Bright Futures:

Oral Health in Childcare

Joseli Alves-Dunkerson, DDS, MPH, MBAPeg Terp, MPH

LeeAnn HoaglinCooper, BS, RDH

National Perspective

BRIGHT FUTURES

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

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. ”

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…

What Is Bright Futures?

Bright Futures is a: VisionPhilosophySet of Expert GuidelinesPractical Developmental

Approach to Providing Health Supervision

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

Bright Futures is a Philosophy

Optimal health for all children requires: Trusting relationships between health

professionals, the family, and the child Collaborative community partnerships

Bright Futures Core Concepts

Prevention WorksFamilies MatterHealth is Everyone’s

Business

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

Prevention Works

Families Matter

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

Community Partnerships

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

Bright Futures Materials for Professionals

State Perspective

Provide consistent and effective oral health messages for local programs

Bright Futures Oral Health

Bright Futures OH Tooth TutorFoundation

Expertise Local Coordinators

Customers MCH-related programs

Results Families getting the same OHmessages wherever they go

Community reps on the samepage in terms of OH

OH education fact sheetsavailable online

Reviewers DOH, UW, MCH programs, associations, parent groups

Increased awareness oforal health

WA State BF OH – Subgroups

WIC CSHCN First Steps/NPF

HS/ECEAP/Childcares Tooth Tutor/Schools Adolescents Child Profile

Bright Futures

Oral Health for Childcare Programs

LeeAnn Cooper, RDH

Peg Terp, MPH

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!

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

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

Key Principles

Plaque Germs

Sugar bugs

Tooth decay is a bacterial Infection

We get bacteria from our primary caregiver.

Li Y, Caufield PW, J Dent Res 1995;74:681-5.

Plaque is the film that grows on our teeth.

Contains different bacteria

Can be reduced by toothbrushing

Nutrition

Healthy food for healthy bodies and teeth!

•Amount

•Texture

•Frequency!

Regular meals and snacks

• Regular Meals

• Regular Meals plus Grazing– Prolonged

bottle feeding, sippy cups, etc.

Breakdown and Repair

Eat carbohydrate

Tooth begins to break down

Fluoride isavailable in paste and

water

Fluoride combines with calcium

Rebuilds the tooth

Repair

Fluorides in caries prevention. Wright, Boston, 1991; p 295-323.

Fluoride

Decreases the breakdown of teeth

Increases the repair of the teeth

Fluoride works best

Available in small daily amounts

drinking water twice daily in toothpaste

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

New things to watch for

Xylitol Chlorhexidine Fluoride varnish

What Childcare Providers can do?

Bright FuturesGuide for Oral Health in Washington State

1. Review activities

2. Oral Health Action Plan Example: We will record the name/phone of every

child’s dentist on our health record.

3. Measure your current status 1. 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.

Ask parents about

Prevention:– What they are doing to prevent tooth decay

on their children?

Access:– Do families AND children have a dental

provider?

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?

Prevention: Toothbrushing in Childcare

Toothbrushes Labeling Cleaning Replacement Storage

– Buy it or make it

Prevention: Classroom Toothbrushing Management

Passing out the brushes Toothpaste

– Dispensing Techniques

IntroductionSink MethodTable Method

Swishing and spitting Rinsing and storage

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

Access: Dental exams and Dental screening

Dental Homes Mobile Dental Programs

Access: insurance, dental provider Registration

– Dentist?– Insurance?– Health (DENTAL) History– Consents

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

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!

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

Planning and Writing Your Oral Health Program

A curriculum is a written plan for your program.

Structure for pre-school

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

Topics/Concepts

Visiting the Dentist Keeping Teeth Healthy

– Plaque– Toothbrushing– Fluoride– Tooth decay

Importance of Baby Teeth Nutrition and Oral Health

Resources

Discussion