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FIRST YEAR WITH FIRST 5
Dental problems can begin with baby's first tooth and early childhood caries continues to be the number one chronic disease in children. But thanks to funding from a California initiative, USC School of Dentistry has partnered with state health organizations to improve oral health for children under the age of five and provide oral health education for their families. The California Children and Families Act, passed by California voters in 1998 and better known as First 5 California, provides funding for services directed at children from prenatal to five years of age, including health and child care, and parent education. As part of the program, the First 5 California Oral Health Initiative supports the efforts of California nonprofits, dental schools, dental plans and professional organizations, among others, that promote oral health care and education at an early age. With tooth decay a major problem for one-third of preschool-age children and 70 percent of children in kindergarten through third grade, the emphasis is on education, prevention and early detection of dental disease.
"So often by the time a child has his first dental exam they already have oral disease," explains Roseann Mulligan, associate dean for community health programs. "Typically their first exam doesn't happen until they are about ready to enter school, so the 0 to 5 period becomes critical to creating a good foundation for oral health."
Working in partnership with health care organizations in the Los Angeles area, School of Dentistry faculty and staff have conducted professional training workshops and educational programs since July 2004. The school has been engaged in the following activities directed at parents, caregivers, and health and human service providers who work with you children.
• Physicians, physician assistants and nurses often perform oral health screenings to compensate for the shortage of available pedodontists, but may not know the fundamentals, such as what a cavity looks like. In association with the local nonprofit L.A. Care Oral Health Plan, USC faculty members Jennifer Holtzman, Rick Udin, Julie Jenks, Phyllis Kawada and Steve Le led a training workshop last February for interested health care providers. Fifty-six participants attended the one-day program that included lessons on conducting oral health screenings, the importance of primary teeth and on prevention aids including fluoride, xylitol and chlorhexidine.
• Throughout the school year, School of Dentistry faculty under contract from Childrens Hopsital Los Angeles and Child Health Works conducted a series of educational workshops for parents and a special session for early-education school nurses working within the L.A. Unified School District. Topics included nutrition and risk assessment, and what to look for during an oral health screening as well as hands-on practice. More than 30 nurses attended the one workshop conducted by Holtzman and Jenks. The two later teamed with Udin, Charles Goldstein and Jose Polido and Children's Hospital to present eight programs at early education centers throughout the city. In total more than 80 parents attended.
• In February, Diane Melrose joined Udin and Holtzman at a special day-long course titled "First Smiles: Dental Health Begins at Birth." USC partnered with the California Dental Association Foundation to provide training for dental practitioners in early oral health care. Topics included risk assessment and anticipatory guidance for children under the age of 5. General dentists, hygienists and office staff received instruction on procedural matters when working with young children and their families, including setting up the office, billing and documentation as well as behavioral management techniques.
"How do you see a one-year-old patient? Do you stick him in a chair?," Holtzman asks. She recommends that the dentist sits knee to knee with the baby's caregiver, laying the baby's head face up in the dentist's lap with the child's lower back in the caregiver's lap, and legs wrapped around the caregiver's body. "The baby probably isn't very happy and when his mouth is open, the doctor can then look into baby's mouth."
Another objective, Mulligan explains, is to shift the emphasis of early oral health care to as early an age as possible, ideally beginning in the prenatal stage. "We know for example that periodontal disease in the mother is implicated in low birth weight and premature babies. So it begins even before the child is conceived," Mulligan says. |
