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Early Childhood Oral Health Care Community Solutions for Champaign County 2009 Participating Agencies: Champaign-Urbana Public Health District Smile Healthy.

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Presentation on theme: "Early Childhood Oral Health Care Community Solutions for Champaign County 2009 Participating Agencies: Champaign-Urbana Public Health District Smile Healthy."— Presentation transcript:

1 Early Childhood Oral Health Care Community Solutions for Champaign County 2009 Participating Agencies: Champaign-Urbana Public Health District Smile Healthy University of Illinois CRAYON Research Head Start of Champaign County Maternal & Child Health Crisis Nursery United Way of Champaign County Parkland College Dental Hygiene Francis Nelson Community Health Center

2 Reduce the percentage of children ages 2-4 with untreated tooth decay down to 9% Reduce the percentage of children ages 2-4 years who have had a dental caries experience (tooth decay) to 11% *The current percentage of children in Illinois age 2-4 years with Early Childhood Caries is 33% Healthy People 2010 Goals for Early Childhood Oral Health:

3 Risk Reduction: Water Fluoridation Five Champaign County community water treatment facilities have met water fluoridation standards of mil per liter for 2+ years: Illinois American Water Company Ludlow Water Department Royal Water Department Sadorus Water Department Sangamon Valley Water District

4 Risk Reduction: Preventative Dental Care Private Dentists Champaign County has three Pediatric Dental Specialists providing services: Beginning by age 1 year Accepting private insurance payments Providing sedation services Providing services to children with special needs

5 Risk Reduction: Preventative Dental Care Smile Healthy is dedicated to working with the community to meet the oral health needs of underserved children and families by focusing on preventative care, treatment and education to provide a lifetime of excellent oral health through: Child Dental Access Program Mobile Clinics Head Start Dental Clinic Dental Health Education Handicap Accessible

6 Risk Reduction: Preventative Dental Care Champaign-Urbana Public Health District Serves children who are residents of Champaign or Urbana with All Kids & Medicaid and Champaign County children in foster care ages 3-18 years. Preventative, restorative, and educational services are provided through: Two full time clinics located in Champaign and Urbana that are handicap accessible Mobile clinics to Champaign & Urbana schools Dental Health Education Fluoride Varnish clinics offered 2 afternoons per month to MCH/WIC infants and toddlers

7 Risk Reduction: Preventative Dental Care Parkland College Dental Hygiene provides preventative and educational dental services to ages 3-adult through: Hygiene Clinics; handicap accessible Dental Health Education Dental Health Promotion through Community Volunteerism

8 Risk Reduction: Preventative Dental Care Urbana Student Health Center Provides preventative and restorative dental services to Urbana school students through Full time dental and hygiene services Dental Health Education Handicap Accessible

9 Community Risk Factors Lack of parent awareness regarding the importance of caring for developing primary teeth from birth Lack of Low-Literacy educational materials for infant/toddler oral health care Lack of oral health educational programming and educational materials for parents of children beginning at birth Low number of dental providers who accept children beginning at age 1 year Low availability of oral health educational materials in languages other than English and Spanish

10 Community Goals 1.Increase availability of educational materials for infant/toddler oral health care 2.Increase promotion of Early Childhood Oral Health Care 3.Increase availability of oral health presentations and information for parents of infants and toddlers 4.Increase access to dental homes for children beginning at age 1 year 5.Provide Bright Smiles from Birth training to Family Practice doctors and Pediatricians

11 Bright Smiles from Birth Developed by the Illinois Chapter of the American Academy of Pediatrics Illinois began pilot program in 2006 Utilizes pediatric dentists to train pediatricians to perform oral health screening of children as part of a well-child visit and provide oral health education and apply fluoride varnish to high risk children

12 Early tooth eruption, (<6 months) Poor parental dental health Child goes to bed with a bottle Frequent snacking (3 or more/day) Enamel defects/pits Prolonged bottle/breastfeeding (>1 year) Well water >3 Weeks (continuous) liquid medicine Bright Smiles from Birth Pre-Existing Risk Factors

13 Bright Smiles from Birth Oral Health Care Questions Does someone clean the child’s teeth daily? Do they use toothpaste containing fluoride? Does the child take fluoride supplements? Does the child go to bed with a bottle? –If “yes”, what are the contents of the bottle? Does the child use a pacifier -If “yes”, is it dipped in anything?

