__MAIN_TEXT__

Page 1

Oral Health America Webinar Series

Self-Reported Oral Health Data vs. Oral Screening Data: What’s the Story?

May 17, 2018


Connect with OHA! /Oral Health America

@Smile4Health

/Oral Health America

@Smile4Health


HOUSEKEEPING INFORMATION •

Please remember to MUTE your phone.

Questions are welcome! We’ll allow 10-15 minutes after the presentation for questions. • •

Questions will be accepted in writing through the control panel on the upper right hand of your screen. Submit questions at any time; we will address them at the end of the presentation.

Webinar is being recorded; for rebroadcast on OHA’s website – OralHealthAmerica.org

Your feedback is important to us. Please take our brief webinar evaluation after this session; link will be sent via email.


CE Credit Available


ABOUT ORAL HEALTH AMERICA America’s leading national oral health nonprofit focused on the nation’s oral and overall health for 63 years, with particular emphasis on children and youth, older adults and Americans whose voices are not well-represented in oral healthcare conversations. OHA employs strategic partnerships and communications to connect the dots between oral and overall health

SMILES ACROSS AMERICA®

CAMPAIGN FOR ORAL HEALTH EQUITY

WISDOM TOOTH PROJECT®

© 2017 Oral Health America


Early Childhood Caries Prevention Project

School-Based Prevention Programs

Demonstration Projects

Product Donation

Enrichment

© 2017 Oral Health America


toothwisdom.org

Advocacy

Health Education & Communications

Professional Symposia

Demonstration Projects

© 2017 Oral Health America


CAMPAIGN FOR ORAL HEALTH EQUITY Addresses oral health inequities in our society and identifies possibilities for closing the oral health divide in America. The campaign strives to: Educate and engage the public, including policymakers, about the importance of oral health for overall health Emphasize the need to prioritize oral disease alongside other chronic health conditions Lead, participate and observe on legislative issues impacting oral health policies critical to OHA, our programs and stakeholders

Š 2017 Oral Health America


Alia Katabi, MA Data Analyst ARCORA Foundation

Karen E. Lewis, BA, CHES Senior Program Officer ARCORA Foundation


Self-reported Data vs. Screening Data: What’s the Story?

10 I Arcora Foundation


Our Mission Bending the arc of oral health toward equity

Our Vision All people enjoy good oral and overall health with no one left behind 11 I Arcora Foundation


Our Three Pillars Transform Health Systems

12 I Arcora Foundation

Improve Access

Prevent Oral Disease


Agenda > Review older adults oral health surveys in Washington state 1. Washington Older Adults Telephone Survey 2. Basic Screening Survey: Washington Elder Smiles

> Surveys’ background and methodology > Key findings > Implications and recommendations 13 I Arcora Foundation


Older Adults Oral Health Telephone Survey Background:

> Implemented in 2012 and 2017 to capture data on the oral health status of adults aged 55 and over and to monitor changes over time in the following areas: > > > >

Self-reported oral diseases (tooth decay, gum disease, dry mouth) Need for dental care Dental visits and barriers to accessing dental care The extent in which health professional (non-dental) are talking to older adults about oral health > Oral health disparity to determine which sub-populations of older adults experience the most oral health problems (e.g. by region, age, race/ethnicity, income) 14 I Arcora Foundation


Older Adults Oral Health Telephone Survey Methodology: > In 2017, a total of 2,688 Washington State residents who are 55 and older were surveyed by phone. > African Americans and Hispanics were oversampled to ensure sufficient minority data was captured for analysis. > Data was statically weighted back to appropriately represent Washington’s older adults population based on age, gender, and race. > Survey questions were adapted from the National Health and Nutrition Examination Survey (NHANES), BRFSS, the Pregnancy Risk Assessment Monitoring System (PRAMS) and the employed adult survey conducted by the National Institute of Dental Research (NIDR). 15 I Arcora Foundation


Basic Screening Survey: Washington Elder Smiles Background: > In 2017, Arcora Foundation conducted Washington’s first oral health screening survey of adults 65 years of age and older. > The objectives of the Washington Elder Smiles screening survey are: > Identify the oral health status of older adults in senior centers and congregate meal sites > Compare clinical evaluation data with self-reported oral health status captured through the statewide telephone survey.

16 I Arcora Foundation


Washington Elder Smiles Methodology: > The screening tool was developed based on methods outlined by the Association of State and Territorial Dental Directors for Basic Screening Surveys. > Oral screenings completed by hygienists and self-reported questionnaires were collected at a convenience sample of 15 senior centers throughout Washington state. The self-reported questionnaires were identical to the Washington 2017 Telephone Survey to allow the comparison of results.

