Oral Health Initiatives
(Prevent Abuse and Neglect through Dental Awareness)
The American Dental Association National survey of dentists concerning child abuse and neglect prompted a survey by Oral Health Program Director, Dr. Jim Sutherland of Louisiana Dentists and Hygienists attending a state dental conference during August, 1996. Of those surveyed, approximately 85% indicated a need for further education as it relates to child abuse and neglect Dr. Sutherland has made the P.A.N.D.A. program development one of three initiatives for FY 1996-1997. The program addresses National Healthy People 2000 Objectives and MCH Block grant objectives.
A coalition of state-wide organization has been formed including: Louisiana Children's Trust Fund, the Louisiana Dental Association and its Alliance, the Louisiana Academy of Pediatric Dentistry, the Louisiana Dental Hygiene Association, the Louisiana Council on Child Abuse, American Society of Dentists for Children, Office of Community Services/Department of Health and Hospitals and Oral Health Program/Office of Public Health. Dr. John Barnett, current president of the Louisiana Academy of Pediatric Dentistry is coordinating efforts to establish a program in Louisiana. A grant has been awarded from the LA Children's Trust Fund to initiate the program in Louisiana. The Louisiana Dental Association will also be providing support in developing the materials for the program. Dr. Jim Sutherland working with the OCS should be able to track Dentists within the state for the first time to facilitate program outcome measures.
Jim Sutherland, DDS, MPH & T. Jay Ray, M.S.
The detail assignment of United States Public Health Service Commissioned Corps Officer, Dr. Jim Sutherland on August 23, 1995 to the Maternal and Child Health Section of the Office of Public Health in Louisiana demonstrates a commitment by OPH to reestablish the Oral Health Program in Louisiana. With program funding removed during the mid 1980's from the previous Dental Program, Dr. Sutherland is charged with conducting an oral health needs assessment and planning an oral health program. A core function of dental public health is needs assessment. This function is one in which Dr. Sutherland is actively engaged and devoting a large percentage of his time.A preliminary assessment by Dr. Sutherland and Mr. Jay T. Ray, indicated a downward or negative trend in Louisiana's community water fluoridation program.
While the Louisiana Office of Public Health's fluoridation program was active in the early eighties, staff was able to initiate fluoridation in 73 community water systems. The 73 systems served 1,949,715 people which represented forty-four percent (44%) of the State's population. Another 116 communities had naturally occurring fluoride levels of 0.7mg/l or greater. The population served by these 116 systems was 354,941 which was about eight percent (8%) of the state population.
In 1986 there were 189 (14%) community systems (municipalities, water districts, mobile home parks, subdivisions) serving fluoridated water to fifty two percent (52%) of the state's population that was either natural or adjusted. Today in 1996, ten years later, there are still the same 116 communities with natural fluoride. However, only 45 of the original 73 systems are continuing to adjust their fluoride content to the optimum level with no additional communities initiating fluoridation (Map 1). The loss of 32 fluoridating systems has resulted in 103,846 less people receiving the benefits of community water fluoridation. Consequently, the percentage of the state's community fluoridation beneficiaries has declined from 52 percent to 49.5 percent in the last ten years. National Healthy People 2000 Objectives call for 75 percent of community water systems to be optimally fluoridated (1). In Louisiana, there are 35 community water systems that serve 10,000 or more people that currently do not adjust water fluoride levels that could benefit from water fluoridation (Map 2).
Much effort has been put forth by Dr. Sutherland to begin to reverse this downward trend. Mr. T. Jay Ray (OPH Laboratory Services) was assigned for a 30 day detail to look at the overall community water fluoridation program and make recommendations to Dr. Sutherland. These recommendations include reestablishing an active surveillance and monitoring system that closely follows Centers for Disease Control and Prevention current guidelines for community water fluoridation systems (2) as well as conducting a more thorough technical assessment of systems currently fluoridating and those that have recently fluoridated but have discontinued fluoridation.
The Office of Public Health in the midst of budgetary cutbacks and a freeze on hiring, is pursuing adding an additional staff person to manage the state fluoridation program. Community water fluoridation is not regulated by the EPA like other facets of the community water system. The Oral Health program within the Office of Public Health is committed to assuring the integrity of the fluoridation program and look forward to once again promoting community water fluoridation.
1) Healthy People 2000 National Health Promotion and Disease Prevention Objectives. U.S. Department of Health and Human Services, Public Health Services. DHHS Publication No. (PHS) 91-50213.
2) MMWR Engineering and Administrative Recommendation for Water Fluoridation, 1995, September 29, 1995, Vol.44, No. RR-13.
Maternal and Child Health, Oral Health Program, 325 Loyola Avenue, Room 612, New Orleans, LA, 70112
For
more information contact: jsutherl@dhhmail.dhh.state.la.us
