school-based dental sealant programs edward f. zapert, d.m.d. executive dental director florida...
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School-based Dental School-based Dental Sealant ProgramsSealant Programs
Edward F. Zapert, D.M.D.Edward F. Zapert, D.M.D.
Executive Dental Director Executive Dental Director Florida Department of HealthFlorida Department of Health
Division of Community Health PromotionDivision of Community Health Promotion
Bureau of Family Health ServicesBureau of Family Health Services
November 18, 2014November 18, 2014
To Protect, promote and improve the health of all people in Florida through integrated state, county and community efforts
CariesCaries
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Caries TypeCaries Type
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Caries TypeCaries Type
Pit and Fissure ~ 85%Pit and Fissure ~ 85% Smooth Surface ~ 15%Smooth Surface ~ 15%
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Smooth SurfaceSmooth Surface
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Pit And FissurePit And Fissure
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What’s the problem?What’s the problem?
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What’s the problem?What’s the problem?
Fissures ~ 0.1 mmFissures ~ 0.1 mm
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What’s the problem?What’s the problem?
Fissures ~ 0.1 mmFissures ~ 0.1 mm Toothbrush bristle ~ 0.2 mmToothbrush bristle ~ 0.2 mm
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Do the math….Do the math….
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Do the math….Do the math….
Streptococcus Mutans ~ 0.75 Streptococcus Mutans ~ 0.75 micronsmicrons
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Do the math….Do the math….
Streptococcus Mutans ~ 0.75 Streptococcus Mutans ~ 0.75 microns diametermicrons diameter
Tooth fissure 0.1 x 0.1 x 0.1 mmTooth fissure 0.1 x 0.1 x 0.1 mm ~2.3 million bacteria~2.3 million bacteria
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SealantsSealants
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Unsealed ToothUnsealed Tooth
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Sealant ApplicationSealant Application
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““Cleaning”Cleaning”
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Acid EtchAcid Etch
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RinseRinse
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DryDry
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Material ApplicationMaterial Application
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Light CureLight Cure
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Tooth With SealantTooth With Sealant
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Before And AfterBefore And After
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Chapter 466Chapter 466
(2) A dental hygienist licensed in (2) A dental hygienist licensed in this state may perform the following this state may perform the following remediable tasks in a health access remediable tasks in a health access setting as defined in s. 466.003 setting as defined in s. 466.003 without the physical presence, prior without the physical presence, prior examination, or authorization of a examination, or authorization of a dentist:dentist:
(e) Apply dental sealants.(e) Apply dental sealants.25
Title I SchoolsTitle I Schools
Most children covered by MedicaidMost children covered by Medicaid
Highest caries riskHighest caries risk
Reduces access to care barriersReduces access to care barriers
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Title I SchoolsTitle I Schools
State of FloridaState of Florida
2442 Elementary Schools2442 Elementary Schools
Number of kids: ~ 2400 x .5 x 100 = Number of kids: ~ 2400 x .5 x 100 = 120,000120,000
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Funding?Funding?
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Funding?Funding?
Medicaid Rate Per Sealant $19.32Medicaid Rate Per Sealant $19.32
4 Sealants Per Hour = $77.284 Sealants Per Hour = $77.28
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Funding?Funding?
Medicaid Rate Per Sealant $19.32Medicaid Rate Per Sealant $19.32
4 Sealants Per Hour = $77.284 Sealants Per Hour = $77.28
All plans cover School Based All plans cover School Based SealantsSealants
(Health Access Settings)(Health Access Settings)
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To protect, promote and improve the health of all people in Florida through integrated state, county, and community efforts.
