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Meeting Date: 
Meeting Document Type: 
Information Report
Oral Health

Prepared By:

Kim Casier, Oral Health Manager, Oral Health Department

Date:

May 16, 2019

Subject:

Oral Health Screening, Assessment and Surveillance, Healthy Smiles Ontario (HSO) Program 2018

Background:

Dental decay (cavities) in children is an important public health issue. The current Oral Health Protocol (2018) provides direction on the delivery of oral health services, which includes oral screening, assessment and surveillance, and services offered through the Healthy Smiles Ontario Program (HSO) Program.

As per the protocol, all children in JK, SK and Grade 2 are screened by registered public health dental hygienists during the school year. The screening protocol requires the collection of the total number of primary and permanent teeth with decay (d+D).

Dental benefits for children and youth fall under provincial/territorial jurisdiction. Children in low-income families (whether on social assistance or not) are typically granted some level of support for accessing dental services. On January 1, 2016, Ontario’s six publicly funded dental programs for children were combined into the new Healthy Smiles Ontario (HSO) program. HSO is a government-funded dental program that provides free preventive, routine, and emergency dental services for children and youth 17 years old and under from low-income households. The services covered by this program may include exams and routine checkups, preventive services, extractions, fillings, and x-rays. This program does not cover cosmetic dentistry and braces.

Current Initiatives

Oral Screening, Assessment and Surveillance

During the 2017/2018 school year, 15,117 elementary children received a dental screening across 115 Windsor-Essex elementary schools (publically and privately funded). Screening is conducted by five teams, each team consisting of a registered dental hygienist and a certified dental assistant. Based on the screening results of the Grade 2 students at each school, the school is categorized into three levels of intensity: Low, Medium or High. Higher intensity levels require additional grades to be screened. The need for and the urgency of care is recorded and parents are advised of the required follow-up. As well indicators of previous dental caries (missing and filled) are recorded.  Of the 115 schools that participated, 27 (23.48%) were classified as high intensity schools, 17 (14.78%) were classified as medium intensity schools and 71 (61.74%) were classified as low intensity schools.

Approximately 91% of eligible students were screened in the 2017/18 school year. Reasons a student is not screened include: absence, exclusion by parent, or refusal to be seen on their own.

 

Total

Screened

Absent

Refused

Excluded

Abs+Ref+Exl

 

#

%

#

%

#

%

#

%

Grand Total

16601

15117

1030

6.20%

102

0.16%

352

2.12%

1484

8.93%

Other significant 2017/18 dental screening statistics include:

  • 1,984 (13.1%) children/youth had an urgent dental care issue/need; eligible for Healthy Smiles Ontario Program’s Emergency and Essential Services Stream (HSO-EESS).
  • 6,157 children/youth were clinically eligible for Healthy Smiles Ontario Program’s Preventive Services Only Stream (HSO-PSO).
  • 74% of JK students surveyed were found to be visually caries free.
  • 62% of SK students surveyed were found to be visually caries free.
  • 45% of Grade 2 students surveyed were found to be visually caries free.

WECHU Healthy Smiles Ontario Dental Clinics

Windsor Essex County Health Unit dental clinics are very busy. Our team of dental hygienists and dental assistants provide dental screenings, topical fluoride treatments, dental sealants, scaling (cleaning) and oral hygiene instruction. In 2018:

  • 2,308 children/youth received a dental screening at one of our HSO dental clinics (Windsor and Leamington). 
  • 1,212 children/youth had an urgent dental care issue/need; or were eligible for HSO-EESS.
  • 798 children/youth were enrolled in the HSO-PSO (preventive services only) program.
  • 1,730 children/youth received PSO (preventive services only) clinical services in our WECHU dental clinics.
  • 734 children/youth received 1634 dental procedures completed by our clinic dentists

There are currently four dentists contracted to work in our HSO dental clinics. Dr. Azza Al-Ryahi works Mondays in our Leamington clinic and Tuesdays in our Windsor clinic. Dr. Robert Trajkovski works in the Windsor clinic on Friday and Dr. Thomas Oper, pediatric dentist, recently joined our clinics in October 2018. Dr. Oper works with us on Wednesday and Thursday mornings.  We currently have an Arabic speaking dental hygienist and dentist working in our HSO clinics.

Baby Oral Health Program (BOHP)

The Canadian Dental Association recommends a dental assessment for infants within six months of their first tooth appearing and no later than one year of age. Our Windsor-Essex County Health Unit also supports the establishment of a dental home by one year of age. The rationale of this program focuses on early professional intervention to provide a dental screening, risk assessment and anticipatory guidance for parents, so that early childhood cavities can be prevented.  In 2018, 265 children received a BOHP screening at one our HSO dental clinics.

Consultation:

The following individuals were contributed to this report:
Mathew Roy, Epidemiologist

Approved by:

Theresa Marentette