14 Individual Risk Factors for developing Early Childhood Caries: *Bright Smiles from Birth Assessment Tool

15 Parental Preventative Measures as Reported 100 WIC parents of children age 0-35 months were surveyed regarding preventative care of their child’s teeth and gums.

16 CRAYON Research Juhee Kim, Ph.D, University of Illinois The CRAYON group will explore the role of early risk factors for pediatric obesity in both the home and child care environment such as: Exploration feeding practices physical activity media influences Collaborative studies reflect disciplines from the UIUC campus and other US and South Korea institutions and include: Studies include public health preventive medicine dental medicine social sciences The CRAYON group focuses on examining health behaviors of the underserved and high-risk population and people with disabilities in the context of family and organizational environment and health policy.

17 Agen% <6 months months >=12 months Total99100 Spring 2009 Dr. Juhee Kim & Dr. Jae Eun Shim, UIUC Two screeners were administered to examine feeding practices and oral health risk factors among WIC children under age 3 years. 247 participants were surveyed for the CRAYON screener and 120 were for the Early Childhood Caries screener. 99 participants from both the CRAYON and ECC screeners were compiled for the following preliminary analysis. Table 1. Distribution of subjects by age: CRAYON-WIC Screeners

18 The prevalence of oral hygiene practices are presented in Table 2. 30% of parents reported children going to bed with bottle 23.3% reported frequent snacking 20% of infants 12 months and older were given prolonged bottle and breast feeding. 53% of infants 6-11 months old were not being given sugared drink, however, the percentage decreased to 26.67% in children age 12 months and older. Table 2: Distribution of dental health related practices by age. Dental Health PracticesTotal <6 months 6-11 months >=12 months n%n%n%n% Frequent snacking (n=99) Prolonged bottle/breast feeding >1 yr. (n=55) Pacifier use (n-90) Toothbrush use (n=64) Goes to bed with bottle (n=93) Not introduced to sugared drinks (n=69) CRAYON-WIC Screeners

19 Survey of Community Agencies A list of area agencies who serve children and parents of children age 0-4 years was developed. A survey was sent to each agency to determine: What oral health services and education was currently being provided to them and, What services they would be willing to promote to their clients Agencies serving children 0-4 Head Start Cultvadores “Latin Kids Club” Urbana & Champaign EC MOPS Mental Health Center Crisis Nursery Childcare Resource Services Refugee Mutual Assistance Center

20 Response from Community Agencies Cultivadores C-U Early Childhood Head Start Mental Health Center Crisis Nursery Serves parents of children age 0-4? YES Partners with an agency providing dental care to children age 0-4? NO YESNO Partners with an agency providing oral health education? NO YESNO Dental coverage of children served by agency. All Kids Medicaid All Kids Medicaid All Kids Medicaid Uninsured All Kids Medicaid Uninsured All Kids Medicaid Private Uninsured 5 Agencies Responding

21 Agency Requests by %

22 Early Childhood Oral Health Goal 1: SmileHealthy will work with CUPHD to develop low-literacy oral health care instructions for parents of infants and toddlers and provide these in English and Spanish. CUPHD will provide low-literacy oral health materials and infant toothbrushes to all MCH/WIC children age 0-35 months and provide referral information to SmileHealthy and CUPHD for fluoride varnish application. CUPHD will work with SmileHealthy to translate and provide low-literacy oral health care instructions to Korean, French, and Mandarin Chinese. CUPHD will provide low-literacy materials and infant tooth brushes to each child born in Champaign County through proposed partnership with Carle and Provena hospitals. Increase educational materials for Infant/Toddler oral health care

23 Early Childhood Oral Health Goal 2: Increase availability of oral health presentations for parents of infants and toddlers CUPHD & SmileHealthy will provide dentists for Bright Smiles from Birth Training to Francis Nelson Health Center and area Family Care Practitioners And Pediatricians. Crisis Nursery will promote Early Childhood oral health care through presentations in parenting classes in partnership with SmileHealthy. CRAYON Research at the University of Illinois will promote Early Childhood Oral Health Care through two Intervention Groups: 1: Oral health care instructions & provider information 2: Free infant finger toothbrushes + oral health care instructions & provider information. SmileHealthy will contact Child Dental Access families about oral health education & encourage families to have Children age 0-5 years participate in the program.

