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Indian Health Service The Federal Health Program for American Indians and Alaska Natives


     Indian Health Manual
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Part 3, Chapter 2:  Manual Appendix 1

Objectives

The following objectives are established in support of the health and service goals and the enterprise objective of the dental program.

  1. Objectives to Support Health Goal.  As a means of reaching the health goal the following long range objectives are specified for achievement by the year 2000.

    1. Health Status

      1. Dental caries.  Decrease to 45 percent the proportion of 6-8 year olds who have experienced dental caries in primary or permanent teeth.  (Baseline in 1983-84: 92 percent for primary and 52 percent for permanent teeth)

        Decrease to 70 percent the proportion of adolescents age 15 who have experienced dental caries in permanent teeth.  (Baseline in 1983-84:  93 percent)

        Decrease untreated dental caries to a prevalence of no more than 35 percent among children ages 6-8.  (Baseline in 1983-84:  64 percent)

        Reduce untreated dental caries to a prevalence of no more than 40 percent among adolescents age 15.  (Baseline in 1983-84:  84 percent)

      2. Periodontal Disease.  Decrease destructive periodontal disease to a prevalence of no more than 20 percent among American Indians ages 35-44.  (Baseline in 1983-84: 35 percent in those over age 35-44 have destructive periodontal disease.  The U.S. baseline was 14 percent in 1985-86.)
      3. Oral Cancer.  Reduce oral cancers to an incidence of no more than 40,000 per males and and 18/100,000 for females.  (Baseline: No specific data available for AI/AN.  The U.S. rate is 51.4/100,000 for males and 20/100,000 for females.  Among black men and women the rates are 71 and 22, respectively.)
      4. Edentulousness.   Reduce to no more than 25 percent the proportion of persons ages 65 through 74 who have lost all their natural teeth.  (Baseline:  No specific data available for 65-74 year old AI/AN.  26 percent of AI/AN ages 55 and older were edentulous in 1983-84.  For U.S. 30% of those ages 65-74 were edentulous in 1986.  Among low income people in the U.S., the prevalence was 41 percent.)

        Increase to at least 45 percent the proportion of dentate people ages 35-44 who have never lost a permanent tooth to caries or periodontal disease.  (Baseline: No specific data available for 35-44 year old AI/AN. For the U.S., 31 percent had not lost a permanent tooth for any reason in 1986.)
    2. Risk Reduction.  Increase to 75 percent the proportion of the people served by public water systems that contain optimal levels of fluoride.  (Baseline:  In 1990 43 percent.)

      Increase to at least 85 percent the proportion of those under age 20 who do not live in communities with optimally fluoridated water who receive other appropriate professionally or self-administered topical or systemic (dietary) fluorides.  (Baseline:  In 1990 > 50 percent.)

      Increase to at least 80 percent the proportions of children ages 8 and 14 who have received protective sealants on the occlusal surfaces of permanent molar teeth.  (Baseline:  In 1990 - 77 percent.)

      Reduce smokeless tobacco to a prevalence of 10 percent among Indians ages 18-24.  (Baseline:  18.5 percent in 1987.)

      Reduce cigarette smoking to a prevalence of no more than 20 percent among Native Americans 20 years of age or older.  (Baseline:  42-70 percent in 1987.)
    3. Public Awareness.  Increase to 75 percent the proportion of 17 year olds who know the primary methods for preventing and controlling dental caries, gingivitis, periodontal diseases, oral soft tissue lesions and oral cancer.  (Baseline:  target for 1990 was 50 percent.)

      Increase to at least 65 percent the proportion of parents and caregivers of American Indian children who know bottle-feeding practices that prevent baby bottle tooth decay.

  2. Objectives to Support Service Goal.  As a means of reaching the service goal, the following long range objectives are specified:

    1. Services and Protection.

      Access to care:  60 percent of the population eligible for care from the IHS will be able to gain access to dental services and receive 80 percent of the services required and desired.

      Increase to at least 90 percent the proportion of children entering school programs for the first time (e.g., Headstart, pre-kindergarten, kindergarten or first grade) who either have or will within 12 months of entry receive an oral health screening and followup for necessary services.  (Baseline:  in 1989:  80 percent.)

      Increase to at least 25 percent the proportion of Indian people ages 50 and older using the oral health care system on a regular basis.  (Baseline for U.S. was 50 percent in 1986.  Approximately 12 percent of Native Americans 50 years and older received dental care in the previous 12 months in 1988.)

      Increase to at least 95 percent the proportion of infants with cleft lips and/or palates diagnosed and recorded within 2 weeks of birth and enrolled in an ongoing system of oral health care.  (Baseline:  No specific data available for AI/AN.  For the U.S. 65 percent in 1986-88.)


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