Update on the IHS ECC Collaborative: 3 ½ years
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Update on the IHS ECC Collaborative:
Tuesday, June 4, 2013Albuquerque Area Dental Chiefs/Prevention Coordinators Meeting
RefresherOverall Goal & PrevalenceReduce ECC prevalence by 25% in 5 years
2010 National BSS Data:
54.1% of 1-5 year-olds had caries experience
2-5 year-olds had an averageof 3.9 teeth decayed or filled, 3X higher than Hispanics and 4X higher than the U.S. general population
21.2% of 1 year-olds & 43.7% of 2 year-olds had caries experience
ECC Collaborative ObjectivesIncrease dental access for 0-5 year old AI/AN children 25% in five years.
Increase the number of children 0-5 years old who received a fluoride varnish treatment by 25% in five years.The overall goal of the ECC Initiative is to reduce the prevalence of ECC among AI/AN children.
We have established four measurable objectives to track our progress on the ECC Initiative.
The first objective is to increase dental access for 0-5 year olds, but we need to focus specifically on increasing access for 0-2 year olds. During FY 2008, only 10% of the medical user population ages birth to two years of age received a dental screening or exam. We know that in order to prevent ECC, we must reach children and their families before two years of age. If we are successful in increasing access for 0-2 year olds, we will easily increase the number of fluoride varnish treatments in this age group. We will be tracking fluoride varnish applied by both dental and medical staff. The goal for 0-2 year olds is to apply four fluoride varnish treatments between the ages of 6-24 months of age.
4ECC Collaborative ObjectivesIncrease the number of sealants among children 0-5 years old by 25% in five years.
Increase the number of Interim Therapeutic Restorations (ITRs) provided for children ages 0-5 by 50% in five years.
3. The third objective is to increase the use of both resin and glass ionomer sealants on the primary teeth.The first 3 objectives are prevention objectives, but the 4th objective is geared towards early intervention and treatment. This objective requires a change in the way we think about treating dental caries in the primary dentition. The goal is to see children earlier to avoid severe ECC that must be treated under general anesthesia.
The objectives will be tracked using both RPMS data and the Basic Screening Survey. For each objective, we will track the objectives separately for 0-2 year olds and 3-5 year olds to be sure that we are adequately reaching children before they develop ECC.5ECC CollaborativeVirtual Learning Community ProgramThe goal of the Virtual Learning Community is to increase awareness and knowledge about ECC and ECC best practices.
39 sites participated in FY 2012
15 sites are participating in FY 2013
What have we learned?Keys to SuccessA local champion is mandatory
Successful programs have good case management
There has been a real paradigm shift with glass ionomers
It takes a team effort
Best Practices: What Works?Identifying local champions: examples included dental staff, public health nurses, and tribal policy makers.
A dedicated case manager.
Marketing ITRs to your own dental staff and getting them comfortable with young children.
Working routinely with the well-child or WIC clinics.
What are the outcomes thus far?How do the first 3 years of the ECC Collaborative compared to our baseline period (FY 2005-09)?
How does this compare to our ECC Collaborative goals?
ECC Collaborative Goal Increase byResults (3 years) Increased byAccess to Dental Care25%10.5%Dental Sealants25%63.0%Fluoride Patients25%66.4%ITRs50%92.5%How are we doing on 2 year-olds?0-2 year-old summaryAccess to dental care for 0-2 year-olds has INCREASED by 7.5%!
Sealants for 0-2 year-olds have INCREASED by 72.6%!
The number of 0-2 year-olds receiving fluoride has INCREASED by 57.9%!
The number of ITRs in 0-2 year-olds has INCREASED by 238.5%!
Are we continuing to show improvements or have we peaked?
As you can see from the graph above, we have increased in all four of the ECC Collaborative measures each of the first three years. FY 2013 is not included in this graph because the year is not complete and it is difficult to make projections as the services provided to this age group are not evenly distributed throughout the year.
15Challenges & the Future
What can you do?Challenges0-2 year-old access needs to increase
0-2 year-old access needs to increase
0-2 year-old access needs to increase
0-2 year-old access needs to increase!FutureSesame Street collaboration
ECC Rx pads
BSS, fall of 2014
End of the five year initiative is Sept. 30, 2014
www.ihs.gov/doh/eccTogether, we can make a difference!
Thanks for all you are doing to promote oral health in 0-5 year-olds!