RCHC Community Project Abstracts

Back to subject search page or search by preceptor site Fluoride Varnish: Parent Educational Pamphlet for Baker City. Project Date: 10/15/2007 Early childhood dental decay can lead to a variety of continuing health problems including extreme pain, difficulty chewing, poor weight gain, malocclusion, spread of dental infection into the body, and a decrease in overall health. Many communities in the United States add fluoride to the water supply to help decrease dental disease in their community. Oregon is ranked 48th out of 50th in the amount of citizens who receive fluoride in their water supply, which places Oregon children at a high risk for early childhood dental decay. Other risk factors for dental decay include low socioeconomic status and children living in rural communities. Fluoride varnish is one way to increase the fluoride a child can receive to prevent early childhood caries. Fluoride varnish has been used in European countries for the past 25 years to prevent early childhood caries. Fluoride varnish is also endorsed by the American Dental Association. Although the use of fluoride varnish is not approved for the use of caries prevention by the FDA, it is a common "off-label" use of the product. Early in 2007, Baker County began a fluoride varnish program for children within the county starting at the age of 9 months. Although the program has been enrolling children, there is little parent education on the benefits of fluoride, the services available to their children, and the importance of early dental health. Therefore, my project included producing a parent brochure with educational material about dental health and the benefits of fluoride varnish. Hopefully, the handout will help to increase enrollment in the fluoride varnish program. Barriers to Accessing Dental Care and Use of Medical System for Oral Health Problems by Low-income Residents in Jefferson County, Oregon. Project Date: 4/30/2007 Despite the preventable nature of most oral disease, Oregonians have high rates of caries and periodontal disease. Low-income populations are disproportionately affected by dental problems and may be influenced by lack of access to dental care. Barriers to accessing dental care and use of emergency department (ED) services for dental needs were studied using interviews and ICD9 code analysis for a local hospital in rural Oregon. Barriers to accessing dental care include transportation and appointment availability for Oregon Health Plan (OHP) patients and cost and appointment availability for underinsured or uninsured low-income patients. Dental appointments and free preventive services are available for Native American patients suggesting other barriers to good oral health. Uninsured patients and Medicaid patients followed by Native American patients represented the largest percentage of patients seen in the ED for dental problems. Preventive resources and education about oral health in the community are limited. These results indicated that lack of access is only one barrier to poor oral health. Increasing preventive services, educational resources and community awareness about oral health may be more beneficial in improving oral health outcomes. Say Cheese: Public Opinion Regarding Community Water Fluoridation in Baker City, OR Project Date: 1/1/2007 Dental caries (tooth decay) poses a significant health risk to the residents of Baker County. Reputable health-professional organizations such as the CDC, WHO, AAFP, American Public Health Association, and Institute of Medicine support community water fluoridation as a safe, effective, and inexpensive way to prevent dental health problems. A majority of the US population has access to fluoridated water, but Baker County has not yet implemented this proven health improvement measure. In order to gauge public opinion regarding community water fluoridation in Baker, a survey was developed with the support and input of several local health providers, and widely distributed amongst varied segments of the community. Analysis of the survey results revealed barriers to public acceptance of water fluoridation. The gaps in dental health knowledge will be addressed as part of a following public health education campaign to be developed by nursing students. The group of local healthcare providers and students involved will organize the Baker medical community through meetings and strategy sessions in order to educate, collaborate, and hopefully unite in the campaign of fluoridation. In addition, the logistics of instituting fluoridation in the Baker County water supply was researched and outlined. Determining the Efficacy of Fluoride Varnish in Preventing Caries in Children – Research Prior to the Start of a New Public Health Initiative in Baker County. Project Date: 7/3/2006 Fluoride Varnish is a widely accepted dental caries prophylactic treatment in America despite being an off-label use. It is easy to apply and regarded as safe. The Baker County Public Health Department is interested in starting a Fluoride Varnish program for children in Baker County. They enlisted me to research the efficacy, safety and technical features of such an initiative and then give a presentation to their staff. I did a literature review of articles found searching Pubmed for all the Randomized Controlled Trials published after 1999 using the terms “fluoride,” “varnish,” and “dental,” limiting my research to studies on the preventative effect on caries in children. I also reviewed the latest relevant professional and independent reviews and meta-analyses searchable under the same terms. I concluded that the evidence in favor of Fluoride Varnish was strongest for permanent teeth despite some controversy over the degree of added benefit when using a fluoride toothpaste and that the most recent evidence suggested a similar protective benefit in deciduous teeth -- though this is more controversial. Furthermore this benefit appears to be greatest in children “at risk” for poor oral health (low socioeconomic status, low fluoride water content, or poor dentition). In the end it was agreed that a biannual Fluoride Varnish program was the most practical solution that offered benefit. Incorporating Dental Health into the Role of the Primary Care Provider in Baker City, OR. Project Date: 5/1/2006 Dental disease is problematic in the United States, especially in the population of poor underserved children. Baker City, similar to many rural areas is composed of a large number of persons below the federal poverty line. The children in Baker City, therefore, are at