17 I Arcora Foundation


Washington Elder Smiles Methodology (continued): > To assure an adequate number of Hispanic/Latino participants, senior centers serving the Hispanic community were oversampled. > To account for the oversampling, data were weighted to represent Washington’s older adult population in terms of race, ethnicity, age, and gender

> Data was collected for 570 adults ranging in age from 65 to 100 years. > IMPORTANT: Washington Elder Smiles is not representative of the entire older adult population in Washington State and results should not be generalized to all adults 65+ years. This survey reflects the oral health of adults attending senior centers that were willing to participate in an oral health screening. > LIMITATION: Efforts were made to screen all adults attending the senior centers but some adults refused to participate. The self-selection process could have biased the results but the direction of the possible bias is unknown. 18 I Arcora Foundation


Key Findings 1. Senior center participants have poor oral health. 2. Oral health disparities are high among senior center participants.

3. Almost half of the senior center participants screened had not been to a dentist in the last year. 4. Tooth loss had a negative impact on nutrition.

5. Compared to the general population of older adults in Washington State, older adults screened at senior centers have poorer oral health.

19 I Arcora Foundation


Key Finding #1 Many senior center participants have poor oral health with one in three (33%) needing restorative dental care. Because xrays and more advanced diagnostic tools were not used, the percentage needing dental care is likely underestimated. No obvious need for dental care

Early care

Urgent care

67%

30%

3%

One-third of adults are in need of dental care. • Men, compared to women, are more likely to need dental care (41% vs. 26%) • 47% of the Hispanic adults screened need dental care compared to 32% of white adults

• People with a dental visit in the last year, compared to those without a dental visit, are less likely to need dental care (22% vs. 43%)

20 I Arcora Foundation


Key Finding #2 There are oral health disparities among senior center participants. Men, compared to women, have higher rates of untreated tooth decay and gum disease while Hispanics, compared to non-Hispanic whites, have a higher prevalence of untreated tooth decay. Percent with Untreated Tooth Decay and Needing Periodontal Care 60% 50%

50% 40%

39%

30%

29% 23%

21%

18%

20%

13% 7%

10% 0% Untreated Tooth Decay Men 21 I Arcora Foundation

Women

Need Periodontal Care Hispanic

Non-Hispanic White


Key Finding #3 Almost half (47%) of the senior center participants screened had not been to a dentist in the last year. The primary reasons for not having a dental visit were “cost” and “no insurance”. Past Year

1-2 Years

2-5 Years

5+ Years

53%

13%

13%

20%

47% of the seniors screened had not been to a dentist in the last year.

• Men, compared to women, were less likely to report a dental visit in the last year (45% vs. 60%) • People without dental insurance were less likely to report a dental visit in the past year (49% vs. 67%) • Adults that reported poor/fair condition of teeth were less likely to have visited the dentist (39% vs. 66%) • 60% of dentate adults had a dental visit in the past year compared to only 19% of edentulous adults 22 I Arcora Foundation


Key Finding #4 Among the senior center participants screened, tooth loss had a negative impact on an individual’s food choices. Adults that reported avoiding particular foods “very often” because of problems with their mouth had significantly fewer teeth than those that “never” or “hardly ever” avoided foods. Mean Number of Teeth by Frequency of Avoiding Foods 25

20.4 20

17.9 15.3

15

11.9 10

5

0

Never 23 I Arcora Foundation

Hardly ever Occasionally Self-Reported Frequency of Avoiding Foods

Very often


Key Finding #5: What’s the Story? Compared to the general population of older adults in Washington State, older adults screened at senior centers have poorer oral health. Older adults screened at senior centers are‌

(1) more likely to have diabetes or pre-diabetes (2) more likely to be edentulous (3) more likely to avoid foods because of problems with their mouth

(4) less likely to have had a dental visit in the last year

(5) less likely to have dental insurance (6) less likely to describe the health of their teeth as good, very good, or excellent

24 I Arcora Foundation


Oral Health Status of Older Adults at Senior Centers vs The General Older Adult Population in Washington

25 I Arcora Foundation


Diabetes or Pre-Diabetes Compared to the general population of older adults in Washington State, those screened at senior centers are more likely to have diabetes or pre-diabetes. Percent with Diabetes or Pre-Diabetes 35%

33%

30% 25%

24%

20% 15% 10% 5% 0%

Telephone Survey

Limited to adults 65+ years of age 26 I Arcora Foundation

Senior Center

33% of older adults screened at senior centers have diabetes or pre-diabetes.


Last Dental Visit Compared to the general population of older adults in Washington State, those screened at senior centers are less likely to have had a dental visit in the last year. Percent with a Dental Visit in the Last Year 90%

Only 53% of older adults screened at senior centers had been to the dentist in the last year.

