Shellie Harden DDS MPH Illinois Department of Human Services Permission given to photocopy slides from Oral Health Training for Health Professionals 2004 by National Maternal and Child Oral Health Resource Center Georgetown University ID: 741291
Download Presentation The PPT/PDF document "Oral Health Program for Early Childhood ..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Oral Health Programfor Early Childhood Home Visiting Programs
Shellie Harden, DDS, MPHIllinois Department of Human ServicesPermission given to photocopy slides from Oral Health Training for Health Professionals. © 2004 by National Maternal and Child Oral Health Resource Center, Georgetown University.Slide2
Training Objectives
Enable Home Visitors to:Understand & explain the importance of good oral health for mothers and babies.Understand and address existing barriers to receiving oral health care.Identify risks for Early Childhood Caries (ECC). Discuss appropriate preventive practices for moms, infants, and young children and increase knowledge of caries prevention.Identify ways to educate families on good oral health & resources for dental care.
Conduct an oral health risk
assessment and document education and referrals to a dental home.Slide3
The Importance of Good Oral Health in Moms
Good oral health in pregnancy and after:can help prevent complications of dental diseases during pregnancy.may reduce preterm and low birth weight deliveries (by preventing the progression of periodontal disease).has the potential to decrease ECC in mom’s children.Slide4
The Importance of Achieving and Maintaining Good Oral Health in Infants and Children
Caries is the most common chronic childhood disease.More common than asthma and hay fever in children (Oral Health in America: Report of the US Surgeon General, 2000)Expensive, painful, and disruptive to growth if left untreatedSlide5
The Importance of Good Oral Health in Infants and Children
Primary teeth are important to overall facial structure and physical development.Healthy primary teeth ensure proper chewing and speech development.Healthy teeth reduce or eliminate the pain associated with pain from tooth decay (decreases school absenteeism).Health primary teeth maintain the space in the dental arch, until the permanent teeth erupt, and decrease the risk for tooth decay in the permanent teeth.Slide6
Addressing Barriers to Oral Care for Mom-to-Be
First, dispel the myths about oral health during pregnancy for expectant moms.Identify individual barriers preventing mom-to-be from receiving dental care during pregnancy and take the time to educate her.Slide7
Preventive Practices for Mom (at Home)
Brush teeth at least twice a day (especially before bed) using a Fluoride toothpaste.Try to floss daily… ***Chew Xylitol gum daily and after meals.Drink Fluoridated water and make healthy food choices.If you smoke, stop!Slide8Slide9Slide10
Preventive Practices and Professional Dental Care for Mom
General guidelines for dental care in pregnancy:Same standard of care as general population after 1st trimesterBest time between 4th and 6th monthDental emergencies creating severe pain can be treated during any trimester.Lidocaine w/epinephrine can be used safely (w/proper aspiration) during pregnancy.Avoid elective x-rays. If x-rays are needed for diagnostic purposes (dental emergency), then they can be done with protection. Slide11
Tooth Development and Identifying Risks for Early Childhood Caries (ECC)Slide12Slide13Slide14Slide15
Bacterial Transmission and ECC Risk
Bacterial transmission from adult to child via salivaOther Modes of Transmission:Child fingers in adult mouthAdult tests bottle temperature with mouthAdult shares utensils with childAdult cleans pacifier with mouthPoor oral hygiene in mothers and childrenActive decay in mom or primary caregiver within 12 monthsBedtime bottles with juice, milk, or other sugary drinksSlide16Slide17Slide18
Preventive Practices for Infants
Clean infant gums with a damp cloth, after feedings, even before tooth eruption.Brush teeth 2-3 times a day (especially before bed), as soon as the first tooth erupts.
