Bright Futures: Oral Health in Childcare

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Bright Futures Oral Health in Childcare

• Joseli Alves-Dunkerson, DDS, MPH, MBA
• Peg Terp, MPH
• LeeAnn HoaglinCooper, BS, RDH

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BRIGHT FUTURES

• National Perspective

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We need to do a better job of weaving a safety
net of understanding, appreciation and guidance
in the family, in the community and school. We
need to start thinking of health and education as
interlocking spheres.

• C. Everett Koop, M.D.Former Surgeon GeneralU.S.
  Public Health Service

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Bright Futures Support

• American Academy of Pediatrics
• Am. Academy of Pediatric Dentistry
• Am. Dental Hygienists Association
• American Dietetic Association
• NAPNAP
• American Public Health Association
• American School Health Association
• American Nurses Association
• National Center for Health Education

• Association of MCH Programs
• National Assembly for School-based Health Care
• National Association of School Nurses
• National Association of WIC Directors
• National Mental Health Association
• Society of Adolescent Medicine
• American Medical Association
• and many more

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What Is Bright Futures?

• Bright Futures is a
• Vision
• Philosophy
• Set of Expert Guidelines
• Practical Developmental Approach to Providing
  Health Supervision

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Bright Futures is a Vision

• Every child deserves to
• be healthy
• experience joy
• have self-esteem
• have caring family friends
• believe s/he can succeed in life
• a Bright Future

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Bright Futures is a Philosophy

• Optimal health for all children requires
• Trusting relationships between health
  professionals, the family, and the child
• Collaborative community partnerships

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Bright Futures Core Concepts

• Prevention Works
• Families Matter
• Health is Everyones
• Business

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Prevention Works

• Fluoridation
• Sealants
• Child Safety Seats
• Immunization
• Back to Sleep
• Bicycle Helmets
• Home Safety

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Families Matter

• Partnership with the Family
• Families as partners
• Families as caregivers
• Families as teachers
• Families as resources

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Community Partnerships

• Local health jurisdictions (LHJs)
• Local oral health coalitions
• Dental providers
• Families
• Community Centers
• Schools
• Early Childhood Programs
• Child Care

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Bright Futures Materials for Professionals
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State Perspective

• Provide consistent and effective oral health
  messages for local programs

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Bright Futures Oral Health
Bright Futures OH
Tooth Tutor
Foundation
Local Coordinators
Expertise
MCH-related programs
Customers
DOH, UW, MCH programs, associations, parent groups
Reviewers
Results
Families getting the same OH messages wherever
they go
Community reps on the same page in terms of OH
OH education fact sheets available online
Increased awareness of oral health
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WA State BF OH Subgroups

• WIC
• CSHCN
• First Steps/NPF
• HS/ECEAP/Childcares
• Tooth Tutor/Schools
• Adolescents
• Child Profile

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Bright Futures

• Oral Health for Childcare Programs
• LeeAnn Cooper, RDH
• Peg Terp, MPH

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Why Are We Here?

• We want childcare programs to promote effective,
  safe and healthy oral health practices at school
  and at home.
• We want children to be Cavity Free by
  Kindergarten!

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What Are We Going To Do Today?

• Review basics in causes and prevention of tooth
  decay
• Develop an understanding of how oral health
  education can be integrated in childcare programs
• Share our guideline and materials to promote oral
  health

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Is Tooth Decay a Problem? YES!

• Preschool children
• (HeadStart, 2000 SMILE Survey)
• 41.5 have had cavities or fillings
• National goal 11
• 2005/HP2010 Health Objectives

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Key Principles
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Tooth decay is a bacterial Infection

• Plaque Germs
• Sugar bugs

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We get bacteria from our primary caregiver.
Li Y, Caufield PW, J Dent Res 199574681-5.
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Plaque is the film that grows on our teeth.

• Contains different bacteria
• Can be reduced by toothbrushing

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Nutrition

• Healthy food for healthy bodies and teeth!
• Amount
• Texture
• Frequency!

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Regular meals and snacks

• Regular Meals
• Regular Meals plus Grazing
• Prolonged bottle feeding, sippy cups, etc.

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Breakdown and Repair
Eat carbohydrate
Repair
Tooth begins to break down
Rebuilds the tooth
Fluoride is available in paste and water
Fluoride combines with calcium
Fluorides in caries prevention. Wright, Boston,
1991 p 295-323.
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Fluoride

• Decreases the breakdown of teeth
• Increases the repair of the teeth

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Fluoride works best

• Available in small daily amounts
• drinking water
• twice daily in toothpaste

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Visits to the Dentist

• Stop decay BEFORE you see it
• High strength fluoride
• Preventive care, as needed
• Fills holes and cavities
• Reduce bacterial infection
• Emergent care, if needed

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New things to watch for

• Xylitol
• Chlorhexidine
• Fluoride varnish

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What Childcare Providers can do?
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Bright FuturesGuide for Oral Health in
Washington State
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• Review activities
• 2. Oral Health Action Plan
• Example We will record the name/phone of every
  childs dentist on our health record.
• Measure your current status
• Example Count the number of children that have
  had a dental examination at the beginning of the
  year
• 4. Oral Health Training for staff and families
• 5. Routine Oral Health Activities
• 6. Repeat measures to evaluate outcomes.
• Example Count the number of dental exams at the
  end of the year, and also from year to year.

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Ask parents about

• Prevention
• What they are doing to prevent tooth decay on
  their children?
• Access
• Do families AND children have a dental provider?

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Prevention fluoride and risk assessment

• Fluoride
• Do children have access to fluoridated water at
  home or school?
• History of decay
• Do parents or children have a history of tooth
  decay?

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Prevention Toothbrushing in Childcare

• Toothbrushes
• Labeling
• Cleaning
• Replacement
• Storage
• Buy it or make it

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Prevention Classroom Toothbrushing Management

• Passing out the brushes
• Toothpaste
• Dispensing
• Techniques
• Introduction
• Sink Method
• Table Method
• Swishing and spitting
• Rinsing and storage

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Prevention Nutrition Planning

• Two component snacks
• Water with meals and snacks
• Thirsty? Offer water first!
• Sit down for meals and snacks
• Fresh, frozen or canned fruits and vegetables
• Others

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Access Dental exams and Dental screening

• Dental Homes
• Mobile Dental Programs

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Access insurance, dental provider

• Registration
• Dentist?
• Insurance?
• Health (DENTAL) History
• Consents

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Access Share Dental Resources

• Dental homes
• Build a relationship with local providers
• Learn about available resources
• CHAP
• Snohomish County Dental Resources
• DOH Oral Health Program website how to find
  dental care

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Access Track Dental Needs

• 90 day enrollment
• Recommended treatment
• Watch for child behaviors
• Recommended check ups for prevention
• 1st dental checkups beginning at age one!

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Access Dental emergencies

• Post dental emergency procedures
• Toothaches
• Falls and bumps
• Cuts or bites(tongue)
• Knocked out permanent tooth
• Celebrate growing up
• Lost baby tooth

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Planning and Writing Your Oral Health Program
A curriculum is a written plan for your program.
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Structure for pre-school

• Circle Time
• Story Time Book List/Song List
• Center Time
• Room Environment
• School to Home

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Topics/Concepts

• Visiting the Dentist
• Keeping Teeth Healthy
• Plaque
• Toothbrushing
• Fluoride
• Tooth decay
• Importance of Baby Teeth
• Nutrition and Oral Health

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Resources
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Discussion