oral health surveillance data chart book

Oral Health Surveillance DataFamily and Community Health Services
Oral Health Program
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Burden of Dental Disease
Adults (18+ Years Old)
Children (1-17 years Old)
Fluoridation
Next Steps
References
Preface
This chart book has the most recent oral health data available to the Texas Department of State Health Services (DSHS) as of July 2012. The data shows oral health trends and status of Texans, and the factors affecting oral health status in the state.
Data in this chart book covers birth defects involving the mouth; dental disease among adults, children, and pregnant women; cancers of the mouth and throat; community water fluoridation; substance abuse among youth; the dental workforce; and access to dental services.
The data is pulled from many data reporting systems on both national and statewide levels. It also spans across varying time frames. All of the data presented here is for public use.
This publication was supported by Cooperative Agreement 5U58DP002840-02 from the Centers for Disease Control and Prevention (CDC). Its content is solely the responsibility of the authors and does not necessarily represent the official views of the CDC.
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Birth Defects Involving the Mouth
Birth defects are a leading cause of death among babies in Texas. Babies born with cleft palate cannot eat as needed and may starve. Children with defects on their faces are at a high risk for problems with their behavior and not feeling good about themselves.
To learn more, visit:
CDC National Oral Health Surveillance System at http://www.cdc.gov/nohss/
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http://www.dshs.state.tx.us/birthdefects/about.shtm
http://www.dshs.state.tx.us/dental/reports.shtm
Oral Cleft Birth Defects
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Texas, 1999-2009
Cleft palate alone (without cleft lip)
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 6.1 6.28 5.92 5.29 5.38 5.51 6.59 5.56 5.87 6.47 6.2 Cleft lip with or without cleft palate
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 10.65 11.04 10.98 10.45 10.33 11.85 11.15 11.19 10.68 10.86 9.4
Year
Data Source: Texas DSHS Birth Defects Registry.
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Texas, 1999-2009 Combined
White Black Hispanic 6.8 4.5999999999999996 5.5 Cleft lip with or without cleft palate
White Black Hispanic 10.9 7.2 11.6
Race/Ethnicity
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Male Female 5.0999999999999996 13 Cleft lip with or without cleft palate
Male Female 6.7 8.4
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PHR 1 PHR 2 PHR 3 PHR 4 PHR 5 PHR 6 PHR 7 PHR 8 PHR 9 PHR 10 PHR 11 6 7.4 6.5 7 5.2 5.23 6 6.5 5.9 5.4 5.21 Cleft lip with or without cleft palate
PHR 1 PHR 2 PHR 3 PHR 4 PHR 5 PHR 6 PHR 7 PHR 8 PHR 9 PHR 10 PHR 11 14.7 13.4 11 11. 91 10 8.5399999999999991 10.93 12.29 13.3 12.66 10.9
Health Service Region (HSR)
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Cleft palate alone (without cleft lip) < 20 20-24 25-29 30-34 35-39 40 + 5.0999999999999996 5.47 5.96 6.12 6.8 10.8 Cleft lip with or without cleft palate < 20 20-24 25-29 30-34 35-39 40 + 11.94 10.9 10.199999999999999 9.92 10.8 17.600000000000001
Mother’s Age in Years
Cases per 10,000 Live Births
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Percent of Oral Clefts by Pregnancy Outcome Distribution, Texas, 1999-2009 Combined
Live Birth Spontaneous Fetal Death Induced Termination 96.7 2 1.3 Cleft lip with or without cleft palate
Live Birth Spontaneous Fetal Death Induced Termination 93.1 4.3 2.6
Pregnancy Outcome
Burden of Dental Disease
Not taking care of dental disease affects more than just the mouth. It also leads to poor diet; illnesses affecting the whole body; low quality of life; and earlier death. The impact of poor health of the mouth on overall health is a public health concern.
CDC Behavioral Risk Factor Surveillance System Survey at http://apps.nccd.cdc.gov/BRFSS/
HRSA Maternal and Child Health Bureau’s National Survey of Children’s Health at http://www.cdc.gov/nchs/slaits/nsch.htm
CDC Pregnancy Risk Assessment Monitoring System at http://www.cdc.gov/prams/
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http://www.buildingbetteroralhealth.org/
http://www.dshs.state.tx.us/dental/
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Adults
Poor health of the mouth in adults can be shown by the loss of teeth. Most adult tooth loss comes from tooth decay and gum disease. Tooth loss can be avoided by finding problems early and seeking routine dental care.
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Reading Level = 5
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Data Source: Texas DSHS Center for Health Statistics - Behavioral Risk Factor Surveillance Survey (BRFSS).
Includes non-institutional adults only.
All reported rates are weighted for Texas demographics and the probability of selection. Estimates based on self-reported data.
