicaid)
• Very poor (Free Lunch Medicaid)

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Explanatory Variables

• Border (Yes/No)
• 32 county border region designated by the
  U.S.-Mexico border health commission
• Race/Ethnicity

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Dental Caries Experience
Not Poor
Poor
Poorest
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Dental Caries Experience
Non-Border Border
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Untreated Caries
Poor
Not Poor
Poorest
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Untreated Caries
Non-Border Border
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Results
Outcome Dental Caries Experience Outcome Dental Caries Experience Outcome Dental Caries Experience
Variable OR (95 CI) AOR (95 CI)
SES
-Poor 2.05 (1.82-2.31) 1.80 (1.60-2.04)
-Poorest 2.00 (1.77-2.27) 1.85 (1.62-2.11)
Border 1.39 (1.17-1.64) 1.08 (0.96-1.27)
Race/ethnicity
-Black 1.32 (1.16-1.50) 1.10 (0.96-1.27)
-Hispanic 1.63 (1.47-1.80) 1.34 (1.20-1.50)
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Results
Outcome Untreated Dental Caries Outcome Untreated Dental Caries Outcome Untreated Dental Caries
Variable OR (95 CI) AOR (95 CI)
SES
-Poor 2.20 (1.95-2.49) 2.08 (1.83-2.37)
-Poorest 1.20 (1.1-1.37) 1.12 (1.01-1.32)
Border 0.91 (0.78-1.01) 0.85 (0.72-0.99)
Race/ethnicity
-Black 1.22 (1.1-1.38) 1.12 (0.98-1.28)
-Hispanic 1.02 (0.77-1.35) 1.14 (1.02-1.27)
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Conclusions

• Regardless of geography, poorer children had a
  greater prevalence of ever having any tooth decay
  (treated untreated)
• Regardless of geography, poor children had a
  greater prevalence of untreated caries than not
  poor children, but prevalence decreases in the
  poorest group, likely due to Medicaid

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Conclusions

• Regardless of geography, poorer children had a
  greater prevalence of ever having any tooth decay
  (treated untreated)
• Regardless of geography,Poor children had a
  greater prevalence of untreated caries than not
  poor children, but prevalence decreases in the
  poorest group, likely due to Medicaid

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Extra Slides

• EXTRA SLIDES

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CSTE/NACDD Oral Health Indicators

• 1) Dental Visit of Adults 18 who have visited
  a dentist or dental clinic in the past year.
• 2)Teeth Cleaning of Adults 18 who have had
  their teeth cleaned in the past year (among
  adults with natural teeth who have ever visited a
  dentist or dental clinic).

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CSTE/NACDD Oral Health Indicators

• 3) Complete Tooth Loss Adults aged 65 who
  have lost all of their natural teeth due to tooth
  decay or gum disease.
• 4) Lost 6 teeth  Adults aged 65 who have
  lost six or more teeth due to tooth decay or gum
  disease.

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CSTE/NACDD Oral Health Indicators

• 5) Fluoridation Status Percentage of people
  served by public water systems who receive
  fluoridated water.
• 6) Dental Sealants  Percentage of 3rd grade
  students with dental sealants on at least one
  permanent molar tooth.

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CSTE/NACDD Oral Health Indicators

• 7) Carries Experience Percentage of 3rd grade
  students with caries experience, including
  treated and untreated tooth decay
• 8) Untreated tooth decay  Percentage of 3rd
  grade students with untreated tooth decay.

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CSTE/NACDD Oral Health Indicators

• 9) Cancer of the Oral Cavity Pharynx

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Oral Health IndicatorsChildren (1)

• Carries Experience Percentage of 3rd grade
  students with caries experience, including
  treated and untreated tooth decay
• Untreated tooth decay  Percentage of 3rd grade
  students with untreated tooth decay.

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Oral Health Indicators Children (2)

• Dental Sealants  Percentage of 3rd grade
  students with dental sealants on at least one
  permanent molar tooth.

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Background

• Dental caries (tooth decay)--most common chronic
  childhood disease
• Oral health indicators developed by CSTE NACDD
• 9 indicators, 3 address children
• 2 specifically address prevalence of dental
  caries

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