Oral Health



Oral Health

What is it?

Oral health is based on two different indicators. Tooth decay refers to the percent of children with suspected dental caries (treated and untreated) as identified by a dental hygienist during school screening programs out of the total number of children screened. Visiting the dentist refers to students who self-reported visiting the dentist at least once a year as part of the Student Survey.

Why is it important?

Oral health can significantly impact overall physical health as well as social and psychological dimensions of well-being. Tooth decay can also lead to further gum, mouth and other systemic health problems including diabetes, respiratory disease and heart disease. Regular dental care, proper oral hygiene and a healthy diet can help reduce the risk of tooth decay. Access to dental care can be influenced by socio-economic barriers.

What does it mean?

Oral health disparities are apparent in Toronto. Figure 1 shows that the percent of tooth decay varies greatly by school. Figure 2 shows that newcomer students were significantly less likely to visit the dentist, compared to Canadian-born and longer-term immigrant students. There was no significant difference between longer-term immigrant and Canadian-born students.

Figure 1: Percent of students with tooth decay by school, Grades K to 8, Toronto, 2013/2014

Map_Decay2013_1pagercropped
Data Notes
Calculation
Numerator: Number of children with tooth decay (i.e. decayed, missing or filled teeth)
Denominator: Total number of children screened by the school screening program

Figure 1
Sources:
Numerator – Oral Health Information Support System 2013/2014, Ontario Ministry of Health and Long Term Care, Date Extracted: April 2015.
Denominator – Oral Health Information Support System 2013/2014, Ontario Ministry of Health and Long Term Care, Date Extracted: April 2015.

  • This indicator does not provide information about how much of the tooth decay was treated (filled) or untreated.
  • While OHISS does allow for detailed collection of decayed, missing and filled (DMF) reports, due to limitations on screening resources and the large number of children in Toronto, this information is not routinely captured.
  • Tooth decay that is suspected by a hygienist during screening may not correspond to diagnosed tooth decay by dentists. Given restrictions of screening programs (i.e. limited time to screen, resources available, etc.), there may false positives and false negatives for tooth decay within this data source.
Figure 2
Sources:
Numerator – Oral Health Information Support System 2013/2014, Ontario Ministry of Health and Long Term Care, Date Extracted: April 2015.
Denominator – Oral Health Information Support System 2013/2014, Ontario Ministry of Health and Long Term Care, Date Extracted: April 2015. Income – Ontario Ministry of Education, Education Opportunities Index 2013/2014, Date Extracted: July 2016.

  • While OHISS does allow for detailed collection of decayed, missing and filled (DMF) reports, due to limitations on screening resources and the large number of children in Toronto, this information is not routinely captured.
  • Tooth decay that is suspected by a hygienist during screening may not correspond to diagnosed tooth decay by dentists. Given restrictions of screening programs (i.e. limited time to screen, resources available, etc.), there may false positives and false negatives for tooth decay within this data source.
  • Since OHISS does not provide record-level data about children, including postal code, area-level analysis was completed using the socio-economic status at the level of schools. As part of their Education Opportunities Index, the Ministry of Education uses student postal codes and income data from tax files to estimate the percent of people living below the percentage of families with income below the After-Tax Low Income Measure (AT-LIM) that have school aged children for each school. Schools were then grouped into 5 equal groups (quintiles), with schools with more children living in neighbourhoods with more low-income individuals being the "Lowest Income" quintile.
Calculation
Numerator: Number of students who reported visiting the dentist at least once a year
Denominator: Total number of students who were surveyed

Figure 3
Source: Numerator & Denominator – Toronto Public Health. Student Survey Questionnaire. 2014.

  • Immigrant status was measured by student self-report. Students were asked if they were born in Canada and if not, how old they were when they arrived in Canada. The number of years in Canada was then derived based on the student's reported age. Newcomer students were those who had lived in Canada for 5 or fewer years. Longer-term immigrant students were those who had lived in Canada for 6 to 10 years.
  • Significant differences were estimated using overlapping 95% confidence intervals estimated using the Normal distribution. Although this method is conservative and most appropriate when comparing mutually exclusive groups, it was chosen as an objective means of making conclusions on population-based data.