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Dental Disease Among Adults
Percent of Tooth Loss Reported Due to Tooth Decay or Gum Disease, Adults Age 18 and Over, by Survey Year and Level of Tooth Loss,
Texas, 2002-2010
None
2002 2004 2006 2008 2010 54.2 56.5 58.8 56.1 54.6 One to Five
2002 2004 2006 2008 2010 31.585269651711624 30.397206979046931 28.12537605345883 31.094981810825097 33.200000000000003 Six or more, but not all
2002 2004 2006 2008 2010 9.4034313761479478 8.8498921173488174 8.8228900556269743 8.8565165653850624 8.6999999999999993 All
2002 2004 2006 2008 2010 4.8037232884324634 4.21120 43961011221 4.2271137475178691 3.9107874053801712 3.5
Survey Year
Image from: http://www.texastribune.org/texas-issues/smoking-ban
Smoking is linked to poor oral health problems. It can lead to early tooth loss and a higher risk for getting cancer of the mouth and throat.
Reading Level = 4
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Data Source: Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System Survey (BRFSS) Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (http://apps.nccd.cdc.gov/BRFSS/).
Percentages are weighted to population characteristics. Estimates based on self-reported data.
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Smoking Among Adults
Percent of Current Smokers, Adults Age 18 and Older, by Survey Year, Texas, 2001-2010
Current Smokers
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 22.4 22.9 22.1 20.5 20 17.899999999999999 19.3 18.5 17.899999999999999 15.8
Survey Year
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Percent of Current Smokers, Adults Age 18 and Older, by Gender, Texas, 2010
Current Smokers
Gender
Percent
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Percent of Current Smokers, Adults Age 18 and Older, by Race/Ethnicity, Texas, 2010
Current Smokers
Race/Ethnicity
Percent
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Percent of Current Smokers, Adults Age 18 and Older, by Survey Year and Level of Smoking, Texas, 2010
Smoke Every Day 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 15.5 16.600000000000001 15.6 13.6 13.2 12.6 13 11.7 11.7 10.5 Smoke Some Days 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 6.9 6.2 6.5 6.9 6.8 5.3 6.4 6.8 6.2 5.3 Former Smoker 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 20.7 20.9 21.6 20.2 21 21.7 20.7 21.5 21.6 21.3 Never Smoked 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 56.9 56.2 56.3 59.3 59 60.4 60 60 60.5 62.9
Survey Year
Percent
Adults
Regular dental visits may help to stop or slow down tooth decay and gum disease. The number of visits to the dentist within a year can often predict health in the mouth.
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Image from: Texas DSHS Take Time for Teeth: Texas Health Steps Dental Health Program
Reading Level = 6
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20
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Percent of Adults, Age 18 Years & Over Who Visited a Dental Clinic Within Past Year, by Survey Year,
Texas, 2002-2010
2002 2004 2006 2008 2010 60.021078860156472 59. 234572816893262 61.405640757337849 59.765736786515689 59.7
Survey Year
Dental Visits Among Adults
Percent of Adults, Age 18 Years & Over Who Visited a Dental Clinic Within Past Year, by Race/Ethnicity and Survey Year, Texas, 2002-2010
2002
White Black Hispanic Other 67 55.6 46.4 61
Race/Ethnicity
Percent
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Percent of Adults, Age 18 Years & Over Who Visited a Dental Clinic Within Past Year, by Level of Education and Survey Year, Texas, 2002-2010
2002
Less than High School High School Graduate Some College College Graduate 40.134624477972409 55.704158578306476 65.40440663820732 73.533736517183399 2004
Less than High School High School Graduate Some College College Graduate 34.300000000000004 49.9 59.4 75.5
Level of Education
Percent of Adults, Age 18 Years & Over who Visited a Dental Clinic within Past Year, by Household Income and Survey Year, Texas, 2002-2010
2002
Less than $15,000 $15,000 to $24,999 $25,000 to $34,999 $35,000 to $49,999 $50,000 + 37.721264052438 499 45.456954751478996 50.007664392097944 56.512114490476065 74.674860939905372 2010
Less than $15,000 $15,000 to $24,999 $25,000 to $34,999 $35,000 to $49,999 $50,000 + 33.700000000000003 38.6 53.1 56.5 75.7
Household Income
Percent
Children
Tooth decay is the most common long-lasting illness in children with severe outcomes. These outcomes include pain; infections of the mouth; tooth loss; and poor appearance. If not treated, pain and infection can lead to problems in eating, speaking, learning, and possibly death.