First
dental
exam by 12 months, but preferably as soon as first tooth erupts (American Association of Pediatrics and American Association of
Pediatric Dentistry)Slide19
Preventive Practices for Infants and Dietary Practices
Breastfeeding decreases risk of developing tooth decay compared with bottle feeding. Children who breastfeed for long periods throughout the day or night may develop tooth decay. To reduce sugary fluids from pooling around the teeth, remove child from the breast when finished feeding.Wean from bottle by 12-14 months when more solid foods are consumed and baby is drinking from a cup.Introduce small cup when child can sit up without support.Water or milk between meals, with no more than 4-6 oz of 100% fruit juice per day (ages 1-5)Slide20
Anticipatory Guidance for Infants and Other Prevention Practices
Water only in bottle at bedtime Do not dip pacifiers in sweetened foods.No prolonged bottle feedingsOther practices: clean pacifier, favorite blanket, reading baby to sleepNo saliva sharing habits (e.g., sharing utensils, cleaning pacifiers w/mouth)No more
than 4–6 ounces of 100 percent fruit juice per dayFoods w/sugar only at mealtimes and limit amount
No added cereal in the bottleSlide21
Preventive/Hygiene Practices for Young Children (Age >2)Similar tooth brushing tips as w/infants, except use pea-size amount of Fluoridated toothpaste
Young children do not have fine motor skills to brush adequately, so use hand-over-hand guidance or brush the child’s teeth again.Slide22
Toothpaste Amounts
“Smear”Ages 2 and Under“Pea Size”Over Age 2Slide23Slide24
Preventive/Hygiene Practices for Children and Topical Fluoride
Topical Fluoride effective for children at high risk for decay if they live in area w/o fluoridated H2O or have history of tooth decay.Use if the child frequently snacks on foods with high sugar content, or has a mechanical condition that makes them susceptible to decay.Topical Fluoride is effective with minimal cost but should never be swallowed.Almost all toothpaste sold in the US is fluoridatedCan also be applied as a varnish=a pale yellow topical Fluoride gel that’s “painted” on the teethProfessionally applied varnish preferred for young children because it’s better tolerated and less likely to be swallowed. Slide25
Preventive/Hygiene Practices for Children and Dental
Sealants< 1/3 of children in the U.S. have sealants on their teeth.Protect the chewing surfaces of the molar teethPlacement is best soon after eruption (6 year and 12 year molars)Slide26Slide27
Discussion Questions:
A pregnant mother tells you that between taking care of her two children (ages 5, 2 years) and working full time, she doesn't have time to brush her teeth, let alone floss.The dad of a 6 month old says that he wants to help take care of his son’s teeth but doesn’t know how or when to start.A mom of a 22 month old says that she’s concerned because her son throws tantrums whenever she tries to brush his teeth.What do you do? Slide28
Role of the Home Visitor in Assessing Oral Health Oral Health Risk Assessment of mom and baby
Engage in Motivational Interviewing (from NC Headstart, https://vimeo.com/84873378)Provide education on oral hygiene, diet, dental care, and anticipatory guidanceSlide29
American Academy of Pediatric Dentistry Risk Assessment Tool Questions
High Risk Factors
Moderate Risk Factors
Protective Factors
Biological Factors
Mother/primary caregiver has active cavities
Yes
Parent/caregiver has low socioeconomic status
Yes
Child has >3 between meal sugar-containing snacks or beverages per day
Yes
Child is put to bed with a bottle containing natural or added sugar
Yes
Child has special care needs
Yes
Child is a recent immigrant
Yes
Protective Factors
Child receives optimally-fluoride drinking water or fluoride supplements
Yes
Child has teeth brushed daily with fluoridated toothpaste
Yes
Child receives topical fluoride from heath professional
Yes
Child has dental home/regular care
Yes
Clinical Findings
Child has white spot lesions or enamel defects
Yes
Child has visible cavities or fillings
Yes
Child has plaque on teeth
YesSlide30
Parent Education and Resources for Home Visitors
Flip ChartPostersVideoHandouts and Fact SheetsOffice NewslettersCommunity ActivitiesRepetition and reinforcementhttps://www2.aap.org/oralhealth/docs/RiskAssessmentTool.pdfhttps://www2.aap.org/oralhealth/docs/RiskAssessmentToolSpanish.pdfmychildrensteeth.orgSlide31
Dental Referrals and the Dental Home
Refer woman or child who has immediate oral health problems or is at high risk for tooth decay to a local dentist. Document your work!For assistance in locating a dentist contact local or state dental societies: American Dental Association (ADA), Academy of General Dentistry (AGD), American Academy of Pediatric Dentistry (AAPD) According to the AAPD, the Dental Home is defined as the ongoing relationship between the dentist and the patient, inclusive of all aspects of oral health care delivered in a comprehensive, continuously accessible, coordinated, and family-centered way. Establishment of a dental home begins no later than 12 months of age and includes referral to dental specialists when appropriate.Slide32
References
AAP.orgaapd.orgada.orgdentistryiq.comdph.illinois.govhdassoc.orghttps://www2.aap.org/oralhealth/docs/RiskAssessmentTool.pdfhttps://www2.aap.org/oralhealth/docs/RiskAssessmentToolSpanish.pdfmychildrensteeth.orgNC Headstart, https://vimeo.com/84873378oralhealthgroup.comOral Health in America: A Report of the Surgeon General, National Institute of Dental and Craniofacial Research, National Institutes of Health, U.S. Department of Health and Human Services (DHHS), 2000.