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					Whatcom County
WA SMILE Survey: Background
WA State SMILE Survey is conducted
every 5 years by WA Dep’t of Health (DOH);
County SMILE Surveys are also encouraged;
2005: ALL 3rd grades in all BELLINGHAM
     public elementary schools;
2010: Kindergarten included for first time!
2010: First Whatcom County SMILE Survey
              Methods
• All SMILE Survey screeners (RDH or dentists)
  were required to attend the DOH SMILE Survey
  calibration training to ensure the data can be
  compared on local, state, & national levels.
• Participating schools sent passive consent
  permission slips home to parents/guardians of ALL
  kindergarten and 3rd graders in randomly selected
  schools, in English & Spanish.
• Screenings were done with only a pen light and
  disposable mouth mirror.
  Locally the survey included:

       Eleven Elementary Schools
       1137 Students Total
        548 Kindergarteners
        589 3rd Graders
1137 Children in kindergarten and 3rd grade from eleven randomly
1137 Children in kindergarten and 3rd grade from eleven randomly
selected sample public schools within Whatcom County were
selected sample public schools within Whatcom County were
screened by Cecily Fosso RDH, of Preventive Dental Services;
screened by Cecily Fosso RDH, of Preventive Dental Services;


            Also surveyed were:
              Eight HeadStart Sites
              208 Children Total
              208 Children Total

      208 children were screened by Chris Harwood RDH
      208 children were screened by Chris Harwood RDH
      (with BTC Dental Hygiene students).
      (with BTC Dental Hygiene students).
This presentation focuses
       only on the
   Elementary School
      Smile Survey
       Survey includes:
Direct Observation:
1. Missing/Filled/Decayed Teeth (MDF)
    (both treated and/or untreated)
2. Visible Sealants
3. Ethnicity
Correlated information
1. Primary Language Spoken at Home;
2. Income status of family (using free or reduced-
    lunch status as a proxy for income);
           Demographics
Children were asked:
    “What language do your parents speak at home?”

Race/ethnicity was filled in by screener;

Socio-economic Status
Screening results are correlated with each child’s corresponding
  Free/Reduced Lunch status by means of a confidential and
  anonymous method used for this purpose .
           Glossary of Terms
Decay Experience: Current or history of
Missing, Filled or Decayed teeth (MFD);
Rampant: Seven or more Missing, Filled or
Decayed teeth (treated or untreated);
Low Income: Free/Reduced Lunch status
used as proxy;
*Data is assumed to be an under-estimation of decay
experience as screenings are done only with a pen light and lasts
approximately 1-2 minutes per child.
Kindergarten & 3rd Grade
          Overall Findings
%
70            61

60

50       42

40
                                 26
30
                       14.5                 16   13
20

10

0
      % Decay      % Rampant          % Untreated
     Experience
              Kindergarten    3rd Grade
               Kindergarten:
               Income : Oral Health

          53
60

50
               36
40

30                      22              22

20                                              13
                               11

10

0
% Decay Experience   Rampant        Untreated
        Low-Income     Not Low-Income
                       Third Grade:
                      Income : Oral Health

80               72

70
                       54
60
50
                                    37
40
30                                        20
                                                      16
20                                                           11

10
0
     %   Decay Experience     Rampant Decay    Untreated Decay
                 Low-Income      Not Low-Income
     2010 State vs. Local:
     Kindergarten

            42     39
45
40
35
30
25                            14.5            16     14
20
15
10
5
0
 %   Decay Experience    Rampant         Untreated

                 Whatcom County      State
           State 2010 vs. Local:
           Third Grade

70       61       58                                       56
60                                                              51
50
40
                           26
30
                                19        13 15
20
10
0
      % Decay          % Rampant     % Untreated       % Sealants
     Experience
                       Whatcom County              State
Whatcom vs. State: 2010 & 2005
      Untreated Decay
 %   25

 % 20
                                                   K
 % 15
                                                   3rd
 %
     10                                            Total

 %
      5
 %
      0
           2010   2010 State   2005   2005 State
          Whatcom              Bham
    Income : Urgency of Care;
         Kindergarten + 3rd Grade
                 19
20
                                  16
           15
15                           13
                      12
                                       11
10


    5                                              3
                                              2        1

    0
        All Urgencies      Dental Care    Seek Immediate
%                            Needed            Care
         Total        Low Income       Not Low Income
      Urgency by Grade & Income
                                     18
20
                                          15
15                                                 12   11

10
         5
               2            1
5                      2

0
% Low-Income;        Not         Low-Income;      Not
     Needs Urgent Low-Income;     Needs Care   Low-Income;
         Care     Needs Urgent                  Needs Care
                      Care
               Kindergarten               Third Grade
               % Sealants (visible);
                  2010; 3rd Graders Only
                  2005; 2nd + 3rd Grade
60      56
                  51      51     50        50
50

40

30%
                                                 20
20

10

0
      2010      2010    2005   2005    HP 2010
     Whatcom    State   Bham   State    Goal
                                        Percent of Medicaid Children
                                         Who Saw a Dentist by Age
                                              Whatcom County, 2009


               70%                                                                        64%
                                                                60%       60%
               60%                                    52%
               50%                      44%
               40%
               30%
               20%          9%
               10%
                0%
                            <1         1to <2        2 to <3   3 to <4   4 to < 5      5 to < 6



         Number of Medicaid Children age 5                                        % of Medicaid Children age 5
           and Under Who Saw A Dentist                                            and Under Who Saw a Dentist
                 Whatcom County                                                        Whatcom County

3600
                                                                45.0%
3400                                                            44.0%
                                                                43.0%
3200
                                                                42.0%
3000                                          3395              41.0%
                                                                40.0%                                            43.8%
2800                                                            39.0%                           40.2%
       2867               2884                                  38.0%     39.6%
2600                                                            37.0%
       2007               2008                2009                         2007                  2008            2009
             Whatcom County Findings :
> Dental decay is a significant public health problem for local children;
> Wide oral health disparities exist, with highest levels of dental disease
   observed in students from low-income families, racial/ethnic minorities;
> Many children do not get the preventive and/or restorative dental care they
   need;
> Untreated decay and the need for urgent dental treatment were higher in
   kindergarteners than third-graders;
> The prevalence of preventive dental sealants on third-graders meets and
   exceeds Healthy People 2010 goal, and is above the WA State average;
> Early prevention is essential to reduce the prevalence of early childhood
   caries in Whatcom County children. Although preventive activities have
   increased over the past decade, much more still needs to be done.

				
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posted:9/11/2011
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