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Reading Level = 5.3
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Dental Disease Among Children
Condition of Children’s Teeth, Age 1-17 Years, by Survey Year and Condition of Teeth,
Texas, 2003 & 2007
Excellent or very good
2003 2007 61.3 61.5 Good condition 2003 2007 25.4 24.5 Fair or poor condition 2003 2007 13.4 14
Survey Year
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DATA ALERT: CSHCN Status is determined using a validated instrument for identification of children with special health care needs as defined by the federal Maternal and Child Health Bureau. The CSHCN Screener asks whether a child currently experiences a health consequences and, if so, whether that specific health consequence is due to a medical, behavioral, or other type of health condition that has lasted or is expected to last 12 months or longer. For more information email [email protected].
http://childhealthdata.org/browse/survey/results?q=222&r=45&g=75
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Condition of Children’s Teeth, Age 1-17 Years by Type of Insurance, Texas, 2003 & 2007
Type of Insurance
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Two or More Oral Health Problems in Past 6 Months,
Texas, 2007
2007
No problems One problem 2 or more problems 71.2 19.5 9.2000000000000011
Percent of Children, Age 1-17 Years Who Had a Toothache in Past 6 Months,
Texas, 2007
Data Source: National Survey of Children’s Health (NSCH).
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Percent of Children, Age 1-17 Years, Who Had Decayed Teeth or Cavities
in Past 6 Months,
Percent of Children, Age 1-17 Years, Who Had Broken Teeth
in Past 6 Months,
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Percent of Children, Age 1-17 Years, Who Had Bleeding Gums in Past 6 Months, Texas, 2007
No
Percent
Children
Regular dental visits are a key part in having a healthy mouth. Visiting the dentist lowers the chance of illness by finding problems early and treating them. These visits are even more important for children. Visits can include applying sealants, plastic coatings put on teeth, or fluoride treatments; suggesting changes in diet; and providing instructions on how to take care of teeth to help lower decay.
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Reading Level = 6.2
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Percent of Children, Age 1-17 Years, With One or More Preventive Dental Care Visits in Past 12 Months,
Texas, 2007
2007 26 One or More Preventive Dental Care Visits
2007 74
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Percent of Children, Age 1-17 Years, With One or More Preventive Dental Care Visits in Past 12 Months, by Type of Insurance, Texas, 2007
No Preventive Dental Care Visit
Public Insurance (such as Medicaid/SCHIP) Private Health Insurance Currently Uninsured 17.600000000000001 23.1 48.6 One or More Preventive Dental Care Visits
Public Insurance (such as Medicaid/SCHIP) Private Health Insurance Currently Uninsured 82.4 76.900000000000006 51.4
Type of Insurance
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Percent of Children, Age 1-17 Years, With One or More Preventive Dental Care Visits in Past 12 Months, by Urban/Rural Residence, Texas, 2007
No Preventive Dental Care Visit
Urban Rural 25.6 30.1 One or More Preventive Dental Care Visits
Urban Rural 74.400000000000006 69.900000000000006
Children Special Needs
Children with special health care needs are at higher risk for dental disease. This includes people living in poverty or with disabilities. They often have a hard time getting the care they need.
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Dental Disease Among Special Needs Children
DATA ALERT: CSHCN Status is determined using a validated instrument for identification of children with special health care needs as defined by the federal Maternal and Child Health Bureau. The CSHCN Screener asks whether a child currently experiences a health consequences and, if so, whether that specific health consequence is due to a medical, behavioral, or other type of health condition that has lasted or is expected to last 12 months or longer. For more information email [email protected].
http://childhealthdata.org/browse/survey/results?q=222&r=45&g=75
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Condition of Children’s Teeth, Age 1-17 Years, by Special Health Care Needs Status and Condition of Teeth,
Texas, 2003 & 2007
Non-CSHCN CSHCN 61.9 59.5 Good condition Non-CSHCN CSHCN 24.9 22.3 Fair or poor condition Non-CSHCN CSHCN 13.1 14
Special Health Care Needs Status
Percent
Data Source: National Survey of Children with Special Health Care Needs (NS-CSHCN).
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Dental Visits Among Special Needs Children
Percent of Special Needs Children, Age 0-17 Years, Who Had a Need for Any Other Dental Care or Orthodontia in Past Year,
Texas, 2005-2006 & 2009-2010
2005-2006 2009-2010 23.6 25.8
Year
Percent
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Percent of Special Needs Children, Age 0-17 Years, Who Had a Need for at Least One Preventive Dental Visit in Past Year,
Texas, 2005-2006 & 2009-2010
2005-2006 2009-2010 79.8 90.7
Year
Percent
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Percent of Special Needs Children, Age 0-17 Years, Who Received All Preventive
Dental Care Needed in Past Year,
Texas, 2005-2006 & 2009-2010
2005-2006 2009-2010 8.3000000000000007 10.3
Year
Percent
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Percent of Special Needs Children, Age 0-17 Years, Who Received All Other
Dental Care Needed in Past Year,
Texas, 2005-2006 & 2009-2010
2005-2006 2009-2010 8.3000000000000007 7.8
Pregnant Women
It is very important to have good health within the mouth during pregnancy. A mother’s health affects both the mother and unborn baby. Pregnancy can lead to a higher risk of tooth decay; early wearing away of teeth; gum disease; and loose teeth. Poor oral health in the mother can lead to poor birth outcomes; high blood pressure; and poor control of long-lasting illnesses such as diabetes. The spread of germs in the mouth from mother to baby can also lead to tooth decay in the baby. It is just as important for a pregnant woman to see a dentist as it is for her to take care of her teeth at home.
