Oral Health in Early Childhood One Communitys Story

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Oral Health in Early ChildhoodOne Communitys
Story

• Andrea Chiasson, MPH, RD and Margaret Perry, RDH,
  MBA

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Collaborative effort
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Dental Caries

• Most common chronic disease of childhood
• Infectious
• Preventable
• If decay is left untreated, there are
  consequences

serious!
Some children learn to live with the constant
pain of rotting teeth and swollen gums. They go
to sleep with it. They go to school with it. It
affects their energy levels and even their
self-esteem.
Jonathan Kozol, Savage Inequalities Children in
America's Schools
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Oral Health Trends

• For most Americans, oral health has improved,
  but
• Increased dental caries in primary teeth of
  youths aged 2-5 years
• Minority and low income children still have
  higher rates
• 31 Mexican American vs 19 non-Hispanic white
• 3X as many children from families below FPL vs
  children from families above (12 vs. 4)

CDC Report on Trends in Oral Health Status,
1988-1994 and 1999-2004
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Caries Experience Percent of kindergarten
students with dental caries (tooth decay)
experience
National Problem
25-49
50-74
National Oral Health Surveillance System (NOHSS),
www.cdc.gov/nohss
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Oral Health In Arizona

• Survey of preschool children
• 35 of 3 year olds
• 49 of 4 year olds have dental decay

ADHS, Office of Oral Health (1994-95)
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Decay in Arizona Children
ADHS, Office of Oral Health 2004
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Caries-risk Assessment
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We had to do something

• Coalition
• Research
• Previous pilot with local HeadStart
• Other State Programs

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Why the Childcare Center?

• Increasing number of children in out-of-home
  care
• Centers were enrolled in quality enhancement
• Oral health recognized as a integral component of
  quality
• Captive audience

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Target the Center

• Increase awareness
• Importance of oral health and primary teeth
• Nutritional connection
• Train and Educate
• Child care providers
• Parents and children
• Interventions
• Toothbrushing Program
• Screening and Referral
• Fluoride Varnish

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ORAL HEALTH IN EARLY CHILDHOOD

• TRAINING CURRICULUM AND GUIDELINES FOR
• EARLY CHILD CARE PROVIDERS

ADHS, Office of Oral Health
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Passing cavity-causing germs to baby
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What do you see?
Lift the Lip
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White Spots or Pre Cavities
Before this...
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Food Factors

• How often?
• How sticky?
• How much sugar and acid?

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Teeth Friendly Diet

• Avoid nibbling or grazing
• Avoid meals and snacks that are only processed
  carbohydrates and sugars
• Combine foods

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• First dental visit by first birthday

• Education
• Prevention
• Detection of early cavities
• Prompt treatment

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Starting a Tooth Brushing Program

• To improve the oral health of children

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Caring for toothbrushes

• Toothbrushes should dry between uses
• Put childrens names on brushes
• New toothbrush every 3-4 monthsor
• if child is sick colds or flu and especially
  strep throat

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Encourage Childcare Centers to.

• Serve healthy snacks at appropriate times
• Provide fluoridated drinking water if possible
• Begin a brushing program or swish and swallow
  routine
• Look in the childrens mouths to observe changes
  and inform the parents if anything looks
  suspicious
• Help parents find dental care

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Early Intervention

• Oral Health Screening
• Referral to dental services
• Fluoride Varnish Application

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Basic Screening Survey (BSS)

• Standardized screening
• Association of State and Territorial Dental
  Directors (ASTDD)
• Adults, School-Aged and Preschool Children
• Used across the country in public health for data
  collection

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Our Project Population

• Ages 0 5 years
• 78 Hispanic
• 81 have dental insurance
• 30 had never seen a dentist

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Decay Status
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Drinking Water Source
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Finding dental care for children under three

• Other parents
• State Medicaid plans
• State or county health departments
• Community dental clinics
• Local dental or dental hygiene schools
• State or local dental or dental hygiene
  associations

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Fluoride

• Evidence-based for preventing, arresting and even
  reversing dental caries
• Systemic water and supplements targeted to
  teeth as they are forming.
• Topical foams, gels, rinses, and now varnishes
• Young children unable to swish and spit so no
  fluoride until 6 years this has been a
  problem!

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Helpful things to know..

• Ask parents or experts what they perceive are the
  barriers (if any )
• Know what your Medicaid and SCHIP programs cover
  for dental and when they start.
• Know which dental professionals accept Medicaid
  and SCHIP
• Know which dental professionals see young
  children in your communitygeneral vs. pediatric
  dentists, are hygienists able to practice outside
  the dental office?
• Know the fluoride status of your water
  www.cdc.gov

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Questions?
Good oral health in childhood means better oral
health for life!
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Thank You
Arizona Department of Health Services, Office
of Oral Health 602-542-1866
www.azdhs.gov
Contact information Margaret Perry, RDH, BS,
MBAPima County Health Department
margaret.perry_at_pima.gov