Academic journal article Journal of Allied Health

Expanding Oral Health Preventative Services for Young Children: A Successful Interprofessional Model

Academic journal article Journal of Allied Health

Expanding Oral Health Preventative Services for Young Children: A Successful Interprofessional Model

Article excerpt

Progressive solutions are needed to solve the oral health chronic disease problem in the U.S. The importance of oral health coupled with urgent community oral health needs, shortage of primary providers, and emphasis on interprofessional collaboration make the timing ripe for allied health training and practice in oral health preventative services. A successful model is described that addressed the unmet oral health care needs of lowincome and at-risk children. The model is a guide for integrating an oral health screen, fluoride varnish, anticipatory guidance, and dental referrals into allied health practice. An alternative oral health provider approach was used to address the low rate of early caries detection, preventative oral care, and access for underserved children. A comprehensive system for the administrative and clinical components of the project, including implementation plan, clinical protocols, prescriptive authority, a dental home referral system, clinical training and competency testing, was developed. The interprofessional project increased oral health services capacity and practice acceptance of oral health screening and fluoride varnishing among dietitians. Oral health care services provide allied health practitioners with unique opportunities to impact the poor access and unmet needs of at risk children and adults and to improve overall health. J Allied Health 2014; 43(1):e5-e9.

IT IS RECOGNIZED that nutrition is an integral component of oral health and that dietetic practitioners, as allied health professionals, should be trained and capable of performing oral health screening and assessments and providing preventative services, counseling and education.1 This paper describes the Kellogg Ohio WIC Oral Health Model which provides one solution to the critical need for pediatric oral health preventative services by utilizing allied health professionals to bridge the gap. The model developed is innovative in its approach to scope of practice, training, and competency in oral health preventative services. Unique aspects of the model include: use of registered dietitians (RDs) as providers of preventative oral health services that include oral health risk screening, oral cavity assessment, and fluoride varnish application, incorporation of oral health care competency into training, and interprofessional team solutions.

Pediatric Oral Health Concerns

The American Academy of Pediatrics states that early childhood caries (ECC) is an infectious process affecting children 5 years and younger that spreads rapidly in the mouth causing tooth destruction and severe dental disease.2 The Surgeon General has declared dental caries the "silent epidemic."3 In children, dental caries are the most prevalent chronic disease. More than half of 5 year olds from low income families have ECC with a high rate of preschool children being untreated.4,5 These dental conditions can contribute to oral pain, difficulty chewing and inadequate nutrition, and in some cases have been linked to failure to thrive. Dental decay and tooth loss can also lead to speech-language development issues, poor self-esteem, declining school performance and costly emergency medical services and dental restorations.2

The good news is that most oral disease is preventable or at least controllable, but it is unfortunate that dental care remains the most common unmet health need.6 Early oral health intervention and preventative services can set the stage for healthy dentition and oral health habits. Yet, profound disparities exist in the level of dental services obtained by children, especially for children of low socioeconomic status.3 Of particular concern is the low rate of early detection and preventative care for children three years and younger. Unfortunately, preventative and curative dental care for children often occurs after damage to teeth has taken place.

Oral Health Care Delivery Paradigm Shift

The urgency of the problem is compounded by increasing evidence that poor oral health can contribute to and exacerbate other disease processes in the body. …

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