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Image from: Texas DSHS Take Time for Teeth Texas Health Steps Dental Health Program
Reading Level = 4.2
Texas PRAMS 2005-2008
Overall percent of women who reported, during pregnancy, that they needed to see a dentist for a problem.
24.2%
Overall percent of women who reported, during pregnancy, that they went to a dentist or dental clinic.
28.8%
Overall percent of women who reported, during pregnancy, that a dentist or other health care worker talked to them about how to care for their teeth or gums.
31.8%
Data Source: Pregnancy Risk Assessment Monitoring System (PRAMS). PRAMS does not currently meet CDC requirement of a 70% response rate sample strata for survey years 2005-2007. All reported rates are weighted. Estimates based on self-reported data.
Texas PRAMS
2009
2010
Overall percent of women who reported that, during their most recent pregnancy, they had their teeth cleaned by a dentist or dental hygienist.
27.2%
28.7%
Overall percent of women who reported that, after their most recent pregnancy, they had their teeth cleaned by a dentist or dental hygienist.
21.3%
23.8%
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Pregnant Women
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Percent
Percent
Percent of women who reported, during pregnancy, that they needed to see a dentist for a problem, by Maternal Age,
Texas, 2005-2008
Maternal Age in Years
Percent of women who reported, during pregnancy, that they needed to see a dentist for a problem, by Maternal Race/Ethnicity,
Texas, 2005-2008
Maternal Race/Ethnicity
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Percent
Percent
Percent of women who reported, during pregnancy, that they needed to see a dentist for a problem,
by Maternal Education,
< H.S. H.S. or GED Some college College grad 22.244 25.660599999999945 30.562999999999946 20.147200000000005
Maternal Education
Percent of women who reported, during pregnancy, that they needed to see a dentist for a problem,
by Household Income,
Household Income
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Percent
Percent
Percent of women who reported, during pregnancy, that they went to a dentist or dental clinic,
by Maternal Age,
Percent of women who reported, during pregnancy, that they went to a dentist or dental clinic,
by Maternal Race/Ethnicity,
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Percent
Percent
Percent of women who reported, during pregnancy, that they went to a dentist or dental clinic, by Maternal Education,
Texas, 2005-2008
Maternal Education
Percent of women who reported, during pregnancy, that they went to a dentist of dental clinic,
< $15K $15K- < $25K $25K- < $35K $35K- < $50K ≥$50K 19.3916 19.978299999999923 28.535699999999945 30.3535 48.935900000000011
Household Income
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Percent
Percent
Percent of women who reported, during pregnancy, that a dentist/healthcare worker talked to them about care of teeth/gums,
by Maternal Age,
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Percent
Percent
Maternal Education
Household Income
Data Source: Pregnancy Risk Assessment Monitoring System (PRAMS). All reported rates are weighted. Estimates based on self-reported data.
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Percent
Percent
Percent of women who reported, during most recent pregnancy, teeth cleaning by a dentist or dental hygienist,
by Maternal Age,
18-24 25-34 35-44 25.2 29.2 33.700000000000003
White Black Hispanic 35.299999999999997 29.4 24
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Percent
Percent
< H.S. H.S. or GED Some college College grad 23.383199999999999 22.401599999999998 27.894300000000001 36.407299999999999 2010
Maternal Education
2009
< $15K $15K- < $25K $25K- < $35K $35K- < $50K ≥$50K 24.395 20.4602 24.260999999999999 24.931799999999999 39.042499999999997 2010
< $15K $15K- < $25K $25K- < $35K $35K- < $50K ≥$50K 19.3 21.4 27 30.3 46.8
Household Income
50
Percent
Percent
Percent of women who reported, after most recent pregnancy, teeth cleaning by a dentist or dental hygienist,
by Maternal Age,
18-24 25-34 35-44 21.775400000000001 22.020900000000001 25.594799999999999
Missing categories $25K- <$35K and $35K-<$50K have sample sizes too small to report
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Percent
Percent
< H.S. H.S. or GED Some college College grad 16.499500000000001 17.074400000000001 22.605699999999999 30.253599999999999 2010
Maternal Education
< $15K $15K- < $25K ≥$50K 19.6843 22.896100000000001 32.532400000000003
Household Income
Cancer of the Mouth and Throat
Oral cancer includes cancers of the mouth and the throat (pharynx). Oral cancer often starts as a tiny white or red spot or sore anywhere in the mouth that does not heal. All areas of the mouth can be involved. Oral cancers can get worse very quickly and finding it early can lead to a better outcome. Risk factors include age, tobacco use, alcohol use, and too much time under the sun for lip cancers. Oral cancers are still found in patients with no known risk factors.
