POSTER # 31
Good News Bad News: Findings
show high rate of dental sealants
but low rate of treatment care
among Minnesota’s low SES 3rd graders
Jon Roesler, MS, Ayo Adeniyi, MBBS, MPH, Barbara Hann, BA, Bilquis Khan Jiwani MSc., MBA, MSc., Merry Jo Thoele, RDH, MPH Minnesota Department of Health, Oral Health Program
MaiSee Moua, University of Minnesota School of Public Health
Conclusion
Study Objective
• More than 51 million school hours
are lost each year due to dentalrelated illness.
• Poor children suffer nearly 12 times
more restricted activity days than
children from higher income families.
• Basic Screening Survey (BSS) to describe prevalence of caries, fillings, and dental
sealants, as well as treatment urgency in Minnesota 3rd graders.
• BSS is a standardized, cross-sectional, non-invasive open-mouth survey developed
by the Association of State and Territorial Dental Directors (ASTTD) to assess and
monitor oral health status of population.
A school chosen to represent the relevant experience of a particular population.
Minnesota 2010 BSS Sentinel School Sampling Procedure
Sentinel schools in the MN2010 BSS were selected based on expected disparities
status.
Limitations
• Sentinel schools were self-selected, so there is selection bias
• Sentinel schools are not representative, but more descriptive
• Results cannot be generalized to MN’s 3rd grade population
Sentinel schools n=10; Student n = 256
Selection criteria:
 Race & ethnicity: Hispanic, American Indian, Hmong, and Somali
 School’s free/reduced-price lunch (RFL) eligibility status
• Proxy for community socioeconomic status
Preventive Care
62.1
64.1
Percent
60
Furthermore, in sample schools 81.5% (78.3% - 84.8%) had no obvious dental problems, 16.8% (14.1% – 19.4%) required early care, and 1.7% (0.9% - 2.5%) required urgent care. In sentinel schools, 63.3% had no obvious dental problems, 30.9% required early
care, and 5.9% required urgent care.
CONCLUSIONS
Sentinel methodology can be an appropriate strategy for describing populations that cannot be adequately characterized from limited samples. Challenges exist in reporting findings because sentinel data is indicative rather than definitive or descriptive.
Furthermore, as the sentinels are not selected as part of a randomized sample, use of confidence intervals is inappropriate.
Funding: Centers for Disease Control and Prevention RFA-DP08-802
• Overall good preventive strategies and treatment
• Disproportionate burden of oral disease in minority populations
and lower income families
• Perhaps due to high proportion of immigrants and lack of prior
fluoridation exposure
• Dental therapy programs good start to strengthening disease prevention
and providing access to care
What is a sentinel school?
80
Authors: Jon Roesler, MS, Ayo Adeniyi, MBBS, MPH, Barbara Hann, BA,
Bilquis Khan Jiwani MSc., MBA, MSc., Merry Jo Thoele, RDH, MPH
TITLE: THE CANARY IN THE COAL MINE: USE OF SENTINEL SCHOOLS WITH THE BASIC SCREENING SURVEY
OBJECTIVES
To establish baseline measures for monitoring oral disease trends and to characterize oral health status in high risk minority and/or low socioeconomic populations.
METHODS
During the 2010 academic year, the Minnesota Department of Health conducted a basic screening survey of third graders in public schools. A simple random sample of 40 schools was selected from 837 elementary schools. In addition, ten sentinel schools were
selected; these had higher proportions of students from minority and/or lower socioeconomic communities.
RESULTS
In randomly sampled schools, caries experience was 54.9% (95% C.I = 50.3% - 59.5%), 18% (14.9% – 21.4%) had untreated caries, and 64.1.9% (60.0% - 68.2%) had a dental sealant on at least one permanent molar. In the sentinel schools, percentages of children
with caries experience, untreated caries and sealant rates were 77.0%, 34.5% and 62.1%, respectively.
Public Health Implications
Good
News
Disease History
80
60
50.0
40
23.0
20
77.0
54.9
Healthy People 2010
Sealant on Molar
70
60
42.0
40
Sentinel
20
USA
0
80
52.0
Sentinel
Minnesota
Bad
News
Treatment Urgency
Percent
• Poor children suffer from dental caries
more than their affluent peers.
Methodology
Percent
• Dental caries is the most common
childhood chronic disease 5 times as common as asthma
and 7 times as common as hay fever.
• Sentinel schools had rates of dental sealants comparable to students statewide
(62% vs 64%), much higher than the US average (23%)
• Prevalence of caries experience almost 50% higher than the state
(77% vs 55%) and the US (52%)
• Prevalence of untreated caries almost double that of the statewide average
(35% vs 18%) and higher than the US (29%)
• To assess the oral health status of Minnesota’s third graders and identify oral
health disparities within underserved populations.
Carries Experience
40
34.5
29.0
30
Minnesota
20
USA
10
Healthy People 2010
0
50
Really
Bad
News
18.1
21.0
Sentinel
Minnesota
USA
Healthy People 2010
0
Untreated Carries