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Mississippi State Oral Health Plan
Building Bridges to Improve Oral Health
Dr. Nicholas Mosca
Dental Director, Mississippi Department of Health
Government Protects Health
Traditional government
view of ‘filling a cavity’
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Most oral diseases
are completely
preventable at
low cost
Governor Musgrove
by executive order
formed task force to
develop a plan.
Preventable Oral Diseases
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Tooth decay or ‘dental caries’
Gingivitis / periodontal disease
Cleft lip / cleft palate
(folic acid deficiency)
Oral cancer (tobacco use)
High Prevalence in Mississippi
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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
Solutions balance costs?
Predict and
manage
people at-risk
Implement
disease prevention
Diagnosis and
Treatment
(Repair)
New View of an Old Problem
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Tooth decay is 5 x more
common than asthma
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Infectious
Transmissible
Predictable
Culturally dependant
Highly prevalent and consequential
The ‘cavity’ is the disease manifestation
Dental caries is well-understood
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Caused by acid
producing bacteria
in dental plaque
Streptococcus mutans
White Spot Lesions
White Spot Lesions
Cavitated Enamel
Dental caries is transmissible
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Vertical transmission
from kissing, feeding
and playing
Window of infectivity
during first 2 years
of life
Prevention should
begin before age 2
State Medicaid EPSDT
FY 2003
Total
eligibles
Ages 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 Problem
Tooth
Mouth
Child
Family
Community
Society
Dental caries is manageable
(like diabetes)
Health
DISEASE
Mobilizing Partnerships for Oral Health
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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 Service
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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 opportunities
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“Creates interagency
initiatives”
“Assures synergy”
“Convenes strategic
alliances”
“ Supports CSHCN
projects (i.e. Special
Olympics)”
“Disease surveillance”
(e.g. BRFSS, YRBS)
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“Obtain and share
federal dollars”
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HRSA, CDC, USDA
“Addresses licensing
and regulatory issues”
Oral health plan sets
“clear expectations”
Areas of collaboration
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Agreements for preventive services
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Planning
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Oral disease surveillance
Community or population-level prevention (public
water fluoridation, dental sealants, fluoride rinse
programs)
Coalition / Summit Meeting / Collaborations
Consultation
Education
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Continuing education / extramural training
Student projects (i.e. community-based education
or outreach services)
Key Barriers
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“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 Health
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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 program
School-based Dental Sealants
UMMC School of Nursing
Mercy Delta Health Express
Consumer / Professional Education
Contact Information
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Phone: 601-576-7500
Email: [email protected]
Website: http://www.healthyMS.com/dental