http://www.dshs.state.tx.us/tcr/default.shtm
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http://www.ada.org/
http://www.nidcr.nih.gov/OralHealth/Topics/OralCancer/
Data Source: Texas DSHS Cancer Registry.
*Rates are per 100,000 and age-adjusted to the 2000 US Std Population (19 age groups - Census P25-1130) standard.
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Oral cavity cancer includes lip, tongue, salivary, floor, gum, and other mouth
Pharynx cancer includes naso-pharynx, tonsil, oroo, and hypo-pharynx
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Age-Adjusted Oral and Pharyngeal Cancer Incidence Rate, by Year, Texas, 2000-2009
Oral Cavity and Pharynx Cancer
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 10.5 11 10.7 11 10.5 10.199999999999999 10.3 10.4 10.9 10. 5 Oral Cavity Cancer
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 7.1 7.5 7.1 7.1 6.8 6.8 6.5 6.6 7 6.6 Pharynx Cancer
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 3.1 3 3.2 3.7 3.4 3.1 3.4 3.4 3.6 3.6
Year
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Oral Cavity/Pharynx Cancer
Average Annual Oral and Pharyngeal Cancer Incidence Rates, by Race and/or Ethnicity,
Texas, 2000-2009
White Hispanic White Non-Hispanic Black Asian/Paci fic Islander American Indian/Alaska Native Hispanic 6.5 12.4 9.4 5.2 2.8 6.5 Oral Cavity Cancer
White Hispanic White Non-Hispanic Black Asian/Pacific Islander American Indian/Alaska Native Hispanic 4.0999999999999996 8.1999999999999993 5.2 2.6 2.1 4.0999999999999996 Pharynx Cancer
White Hispanic White Non-Hispanic Black Asian/Pacific Islander American Indian/Alaska Native Hispanic 2.1 3.8 3.8 2.5 0.7 2.1
Race and/or Ethnicity
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Average Annual Oral and Pharyngeal Cancer Incidence Rates, by Gender, Texas, 2000-2009
Oral Cavity and Pharynx
Male Female 10.1 4.2 Pharynx
Male Female 5.6 1.4
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Average Annual Oral and Pharyngeal Cancer Incidence Rates, by Select Age Groups,
Texas, 2000-2009
Oral Cavity and Pharynx Cancer ≤ 34 35-44 45-54 55-64 65+ 0.5 4.3 15.8 30 38.700000000000003 Oral Cavity Cancer ≤ 34 35-44 45-54 55-64 65+ 0.4 2.7 9 18.100000000000001 27.5 Pharynx Cancer ≤ 34 35-44 45-54 55-64 65+ 0.1 1.5 6.4 10.9 9.8000000000000007
Age Group in Years
*Incidence Rate per 100,000
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Average Annual Oral and Pharyngeal Cancer Incidence Rates, by Gender and Race/Ethnicity, Texas, 2000-2009
White Hispanic
Texas Male Texas Female 19 6.6 Black
Texas Male Texas Female 15.1 5.0999999999999996 Asian/Pacific Islander
Texas Male Texas Female 7.5 3.3 Amer. Indian/Alaskan Native
Texas Male Texas Female 5 0.8 Hispanic
Texas Male Texas Female 10 3.5
Gender
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Oral and Pharyngeal Cancer Mortality Rate, by Year, Texas, 2000-2009
Oral Cavity and Pharynx Cancer 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2.9 2.8 2.8 2.6 2.7 2.6 2.6 2.6 2.4 2.4 Oral Cavity Cancer 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 1.4 1.3 1.5 1.4 1.4 1.3 1.2 1.2 1.2 1.1000000000000001 Pharynx Cancer 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 0.7 0.8 0.7 0.7 0.7 0.8 0.7 0.8 0.6 0.7
Year
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Oral Cavity and Pharyngeal Cancer Mortality Rate, by Race/Ethnicity, Texas, 2000-2009
White Hispanic White Non-Hispanic Black Asian/Pacific Islander American Indian/Alaska Native Hispanic 1.6 2.8 3.6 1.7 0.4 1.6 Oral Cavity Cancer
White Hispanic White Non-Hispanic Black Asian/Pacific Islander American Indian/Alaska Native Hispanic 0.8 1.4 1.4 0.7 0.3 0.8 Pharynx Cancer
White Hispanic White Non-Hispanic Black Asian/Pacific Islander American Indian/Alaska Native Hispanic 0.4 0.8 1 0.8 0 0.4
Race/Ethnicity
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Oral Cavity and Pharyngeal Cancer Mortality Rate, by Gender, Texas, 2000-2009
Male Female 4.0999999999999996 1.4 Oral Cavity Cancer
Male Female 1.9 0.8 Pharynx Cancer
Male Female 1.1000000000000001 0.3