a greater risk of developing dental caries and other dental complications. In an effort to incorporate the primary care provider into the dental screening and health of the pediatric population in Baker, a project was designed to help screen children seen in the clinic and assist in referring these patients to the appropriate dentist. The primary question that this project was intended to answer when is the best time for children to have their first dental examination, and how can primary care practitioners assist in this screening? To aid in this dilemma, a brochure was generated based on information gathered from a local dentist and an extensive literature search. In conclusion, pediatricians and family health care providers may be able to play an important role in improving the dental health of their patients who have difficulty obtaining access to professional dental care. School healthcare in Malheur & Multnomah counties: An argument for School Based Health Centers Project Date: 1/2/2006 Diabetes and asthma are two of the most common diseases afflicting children. As chronic ailments, their acute and long-term management are very important in preventing crises and slowing disease progression. With Oregon law not mandating a nurse in schools, the management of these diseases can become the responsibility of school staff, especially in underserved counties. In this study, quality of school healthcare management of type I diabetes and asthma was assessed in 9 schools in Malheur County. A survey consisting of 12 questions assessing acute critical and chronic management and education competency was conducted by telephone with each school’s primary healthcare provider. The Malheur County mean score was 2.3 out of 12 (SD 1.0). A higher score of 11.375 (SD 0.744) was obtained through survey of 8 schools in Multnomah school district, all of which have at least a part time nurse or a School Based Health Center (SBHC). This study identified that Malheur County had a sufficient database of the protocols for the acute and chronic management of asthma and diabetes, but lacked knowledge in recognizing clinical situations and educating students on disease management. Their staff consists of school secretaries who receive a health source guide and instruction from a registered nurse once annually. While financially expensive, a possibly more efficient and long-term cost-effective solution for Malheur County could be the School Based Health Center. This system has been shown to provide large savings in direct costs of healthcare for school aged children and almost double the service value of each invested tax dollar. It also offers basic healthcare to the uninsured and the intangible benefits such as improved attendance and school performance in the classroom. Assessment of Fluoride Concentration in the Drinking Water in Ontario, Oregon and Surrounding Areas and Recommendations for Fluiride Supplementation for the Pediatric Population in this Community. Project Date: 3/21/2005 Tooth decay is one of the most common problems facing the population. Fluoride has been shown to be an effective means of helping slow or reverse the progression of disease. Excessive fluoride intake can lead to fluorosis, a poor cosmetic result. This risk necessitates optimization of fluoride intake. The average intake of fluoride in the community, based on its concentration in drinking water, was assessed by phoning various water treatment plants in the surrounding communities. Then, using extensive research data complied from multiple sources, a specific set of recommendations for fluoride supplementation in the pediatric population were made based on fluoride intake in the community in which the patient lives. Water Fluoridation--Surveying Attitudes of Parents in a Community Water Fluoridated Town Towards Water Fluoridation Project Date: 9/23/2002 Tooth decay is the most chronic disease of childhood (1). Early studies have shown that water fluoridation (the adjustment of the natural fluoride concentration of fluoride deficient water to the level recommended for optimal dental health) is responsible for a 50-70% reduction in dental caries in children who live in areas with community water fluoridation (2). Despite its effectiveness and ubiquity (over 60% of all public water sources in the US are fluoridated), many people are unaware of the benefits of fluoride and are resistant to its use. This study attempted to determine the attitudes of parents towards fluoride supplementation in a pediatric practice in Newport, Oregon (one of the only cities in Oregon to fluoridate the municipal water supply). Eighty patients were surveyed. Ninety-four percent of patients surveyed supported the use of fluoride to prevent tooth decay, but only 78% wanted it in their water. Almost half of patients living in Newport were unsure whether or not their water source was fluoridated. Almost half of patients living in non-fluoridated surrounding towns were also unsure. Because almost half of the patients surveyed were unsure of the fluoridation status of their hometown, a handout was developed and given to patients in order to provide simple facts about fluoride, including identification of the towns in the area that fluoridate the water supply. Yuck Mouth: Pediatric Dental Health in Jefferson County Project Date: 7/1/2002 Tooth Decay is the most common chronic disease of childhood. Despite the significant consequences for childhood health and wellbeing, many children go untreated. Dental care has recently been cited as the most prevalent unmet health need in U.S. children, particularly amongst minorities and those living in poverty. These disparities and the prevalence of unmet need often goes unrecognized by physicians, in part due to the traditional separation of medicine and dentistry. Primary care physicians, however, play an important role in child and family development at precisely the time where dental guidance is needed. In an effort to increase parental education about dental disease prevention, a pamphlet was constructed for the Highlakes Clinic and the surrounding area. The pamphlet was constructed utilizing reviews of journal and internet sources as well as interviews of community members. The role of primary care physicians in oral health and disease prevention was then explored. It was found that by incorporating education about preventative oral health physicians could compliment existing dental services and help better meet the health care needs of area children, particularly the underserved. Back to subject search page or search by preceptor site