24 Early Childhood Oral Health Goal 3: Early Childhood Oral Health Goal 3: Increase availability of oral health presentations for parents of infants and toddlers SmileHealthy will promote & offer Oral health Care Presentations in English & Spanish throughout Champaign County. They will provide oral health presentations for Crisis Nursery & HeadStart CUPHD will provide oral health presentations to Champaign & Washington (Urbana) Early Childhood Centers & to WIC families in partnership with Maternal & Child Health Crisis Nursery will schedule Oral Health Presentations for all parenting classes.

25 Early Childhood Oral Health Goal 4: Early Childhood Oral Health Goal 4: Increase access to dental homes for children beginning at age 1 year SmithHealthy will provide preventative care and treatment to HeadStart children and siblings age 0-5 years. Focus will be placed on re-check appointments and family oral health counseling. CUPHD & SmileHealthy will promote Bright Smiles from Birth to all community dentists through the local Dental Society. CUPHD will begin to see Champaign & Urbana children at age 1 year. Preventative care and oral health education will be provided along with restorative care as tolerated.

26 Early Childhood Oral Health Goal 5: Step 3 Step 2 Step 1 Provide Bright Smiles from Birth training to Family Practice doctors and Pediatricians Bright Smiles from Birth Available through: Francis Nelson Health Center Family Care Practitioners Pediatricians CUPHD & SmileHealthy will send Dentists For Bright Smiles from Birth Certification To train Francis Nelson Health Care Practitioners, Family Care Practitioners, & Pediatricians to apply fluoride varnish. Until Bright Smiles from Birth certification is available, CUPHD & SmileHealthy will promote and provide Early Childhood Oral Health Care training to: Francis Nelson Health Center Family Care Practitioners Pediatricians

27 Measuring Outcomes CUPHD will track Bright Smiles from Birth screening responses for all children age 1-3 years and report the incident of caries in children age 2-4 years at their first dental appointment. CRAYON Research will conduct a parent survey at 6 month Well Child Care visit to assess whether intervention group has more favorable oral health practices and less risk behaviors compared to those of group receiving no new intervention. SmileHealthy will continue survey of families of children age 0-5 and assess dental caries of 3 year old children participating in programs.

28 SUCCESS Ish Patel is an active 3 year old. Ish’s parents brought him to a Champaign-Urbana Public Health District Fluoride Varnish Clinic when he was 2 ½. CUPHD’s Dental Clinic does not begin services to children until age 3 years, but began to offer Infant & Toddler dental exams, oral health education with a Registered Dental Hygienist, and fluoride varnish applications through a partnership with Maternal & Child Health. Ish was still using a bottle at 2 ½ so Michelle Kramer, RDH talked to his parents about switching him from a bottle to a cup to lower his risk of developing tooth decay and, after Kara Ruffatto, DMD examined Ish’s teeth, fluoride varnish was applied. Ish arrive at the CUPHD Dental Clinic 6 months later for his first complete dental appointment; he was no longer using the bottle and had only 1 small area of decay. Early intervention is key to avoiding and breaking habits that lead to Early Child Caries, formerly known as Baby Bottle Decay.

29 The Champaign-Urbana Public Health District would like to thank the following committee members and agencies for their participation: Ann Ambrose, Crisis Nursery Beverly Baker, United Way of Champaign County Peg Boyce, RDH, BA, Parkland College Dental Hygiene Liliana Castelari, Head Start of Savoy Chifan Cheng, DDS Alicia Ekhoff, Champaign-Urbana Public Health District - Dental Program Deb Fruitt, Champaign-Urbana Public Health District - Wellness and Health Promotion Nancy Greenwalt, Smile Healthy Vickie Heman, DDS Heidi Kaufmann, Head Start of Savoy Juhee Kim, Ph.D., University of Illinois CRAYON Research Michelle Kramer, RDH, Champaign-Urbana Public Health District - Dental Program Brandon Meline, Champaign-Urbana Public Health District - Maternal and Child Health Jill Myers, RDH, Smile Healthy Nicole Wente, Champaign-Urbana Public Health District - Maternal and Child Health Kara Ruffatto, DMD, Champaign-Urbana Public Health District - Dental Program Awais Vaid, Epidemiologist, Champaign-Urbana Public Health District


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