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Oral Cavity and Pharyngeal Cancer Mortality Rates, by Selected Age Group, Texas, 2000-2009
Oral Cavity and Pharynx Cancer ≤ 34 35-44 45-54 55-64 65+ 0 0.5 2.8 6.7 12.4 Oral Cavity Cancer ≤ 34 35-44 45-54 55-64 65+ 0 0.3 1.2 3 6.2 Pharynx Cancer ≤ 34 35-44 45-54 55-64 65+ 0 0.1 0.9 2.1 3
Age Group in Years
*Mortality Rate per 100,000
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Oral Cavity and Pharyngeal Cancer Mortality Rates, by Gender and Race/Ethnicity, Texas, 2000-2009
White Hispanic
Texas Male Texas Female 4.3 1.6 Black
Texas Male Texas Female 6.3 1.6 Asian/Pacific Islander
Texas Male Texas Female 2.9 0.7 Amer Indian/Alaskan Native
Texas Male Texas Female 0.8 0.1 Hispanic
Texas Male Texas Female 2.6 0.8
Gender
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SEER - Surveillance, Epidemiology and End Results
In-situ category – abnormal cells are present only in the layer of cells in which they developed
Localized category – cancer is limited to the organ in which it began, without evidence of spread
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Oral Cancer Summary Stage Percent, Early Diagnosis, by Year, Texas, 2000-2009
In-situ%
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2.4 2.29 99999999999998 2.7 2.2000000000000002 3 2.2999999999999998 1.9 2.8 1.7 1.5 Local%
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 42.5 41.7 42.2 39.700000000000003 37.9 35.700000000000003 35.200000000000003 36 .5 34.6 35.6
Year
Percent
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Pharyngeal Cancer Summary Stage Percent, Early Diagnosis, by Year, Texas, 2000-2009
In-situ%
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 0.9 1.6 0.2 1 0.9 1.1000000000000001 0.9 0.4 0.7 0.9 Local%
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 16.600000000000001 16.600000000000001 15.8 16.899999999999999 14.7 14 15 15.4 13.8 13.1
Year
Percent
Fluoridation
Community water fluoridation plays a part in good health within the mouth. Adding fluoride to the water is low cost, useful, and safe. It helps to lower the chances of tooth decay and tooth loss to lower the cost of dental care.
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http://www.dshs.state.tx.us/epitox/fluoride.shtm
Reading Level = 5
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Data Source: Centers for Disease Control and Prevention (CDC) Water Fluoridation Reporting System (WFRS) via Texas DSHS Environmental and Injury Epidemiology and Toxicology Group.
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Fluoridation
by Year, Texas, 2002-2010
Year
Percent
Substance Abuse
The use of tobacco and marijuana is harmful to the health of the mouth, as well as general health. Most adult smokers start smoking before age 19. Therefore, stopping substance abuse among youth plays a role for better overall health of Texans. Smoking related illnesses are the leading cause of death in Texas. The use of smokeless tobacco can be just as bad as smoking tobacco. It can lead to loss of gum tissue; wear on teeth; tooth decay; loss of teeth; and cancers of the mouth and throat.
Texas DSHS Mental Health and Substance Abuse Services’ Decision Support Unit at
http://www.dshs.state.tx.us/mhsa-decision-support.aspx
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http://www.dshs.state.tx.us/tobacco/
http://www.dshs.state.tx.us/dental/smokeless.shtm
67
Data Source: Mental Health and Substance Abuse Services, Decision Support Unit, Texas DSHS.
Includes only public schools. Private school students and dropouts not represented in sample. Estimates based on self-reported data.
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Percent of Secondary Students,
Grades 7 – 12, Who Had Ever Used Selected Substances, by Year, School Survey of Substance Use,
Texas, 1988-2010
Tobacco 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 56.2 54.3 54.5 55.2 54.7 51.1 44.9 39.4 35.4 31.7 30.5 Marijuana 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 31.5 22.6 19.7 25.3 31.2 34.5 32.200000000000003 32.299999999999997 29.8 26.4 24.6 26.2
Data Source: Mental Health and Substance Abuse Services, Decision Support Unit, Texas DSHS.