Escambia Santa Rosa
Okaloosa Walton
Holmes
Washington
Bay
Gulf
Jackson
Calhoun
Liberty
Gadsden Leon
Wakulla
Franklin
Madison
Taylor
Hamilton
Suwannee
Lafayette
Columbia
Gilchrist
Dixie
Levy
Alachua
Baker
Union
Nassau
Bradford
Clay St. Johns
Putnam
Flagler
Marion
Citrus
Hernando
Sumter
Lake
Volusia
Seminole
Orange
Brevard
Osceola
Pasco
Hillsborough
Pinellas
Polk
Manatee
Hardee
Highlands
Okeechobee
Lake Okeechobee
DeSoto Sarasota
Charlotte
Lee
Glades
Hendry
Collier
Indian River
St. Lucie
Martin
Palm Beach
Broward
Dade
Monroe
Jefferson Duval
Alachua, Bay, Baker, Calhoun, Charlotte, Collier, Columbia, Desoto, Duval, Franklin, Highlands, Hillsborough, Indian River, Jackson, Lake, Leon, Marion, Miami-Dade, Nassau, Okaloosa, Orange, Palm Beach, Pasco, Polk, St. Johns, Taylor, Volusia, Wakulla, Washington
Charlotte, Glades, Hendry, Highlands, Martin
Regional School-based Sealant Pilot Project
Existing School Based Services Programs
Florida Department of Health School Based Pilot Programs
EscambiaSantaRosa
Oka
loos
a
Walton
Holmes Jackson
Washington
Bay
Gulf Franklin
Calhoun
Liberty
Gadsden
Leon
Wakulla Jef
fers
on Madison
Taylor
Hamilton
Suwannee
Lafayette
Dixie
Co
lum
bia
Baker
Nassau
Duval
Clay St. Johns
Alachua
Bra
dfor
d
Gilchrist
Levy
Putnam
Marion
Citrus Lake
SumterHernando
Flagler
Volusia
Seminole
Orange Brevard
OsceolaPasco
Hillsborough
PinellasPolk
Indian River
ManateeHardee
Highlands
Okeechobee St. Lucie
Martin
Palm Beach
SarasotaDeSoto
Charlotte Glades
Lee Hendry
Collier Broward
MonroeDade
Union
Legend-County without a Fixed CHD Dental Clinic Site (21 counties; 31.3% of the state) -County with at least one Fixed CHD Dental Clinic Site
Counties Without Fixed CHD Dental Clinics SFY2014-2015
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To protect, promote and improve the health of all people in Florida through integrated state, county, and community efforts.
Statewide School-based Sealant Program
• Expand school-based sealant programs from
current total of twenty-nine (29) programs in 31
counties to having school-based programs in
all 67 counties.
• Pursue dental hygienist workforce model in
Title I schools.
• Exploring additional funding options for school-based
preventive dental programs.
To protect, promote and improve the health of all people in Florida through integrated state, county, and community efforts.
Future Expansion of School-based Programs
•Seven additional counties are interested in developing school-based programs in 2015 (Alachua, Brevard, Holmes, Osceola, Okeechobee, Putnam, Sumter).•Identifying areas where regional programs are needed due to health professional shortages.•Develop a statewide database for reporting sealant program data.
Workforce (Innovation)Workforce (Innovation)
Dental Hygienists with school age Dental Hygienists with school age childrenchildren
Stay at home momsStay at home moms
Work school year / school hoursWork school year / school hours
DOH / OPS employeesDOH / OPS employees36
Winners !!!Winners !!!
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Winners !!!Winners !!!
State of Florida (out of last place…)State of Florida (out of last place…)
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Winners !!!Winners !!!
State of Florida (out of last place…)State of Florida (out of last place…)
MMAs (increased utilization rates)MMAs (increased utilization rates)
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Winners !!!Winners !!!
State of Florida (out of last place…)State of Florida (out of last place…)
MMA plans (increased utilization MMA plans (increased utilization rates)rates)
Kids in Florida (85% reduction in Kids in Florida (85% reduction in cavities )cavities )
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Contact InformationContact Information
Edward F. Zapert, D.M.D.Edward F. Zapert, D.M.D.
850-245-4328850-245-4328
To Protect, promote and improve the health of all people in Florida through integrated state, county and community efforts 41