State Sets Goals to Improve Oral Health, Already Third in the Nation

Connecticut ranks third for overall dental health in the nation, but there are still people who are at risk in the state, based on age, income, race, ethnicity, or education, among other demographic characteristics. Oral health is essential to overall health and quality of life, according to experts in the field, who point out that oral health is closely linked to physical health and well-being. Having good oral health means being free of gum disease, tooth decay, and tooth loss; as well as oral cancer, infection, and pain, officials note. That is because all may limit one’s ability to chew, bite, smile, and speak properly. Pre-term births and chronic conditions, such as diabetes, heart disease, lung disease, and stroke, are also associated with poor oral health, data indicates. 

Looking ahead to determine the steps to take on a statewide basis, the Connecticut Department of Public Health (DPH) contracted last May with the Connecticut Oral Health Initiative (COHI), to develop and write the state oral health improvement plan. An advisory committee of experts assessed the needs, available resources and gaps related to the oral health of all populations, and formulated focus areas, goals, objectives, strategies, and identified potential partners.

The report, now complete, is the Oral Health Improvement Plan for the State of Connecticut, 2019-2024.  Over 60 interested parties submitted comments, recommendations and data resources. The data in this plan were taken from surveys and studies conducted in Connecticut. Throughout the process, COHI collaborated with DPH's Office of Oral Health, used a "health equity lens" to address oral health disparities, and ensured that the objectives were measurable.

The framework of the plan includes four focus areas - prevention, access and utilization, medical and dental integration, and data collection and analyses. The plan goes on to outline 16 objectives, suggested strategies, and potential partners. It is intended to “guide efforts of state and community programs that are dedicated to ensuring access to oral health services for all residents; regardless of race, ethnicity, education, or class background,” wrote State Health Services Commissioner Raul Pino M.D, M.P.H. in the report’s forward.

The four goals determined through the process that provide the framework for the report’s recommendations:

  1. Reduce the incidence of oral disease among Connecticut populations by use of  evidence-based preventive interventions.
  2. Ensure access to, and utilization of, quality, comprehensive, and continuous oral health care for all Connecticut residents, particularly at-risk populations.
  3. Increase integration of dental and medical health care systems, policies, and programs.
  4. Collect and analyze oral health data to measure outcomes and inform decisions to improve the health of Connecticut residents.

In the prevention area, the report determined four objectives:

  1. Reduce to 35%, the proportion of Connecticut children in third grade who have dental caries (tooth decay) experience in their primary or permanent teeth.
  2. Increase by 10%, the proportion of Connecticut third grade children who receive dental sealants on at least one of their permanent molar teeth.
  3. Reduce to 0%, the five-year rate change in the incidence of Connecticut residents who experienced oral and/or pharyngeal cancer.
  4. Maintain Connecticut’s statute for community water fluoridation

In the access and utilization category, the recommendations included:

  • Reduce to 14%, the proportion of Connecticut third grade children with untreated dental decay.
  • Increase to 31%, the number of Connecticut schools with 50% or greater participation in Free and Reduced Meals (FARMs) in which dental services are provided.
  • Increase by 5%, the proportion of Connecticut children and adults who had a dental visit in the past year.
  • Reduce by 5%, the proportion of Connecticut older adults who attend congregate meal sites who have untreated dental decay.
  • Reduce by 5%, the proportion of Connecticut older adults in long-term care sites who have untreated dental decay.
  • Increase by 5%, the proportion of Connecticut older adults who have dental benefits.

In medical/dental integration, the report set as the state’s goals:

  1. Increase by 10%, the number of Connecticut’s federally-qualified health center (FQHC) locations that offer dental services.
  2. Increase by 5%, the proportion of Connecticut HUSKY Health primary care providers who include an oral health assessment in child wellness visits.
  3. Increase by 5%, the proportion of Connecticut HUSKY Health children under the age of 6 who received fluoride applications by a primary care provider in the past year.
  4. Implement diabetes pre-screening and referral to a primary care provider in at least five Connecticut FQHC dental programs.

The report also called for incremental change in the area of data collection and analysis, including increasing to fifteen the number of data sources and indicators that are collected, analyzed, interpreted, and disseminated; and increasing to three the number of Connecticut agencies and organizations - beyond State Agencies - that implement a health equity checklist to inform oral health policies and programs.