Includes only public schools. Private school students and dropouts not represented in sample. Estimates based on self-reported data.
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Percent of Secondary Students,
Grades 7 – 12, Who Had Used Selected Substances in Past Month, by Year, School Survey of Substance Use,
Texas, 1988-2008
Tobacco 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 22.9 20.9 24.2 26.2 26.3 22.4 18.2 17 15.2 12.9 12.5 Marijuana 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 11.5 7.8 6.8 12 15.9 15.2 13.7 14.4 12.6 11 10 11.4
Data Source: Texas DSHS Center for Health Statistics. Youth Risk Behavior Survey (YRBS) conducted biennially in selected metropolitan areas and only includes students in 9-12 grades in public and private schools. All reported rates are weighted for Texas demographics and the probability of selection. Estimates based on self-reported data.
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Tobacco Usage Among High School Students
Percent of High School Students, Grade 9 – 12, Who Used Chewing Tobacco, Snuff, or Dip on One or More of Past 30 Days, by School Year (SY), Texas, 2005-2011
SY05
6.2
Percent
71
Percent of High School Students, Grade 9 – 12, Who Used Chewing Tobacco, Snuff, or Dip on One or More of Past 30 Days, by School Year (SY) and Gender,
Texas, 2005-2011
Male Female 10.199999999999999 2
Gender
Percent
72
Percent of High School Students, Grade 9 – 12, Who Used Chewing Tobacco, Snuff, or Dip on One or More of Past 30 Days, by School Year (SY) and Race/Ethnicity, Texas, 2005-2011
SY2005
White Black Hispanic Other 10 3 4.4000000000000004 4.0999999999999996
Race/Ethnicity
Percent
73
Percent of High School Students, Grade 9 – 12, Who Used Chewing Tobacco, Snuff, or Dip on One or More of Past 30 Days, by School Year (SY) and Grade Level,
Texas, 2005-2011
9th 10th 11th 12th 5.8 5.6 6.7 6.4
Grade Level
Percent
74
Percent of High School Students, Grade 9 – 12, Who Smoked Cigars, Cigarillos, or Little Cigars on One or More of Past 30 Days, by School Year (SY), Texas, 2005-2011
SY2005
Percent
75
Percent of High School Students, Grade 9 – 12, Who Smoked Cigars, Cigarillos, or Little Cigars on One or More of Past 30 Days, by School Year (SY) and Gender, Texas, 2005-2011
SY2005
Male Female 20 11.5
Gender
Percent
76
Percent of High School Students, Grade 9 – 12, Who Smoked Cigars, Cigarillos, or Little Cigars on One or More of Past 30 Days, by School Year (SY) and Grade Level, Texas, 2005-2011
SY2005
9th 10th 11th 12th 12.4 14.6 17.2 20.3
Grade Level
Percent
77
Percent of High School Students, Grade 9 – 12, Who Smoked Cigars, Cigarillos, or Little Cigars on One or More of Past 30 Days, by School Year (SY) and Race/Ethnicity, Texas, 2005-2011
SY2005
White Black Hispanic Other 14.6 15.5 16.7 15.8
Race/Ethnicity
Percent
78
Percent of High School Students, Grade 9 – 12, Who Smoked Cigarettes on 20 or More of Past 30 Days,
by School Year (SY), Texas, 2005-2009
SY2005
6.2
Percent
79
by School Year (SY) and Gender, Texas,
2005-2009
SY2005
Male Female 7.8 4.5
Gender
Percent
80
by School Year (SY) and Race/Ethnicity,
Texas, 2005-2009
White Black Hispanic/Latino 9.4 3.3 4.2
Race/Ethnicity
Percent
Workforce - Access to Dental Services
The number of people in Texas is predicted to grow. It is important to have enough dental care workers for this growth. The dental team includes dentists, dental hygienists, and assistants. These team members will play a major role in dealing with the rising need for dental care. This need is greatest in rural and frontier areas of Texas.
Federally Qualified Health Centers (FQHCs) play a key role in rural areas of Texas. Many of the people served are poor and have no dental insurance. They often have trouble getting dental care.
Texas DSHS Center for Health Statistics’ Health Professions Resource Center at http://www.dshs.state.tx.us/chs/hprc/DENT-lnk.shtm
Texas State Board of Dental Examiners at http://www.tsbde.state.tx.us/
HRSA Bureau of Primary Health Care’s Uniform Data System at http://bphc.hrsa.gov/healthcenterdatastatistics/
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http://www.dshs.state.tx.us/chs/hprc/
http://www.dshs.state.tx.us/chpr/fqhcmain.shtm
81
Data Source: Texas State Board of Dental Examiners. Includes: Dentists with a status code of “active” or “expired” and a practice type of general dentistry, pediatric dentistry, or dental public health. Excludes: Dentists with a status code as “retired”, “revoked”, “suspended”, “cancelled”, “surrendered”, or “deceased”; and those who are non-primary care; federal or military; dental residents; or faculty.
