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The Intersection of Primary
Care and Public Health
Through Oral Health Services
For Students In an SBHC
July 7, 2015
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Objectives
1. The attendee will be able to discuss the
significance of oral health disease in children and
youth
2. The attendee will be able to list three strategies for
preventing dental caries using School-Based
Health individual and population based approaches
3. The attendee will be able to explain how a SBHC
working with other community resources can
provide care to children with dental disease and
can participate in prevention initiatives.
Poll Question
Do you or does your
organization provide
direct patient care to
children and youth?
1) Yes
2) No
Today’s Presenters
Jane Hamilton,
RN, BSN
Manager, School-
Based Health
Elizabeth Bray,
RDH
Oral Health Access
Project Coordinator
Leah Carpenter,
DMD
School-Based
Health Dentist
Carissa Neubert,
RPA
School-Based
Health Physician
Assistant
Jane Hamilton, RN
Leah Carpenter, DMD
Betsy Bray, RDH
Carissa Neubert, RPA
“Oral Health: the Teeth in School-Based Health”
Why Oral Health for Children Matters
May 28, 2015
.
Growth of SBHC Program
1992-2015
Quiz: What is the most common chronic
illness among children?
May 28, 2015
Quiz: What is the most common chronic
illness among children?
May 28, 2015
May 28, 2015
History of SBH Oral Health
May 28, 2015
Insert Poll Question: What percentage of 5-11 yr olds have untreated decay?
May 28, 2015
Caries in Children
Ages 6-11: 1 in 5
Ages 12-19: 3 in 5
May 28, 2015
Caries in Children
• >51 million school hours are lost each year to dental-related illness.
• Problems in eating, speaking, and
attending to learning
May 28, 2015
Caries in Children
• >51 million school hours are lost each year to dental-related illness.
• Problems in eating, speaking, and
attending to learning
Epidemiology of Oral Health
May 28, 2015
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
All children High Income Children Low Income Children
Untreated Tooth Decay in 3rd Grade Children (excluding NYC)
SBHC-all grades
2002-2004
2009-2011
SBHC 2013-14
Source for NYS data, NYSDOH Oral Health Survey of Third Grade Children & Bassett SBHC
May 28, 2015
Disparities in Oral Health
• Poor Children • Poor Seniors • Racial Minorities • Special Needs
May 28, 2015
Delaware County Poverty Profile Individuals in Poverty ………….….……12.7% Children (under 18) in Poverty ……..…17.9%
Otsego County Poverty Profile Individuals in Poverty ………….….……14.7% Children (under 18) in Poverty……..…16.4%
Chenango County Poverty Profile Individuals in Poverty ………….….……15.1% Children (under 18) in Poverty …...……23.8%
Changing the Context of Decision Making
More of Less or none of
May 28, 2015
NYS DOH Prevention Agenda 2013-2017
May 28, 2015
Objective 5-1: Reduce the prevalence of tooth decay among children
Objective 5-2: Increase the proportion of children who have sealants
Objective 5-3: Increase the proportion of children who receive regular
dental care
Objective 5-4: Increase the percentage of NYS population with
fluoridated water
Objective 5-5: Strengthen systems to improve oral health those with
special health needs
NYS Recommended Oral Health Interventions:
May 28, 2015
Counseling and education Long-lasting protective interventions Clinical interventions Changing the context of decision making Socioeconomic factors (not a SBHP option)
Counseling and Education
May 28, 2015
May 28, 2015
Discover Champions Begin the conversation.
Where to start….. School Nurses Dental Community Early Childhood Learning Center Teachers Coalitions serving youth
May 28, 2015
Identifying Partners A public Health Approach State and Local Health Departments Hospital Affiliates (SQHC, ART. 28) Present relevant data Project Outcomes Enhance existing programs
May 28, 2015
Building on Success
• Prevention Based
Mission
• Securing Partners
Funding
• PR/Messaging
Outreach
May 28, 2015
Challenges Uncommon Ground Private Practice Model Delayed Results Funding Shortage
Long-lasting Protective Interventions
May 28, 2015
Sealants: A thin plastic coating that are applies to the grooves on the chewing surfaces of back teeth to protect them from decay
Poll
May 28, 2015
Water Fluoridation is one of the “Ten Greatest Public Health Achievements in the United States between 1900-1999 Unfortunately most children in rural areas do not live within a village where water is fluoridated
Changing the Context of Decision Making
Changing the Context of Decision Making School Wellness Policies and Practices
More of Less of
May 28, 2015
Changing the Context of Decision Making
More of Less or none of
May 28, 2015
Socioeconomic Factors (Beyond the scope of SBHC’s work)
May 28, 2015
May 28, 2015
Clinical Interventions
Integrating Oral Health
May 28, 2015
Success measured in SMILES
Integrating Oral Health into Primary Care *Caries Risk Assessment *Nutrition Counseling *Fluoride Varnish Application *Referrals to Dental Care May 28, 2015
Caries Risk Assessment
May 28, 2015
http://www2.aap.org/oralhealth/docs/riskassessmenttool.pdf
May 28, 2015
Caries Risk Assessment Tool
Incipient caries are caries
May 28, 2015
Fluoride Varnish Application
May 28, 2015
Thank you to Oral Health America, who has donated varnish to our program since its inception.
May 28, 2015
Nutrition Counseling
May 28, 2015
pH (acid) Level Sugar per 12-oz serving Pure Water 7.00 (Neutral) 0.0 Coffee (Average, Black) 5.00 0.0 Barq’s Root Beer 4.61 10.71 tsp. Sprite 2.90 9.29 tsp. Gatorade 2.83 5 tsp. Mountain Dew 2.80 11.07 tsp. Pepsi 2.43 9.64 tsp. Battery Acid (Yikes!) 1.00 (Acidic) 0.0
Acid & Sugar – A Dental Double Whammy It’s how drinks destroy teeth!
May 28, 2015
Sipping all day Every sip counts as an exposure. Drinking all day does more damage
"Athletes are especially prone to erosion from sports drinks because they drink them frequently to maintain hydration."
May 28, 2015
Referral to Dental Care Community Dental Practitioners SBHC Dentist
May 28, 2015
May 28, 2015
SBH Dental Team
May 28, 2015
New York State Department of Health
Children’s Oral Healthcare Access Project(HRSA)
Dental Trade Alliance Foundation
May 28, 2015
Work supported by:
Thank you.
May 28, 2015
Betsy Bray, RDH [email protected] Leah Carpenter, DMD [email protected] Jane V Hamilton, RN Manager [email protected] Carissa Neubert, RPA [email protected]
May 28, 2015
Contact Information
Exciting News
DentaQuest Foundation funded SBHA grant:
Innovation in School-Based Oral Health
Services: Learning Collaborative Network
Project Goal:
Facilitate systems change to incorporate oral health
services into the nation’s ten largest school districts.
Three Objectives:
1. Assess the capacity and
readiness of the ten school
districts to engage in a
collaborative
2. Bring together a panel of
experts to advise and provide
expert content to learning
collaborative
3. Establish a framework and
curriculum based on national
scan of best practices
Contact Information
Donna Behrens
Project Advisor, School-Based Oral Health Services
410-241-9604
Kate Schechter
Program Associate, School-Based Health Alliance
202-638-5872 x215
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Closing Reminders
This presentation has been recorded and will be archived on the
School-Based Health Alliance website within the next 3-5 business
days.
To request support and technical assistance related to Oral Health
and SBHCs, please send us an e-mail at: [email protected]
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Poll Question
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webinar to others?
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