Integrating pediatric oral health into a rural, public-health setting

Abstract

Rural, low-income families in Montana experience individual and environmental barriers to oral healthcare access. In addition to knowledge deficits regarding pediatric milestones in oral health care, families in rural areas also have few, if any, pediatric dentists who accept Medicaid clients. The Centers for Disease Control and Prevention reported 2- to 5-year-olds are the only age group where the incidence of tooth decay is on the rise. This evidence-based demonstration research documents the baseline oral-health status of Park County Women, Infants, and Children (WIC) participants as well as the longitudinal efficacy of a bundled intervention to improve oral-health status in this high-priority population. Anticipatory guidance, caries risk assessment, repeated fluoride varnish application, and referrals for establishing a dental home and completing referrals for untreated decay are the bundled interventions under investigation in this project. Each level of intervention was documented in terms of state and national goals for the prevention of early childhood caries. The rate of signed forms consenting to treatment was used as a proxy measure that educating pregnant moms, parents, and caregivers about caring for baby teeth was effective. The long-term goal is to improve oral-health status in the Park County WIC population. The results of this research illustrated that performing oral-health assessments in a public-health setting provides an opportunity for nurses to promote sound oral-health practices, educate families on oral hygiene, and provide interventions aimed at preventing early childhood caries. Integrating oral health into public health as well as primary-care settings is a feasible and imperative practice in order to decrease the rates of ECC. A collaborative and integrative effort will ensure more children are screened for and educated on ECC. Introducing the intervention bundle at the WIC office in Park County proved to be a successful way of performing oral-health screenings, applying preventative FV, educating families on oral hygiene practices, and referring children to a dental home.