82%

80% 70% 60%

53%

20% of older adults screened at senior centers had not been to a dentist in the last 5 years.

50% 40%

30% 20%

10% 0% Telephone Survey

Limited to adults 65+ years of age 27 I Arcora Foundation

Senior Center


Dental Insurance Compared to the general population of older adults in Washington State, those screened at senior centers are less likely to have dental insurance. Only 42% of older adults screened at senior centers had dental insurance.

Percent with Dental Insurance 60%

54%

50% 42% 40% 30% 20%

10% 0% Telephone Survey Limited to adults 65+ years of age 28 I Arcora Foundation

Senior Center


Prevalence of Total Tooth Loss Compared to the general population of older adults in Washington State, those screened at senior centers are more likely to have lost all of their natural teeth. Percent with no Natural Teeth 20%

18%

18% 16% 14% 12% 10% 8%

8%

6% 4% 2% 0% Telephone Survey Limited to adults 65+ years of age 29 I Arcora Foundation

Senior Center

18% of older adults screened at senior centers had lost all of their natural teeth.


Condition of Teeth Compared to the general population of older adults in Washington State, those screened at senior centers are less likely to describe the health of their teeth as good, very good or excellent. Self-Reported Condition of Teeth Telephone Survey

19%

Senior Center

6% 0%

37%

20% 10%

20%

28%

29% 30%

40%

Excellent

50% Very Good

60%

70%

80%

90%

100%

Good

Only 55% of older adults screened at senior centers describe the health of their teeth as “good� or better compared to 84% of the general population of Washington state. Limited to adults 65+ years of age 30 I Arcora Foundation


Condition of Gums Compared to the general population of older adults in Washington State, those screened at senior centers are less likely to describe the health of their gums as good, very good or excellent. Self-Reported Condition of Gums Telephone Survey

22%

Senior Center

8% 0%

35%

18% 10%

20%

30%

41% 30%

40%

Excellent

50% Very Good

60%

70%

80%

90%

100%

Good

About 67% of older adults screened at senior centers describe the health of their gums as “good� or better compared to 87% of the general population of Washington state. Limited to adults 65+ years of age 31 I Arcora Foundation


Frequency of Avoiding Food Compared to the general population of older adults in Washington State, those screened at senior centers are more likely to avoid particular foods because of problems with their teeth, mouth or dentures. Frequency of Avoiding Food Telephone 4% 8% Survey Senior Center

11% 0%

10%

21%

66%

21% 20% Very Often

23% 30%

40% Occasionally

45% 50%

60%

Hardly Ever

70%

80%

90%

100%

Never

32% of older adults screened at senior centers avoid foods either very often or occasionally because of oral problems compared to 12% of the general population of older adults in Washington state. Limited to adults 65+ years of age 32 I Arcora Foundation


Recommendations To improve the oral health of senior center participants, efforts must be made to increase access to both preventive and restorative dental care for vulnerable older adults. Work with senior centers and other agencies (Area Agencies on Aging) to develop and implement onsite hygiene programs.

Connect seniors to lower cost dental care through DentistLink. Develop culturally and age appropriate oral health education materials for distribution at senior centers with congregate meal programs.

Retain and improve adult Medicaid coverage. Encourage all health care providers to screen and assess patients for risk of dental disease and track disease severity.

Expand community water fluoridation to prevent tooth decay. Provide continuing education to dental providers to support the needs of vulnerable older adults and patients with chronic conditions. 33 I Arcora Foundation


Using the Data > Investment decisions > Advocacy opportunities > Partnerships/promotions > Workforce education > Conferences and journals 34 I Arcora Foundation


Thank you! For more information, please contact: Alia Katabi: akatabi@arcorafoundation.org Karen Lewis: klewis@arcorafoundation.org

35 I Arcora Foundation


Washington Elder Smiles

Prepared by: Kathy Phipps, DrPH Health Research Consultant May 2018


Question and Answer Session • Questions are welcome! This session may last for 10-15 minutes. • Write your questions in your control panel on the upper right hand of your screen. • Submit questions at any time.


CE Credit Available


Contact Information • Alia Katabi • akatabi@arcorafoundation.org • Karen E. Lewis • klewis@arcorafoundation.org • Eamari Bell • eamari.bell@oha-chi.org

Profile for Oral Health America

OHA Webinar | Self-Reported Oral Health Data vs. Oral Screening Data: What’s the Story?  

This session will highlight the oral health status – and recommendations for improvement – of older adults discovered through research. We w...

OHA Webinar | Self-Reported Oral Health Data vs. Oral Screening Data: What’s the Story?  

This session will highlight the oral health status – and recommendations for improvement – of older adults discovered through research. We w...

Advertisement