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Workforce
Ratio of Primary Care Dentist per 100,000 Population, by Year, Texas, 2000-2011
Ratio of DNs per 100,000 Population
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 36.5 36.5 36.700000000000003 36.4 35.700000000000003 35.700000000000003 36 36.5 37.200000000000003 37.799999999999997 38.200000000000003 38.299999999999997
Year
Ratio per 100,000 population
Data Source: Texas State Board of Dental Examiners. Excludes: Dental hygienists with a license status code of “surrender”, “revoked”, “retired”, “deceased”, or “cancelled”.
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Workforce
by Year, Texas, 2000-2011
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 34.700000000000003 35.4 36.299999999999997 36.4 36.6 37.200000000000003 37.700000000000003 38.700000000000003 38.799999999999997 39.5 39.9 39.5
Year
Data available only for 2011.
84
Workforce
Texas, 2011
2011 97.6
Ratio per 100,000 population
Data Source: Texas State Board of Dental Examiners. Includes: Dentists with a status code of “active” or “expired” and a practice type of general dentistry, pediatric dentistry, or dental public health. Excludes: Dentists with a status code as “retired”, “revoked”, “suspended”, “cancelled”, “surrendered”, or “deceased”; and those who are non-primary care; federal or military; dental residents; or faculty. Excludes: Dental hygienists with a license status code of “surrender”, “revoked”, “retired”, “deceased”, or “cancelled”.
Dental Assistant: Data available only for 2011.
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Workforce
Number of Counties without a Primary Care Dentist/ Dental Hygienist/Dental Assistant, by Year,
Texas, 2000-2011
Primary Care Dentist
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 41 41 46 46 47 49 46 47 46 44 48 46 Dental Hygientist
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 63 58 56 58 61 58 61 57 59 53 50 48 Dental Assistant
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 28
Year
Number
Data Source: Texas State Board of Dental Examiners. Includes: Dentists with a status code of “active” or “expired” and a practice type of general dentistry, pediatric dentistry, or dental public health. Excludes: Dentists with a status code as “retired”, “revoked”, “suspended”, “cancelled”, “surrendered”, or “deceased”; and those who are non-primary care; federal or military; dental residents; or faculty. Excludes: Dental hygienists with a license status code of “surrender”, “revoked”, “retired”, “deceased”, or “cancelled”.
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Workforce
Texas, 2000-2011
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 24.803149606299215 22.834645669291341 22.047244094488189 22.834645669291341 24. 015748031496063 22.834645669291341 24.015748031496063 22.440944881889763 23.228346456692915 20.866141732283463 19.685039370078741 18.899999999999999 Dental Assistant
2000 2001 2002 2003 2004 2005 2006 2007 2008 20 09 2010 2011 11
Year
Percent
Data Source: Texas State Board of Dental Examiners. Includes: Dentists with a status code of “active” or “expired” and a practice type of general dentistry, pediatric dentistry, or dental public health. Excludes: Dentists with a status code as “retired”, “revoked”, “suspended”, “cancelled”, “surrendered”, or “deceased”; and those who are non-primary care; federal or military; dental residents; or faculty.
87
Workforce
Primary Care Dentist
Year
Percent
88
Workforce
Dental Schools Dental Hygiene School 3 23
Number of Schools
Data Source: Human Resources and Service Administration (HRSA), Bureau of Primary Health Care (BPHC), Uniform Data System (UDS).
89
Access to Dental Services
Proportion of Patients Receiving Oral Health Services at FQHCs, by Year, Texas, 2007-2010
Proportion Patients Using Dental Services at FQHC in Texas
2007 2008 2009 2010 19.7 19.399999999999999 19.8 19.7
Year
Medicaid/Children’s Health Insurance Program (CHIP)
To learn more about Texas Medicaid/CHIP and access program data, visit:
90
Next Steps
Future data collection sources in the upcoming years will include:
Basic Screening Survey (BSS) for 3rd graders during school year 2012-2013.
BSS for Head Start children during school year 2013-2014.
Dental question added to the Texas YRBS for year 2013.
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References
http://www.ada.org/
http://www.nidcr.nih.gov/oralhealth/topics/oralcancer/
http://www.dshs.state.tx.us/birthdefects/about.shtm
http://www.dshs.state.tx.us/chpr/fqhcmain.shtm
http://www.dshs.state.tx.us/epitox/fluoride.shtm
http://www.dshs.state.tx.us/tobacco/
http://www.dshs.state.tx.us/dental/smokeless.shtm
http://www.dshs.state.tx.us/chs/hprc/
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oral health surveillance data chart book

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