Integrating oral assessment and education into pediatric wellness visits at a Federally Qualified Health Center, Community Action Partnership of Western Nebraska Health Center: Pilot Project
University of Nebraska Medical Center, College of Dentistry
This project was a collaborative partnership between the University of Nebraska Medical (UNMC) School College of Dentistry and College of Nursing and the Federally Qualified Health Center: Community Action Partnership of Western Nebraska Health Center in Gering, Nebraska. This project was exempt from UNMC IRB oversight because the health services provided were standards of care. In addition, this integrative approach provided Interprofessional education (IPE) experience for dental hygiene and nursing students from the University of Nebraska Medical (UNMC) School College of Dentistry and College of Nursing respectively. We successfully showed support of the pilot project goals to 1) Improve quality of life for high-risk children by maintaining oral health and reducing oral complications through early detection and intervention which may affect their nutrition, speech, and self-esteem. 2) Streamline access to care by providing dental and medical care in one visit, eliminating barriers for many underserved, high risk families. 3) Enhance dental hygiene and nursing students’ awareness and perceptions regarding IPE. Outcomes have been quantified using statistical analysis and descriptive statistics to capture oral health history, status of dental hygiene, related secondary comorbidities, patient demographics, and access to care with follow up and referral services.
Additionally, the dental hygiene students and nursing students had very positive experiences working together as a team and learning about each other’s roles, enhancing their understanding of the importance of interprofessional teams in healthcare. Our integrated model of care provided a smooth transition between dental and medical care and was a valuable approach for reaching underserved families, particularly those who had never been seen by a dental team. This model of care is feasible if clinics allow providers an extra 15-20 minutes per appointment to integrate oral health screenings and education into primary care well child visits.
In conclusion the findings show one of the greatest impacts of providing oral health screenings to children who had never been assessed a dental provider significantly increased oral health awareness. Educating the parents, many of whom did not understand the importance of their child seeing a dentist before age 3, was also an important outcome. Students had positive Interprofessional experiences, learning the importance of medical-dental collaboration. The referral between medical and dental provided a smooth transition of care, and is a valuable approach for reaching underserved families and increasing access to care. 2020 Results Cohort 1 (N=39)
RISK FACTORS
12% of Mothers or caregiver has had decay in the past 12 months
69% of Mothers or Caregivers do not have a dentist
64% Drinks sugar sweetened beverages (33% 1 or more per day)
None of the patients Vape, Smokes or Drinks Energy Drinks, however, 31% of parents smoke and 21% of parents use energy drinks.
Protective Factors
49% of children do not have an established dental home
79% do not drink fluorinated water or take fluoride supplements
74% has not had fluoride in the last 6 months
36% does not brush twice per day
95% or more agreed that oral health is related to systemic health & we increased knowledge
38% of the children have never been to the dentist.
2021 Results Cohort 2 (N=60)
RISK FACTORS
63% of Mothers or caregiver has had decay in the past 12 months
45% of Mothers or Caregivers do not have a dentist
78% Drinks sugar sweetened beverages (35%) 1 or more per day)
None of the patients Vape, Smokes or Drinks Energy Drinks, however, 8% of parents smoke and 14% of parents use energy drinks.
Protective Factors
63% of children do not have an established dental home
83% do not drink fluorinated water or take fluoride supplements
72% has not had fluoride in the last 6 months
55% does not brush twice per day
100% or more agreed that oral health is related to systemic health & we increased knowledge
45% of the children have never been to the dentist.
2020-2021 Results Combined Cohort (N=99)
RISK FACTORS
53% of Mothers or caregiver has had decay in the past 12 months
40% of Mothers or Caregivers do not have a dentist
73% Drinks sugar sweetened beverages (35%) 1 or more per day)
None of the patients Vape, Smokes or Drinks Energy Drinks, however, 17% of parents smoke and 17% of parents use energy drinks.
Protective Factors
58% of children do not have an established dental home
82% do not drink fluorinated water or take fluoride supplements
73% has not had fluoride in the last 6 months
47% does not brush twice per day
98% or more agreed that oral health is related to systemic health & we increased knowledge
42% of the children have never been to the dentist. Our results from our oral health risk assessment tool show that 98% of participates in pilot project agreed that oral health is related to systemic health & that we increased their knowledge on how oral health is related to overall health. In conclusion the findings show one of the greatest impacts of providing oral health screenings to children who had never been assessed a dental provider significantly increased oral health awareness and provided opportunity for early referral for dental care.