Theses and Dissertations at Montana State University (MSU)
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Item Addressing preventive oral health for pregnant women, childbearing age females & children age zero to six in primary care(Montana State University - Bozeman, College of Nursing, 2017) Johnson, Abrianna Lee; Chairperson, Graduate Committee: Elizabeth S. KinionMost oral health disease is preventable despite the availability of effective prevention and treatment (Nathe, 2016). Oral health conditions are becoming a silent epidemic and during pregnancy the risk increases for oral disease (Qualis Health, 2015; Vamos, Walsh, Thompson, Daley, Detman, & DeBate, 2015). About 40% of pregnant women have a varying form of periodontal disease (Lieff et al., 2004). The social impact on school-age children substantially affects their academics, as more than 51 million school hours are lost each year due to dental related illnesses (U.S. Department of Health and Human Services, 2003). The purpose of this project was to educate providers, nurses, and patients in a primary care clinic on the importance of oral health care and to create simple referral process for at risk patients. The author gave a pretest on oral health best practice to seven primary care nurses. After the pretest, the author gave an oral health education seminar. The nurses took a posttest based on content from the educational seminar. Patients who met the inclusion criteria were given oral health surveys to determine oral health status and need for referral to a dentist. Six of the seven nurses completed the seminar and testing showing a higher post-seminar test score. The V-statistic of 21 showed a p-value of 0.0178 suggesting strong evidence the nurses' scores tended to be higher after the seminar. Of the nineteen adults surveyed regarding their oral health status, 62% showed good oral health behaviors. Of the eleven pediatric patients surveyed regarding their oral health status, 75% answered positive oral health behaviors. The literature supported the value of oral health education in primary care. Awareness was created in the clinic with the use of posters and educational packets given to all participating patients. There is a great need for preventive oral health education to primary care providers, pregnant women, childbearing age females, and parents of children. Current research on the value of preventive oral health education and dental care is needed in primary care.Item Oral health outreach and education in a non-dental, American Indian setting(Montana State University - Bozeman, College of Nursing, 2016) Taubert, Kate Lisco; Chairperson, Graduate Committee: Laura LarssonTooth decay is the single most common chronic childhood disease (Centers for Disease Control and Prevention, 2014) and children with minority and low socioeconomic status are at an increased risk for early childhood caries (ECC) development. The number of children who routinely visit primary care providers is much higher than those who have seen a dental provider (American Academy of Pediatrics, 2008). Thus, pediatric primary care providers are in an opportune position to provide oral health screenings, interventions, and referrals. The purpose of this quality improvement project was to identify, implement, and evaluate a Doctor of Nursing Practice (DNP) pediatric oral health outreach and education quality improvement project in an American Indian, pediatric primary care setting. The intervention contained three parts including a caries risk assessment, caregiver education, and a same-day dental home referral. All caregiver/child dyads age birth - 5 years presenting to the pediatric clinic for a well-child visit were eligible and consented to the intervention (n = 47). The results determined that 86.84% of the sample population was at high risk for caries development and that 52.78% of children with first tooth eruption had previously seen a dentist. Of those children, 78.95% had caries. For children with first tooth eruption that had not seen a dental provider in the past three months, a successful completed referral rate of 72.41% was obtained. The average intervention duration was 4.73 minutes. The intervention was successful in integrating well-child and well-dental visiting into a combined visit that was feasible to sustain. All caregiver/child dyads consented to the intervention and received age appropriate oral health education. This interprofessional collaboration and was effective in addressing three aspects of oral health prevention and outreach. Oral health is part of total health, and thus should be incorporated into routine well-child visits.Item School nurse collaboration to provide evidence based flouride varnish for high caries risk students and referral for restorative dental care(Montana State University - Bozeman, College of Nursing, 2016) Trost, Michelle Louise; Chairperson, Graduate Committee: Laura LarssonDespite improvements in public health dentistry, low-income children continue to experience dental caries at higher rates than their counterparts. Commonly cited factors that impede low-income families from obtaining dental care include difficulty getting time off from work, lack of transportation or childcare, and lack of knowledge regarding the importance of oral health care. Community-based approaches to reduce caries rates, such as school-based dental sealant programs, are gaining popularity. School nurses can have an instrumental role in improving oral health access within their schools by collaborating with personnel from these programs to perform assessments, case-finding, and fluoride varnish application with increased frequency. Utilizing dental sealant program screening data from a low-income elementary school, school nurses identified students at highest risk for dental caries (N = 98) and offered a repeat application of fluoride varnish six months following the initial screening and application. In addition, school nurses utilized the screening data to identify students with untreated decay (N = 49). Those students who had not obtained professional dental care following the initial screening were offered referral to an onsite mobile dental van for professional restorative care. The results of this project indicated that school nurses can successfully enhance fluoride protection and improve access to preventive and professional oral health care for children attending low-income schools.Item The effect of contracted reinforcers on targeted nutrition-related dental behaviors in six Bozeman pediatric subjects(Montana State University - Bozeman, College of Education, Health & Human Development, 1980) Lilly, Karen Pal