Healthy, Happy Smiles!

Transcription

1 Healthy, Happy Smiles! Preventative Dental Services in Eastern Oregon s By Alanna Chamulak and John V. Adams, MA Funding for the project is provided in part by the Oregon Community Foundation, and the Eastern Oregon Coordinated Care Organization. Eastern Oregon Healthy Living Alliance, PO Box 1230 Lakeview, OR jadams@gobhi.net (541) A program of the Eastern Oregon Healthy Living Alliance

2 Preventative Dental Services in Eastern Oregon s Background In 2016, Eastern Oregon Healthy Living Alliance (EOHLA), in partnership with Advantage Dental, launched a school based oral health program called Healthy, Happy Smiles that provides free dental screenings, fluoride application, sealants, oral health education, and follow up and referrals with kids identified with urgent dental care needs. The program reaches 2983 students attending public schools in Kindergarten through 8th grades, regardless of insurance status, in 23 schools in four frontier counties in Eastern Oregon, including Baker, Grant, Harney, and Malheur. Many children in Eastern Oregon do not have adequate access to oral health preventative programs and it contributes to some of the highest percentages of tooth decay and cavity rates amongst 6-9 years olds throughout the state. According to the 2012 Oregon Smile Survey, 73% of southeastern Oregon children ages 6 to 9 years old suffer the ravages of tooth decay, which are substantially higher than the state average of 52% [1]. Additionally, 14% of Oregon children within this age group experience rampant decay. The Oregon Healthy Authority reports how 43% of eligible schools in rural Oregon do not participate in school based dental sealant programs. Prior to the introduction of Healthy, Happy Smiles only six of the 23 schools had previously been served by the Oregon Health Authority dental sealant program, and two schools had previously been served by a local dental care office in their community. Healthy, Happy Smiles reaches an additional 1639 students in 15 schools that previously did not have access to preventative programs and services. Participating schools have at least a 40% Free and Reduced Lunch (FRL), expanding across a vast region of Eastern Oregon covering 27,773 miles, where there are limited services. For example, Fields Elementary in Harney County is 112 miles from the nearest dental office. By going to where the children are, we decrease access barriers and demonstrate that oral health is both important and a routine part of health monitoring and prevention services. Healthy Happy Smiles received funding support from the Eastern Oregon Coordinated Care Organization and the Oregon Children s Dental Health Initiative. Program The overarching goal of the program is to reduce the cavity rate of children in participating counties by 3% by To track progress, goals were set around various process measures, including 50% of eligible children to return parent consent forms for fluoride supplement and dental sealant treatment; 60% of eligible children to receive a dental screening or assessment; and at least 40% of eligible students to receive the fluoride supplement and dental sealant services within the first 12 months of the program. 1 P a g e

3 Participation in the program requires parent consent. Free dental screenings that examine the dental health are provided to every child with parent consent. A dental mouth mirror is all that is used for the screening. A fluoride application is provided to every child with parent consent. The fluoride takes about 1 minute to put on the teeth and can result in 37% less cavities on baby teeth and 43% less on adult teeth. Dental sealants are thin plastic coatings that are put on the chewing surfaces of permanent molars to stop decay, when fissures are exposed. Children with parent consent will receive dental sealants when the deep grooves or fissures are identified on the molars. s also had the opportunity to participate in a hands-on dental health learning lab. The lab features age appropriate educational material on brushing, flossing, fluoride, orthodontics, tooth anatomy, oral safety, tobacco s effect on the mouth, sugary foods and drinks, and dental careers. EOHLA partners with Advantage Dental who utilizes an already existing dental delivery service model that assists in connecting the local community of dentists to provide care to the members of the county. Each county is assigned an expanded practice dental hygienist (EPDH) that provides the services to students. EOHLA Program Coordinator, Alanna Chamulak, has been working in coordination with each hygienist to work with schools, schedule service days and provide care to students. All students that are seen by the EPDH are sent home with a printed report card of the screenings findings and of any services that were provided. If a student is identified to have urgent dental care needs it is indicated on the report card and the Advantage Dental Case Management team contacts the parents by phone. Case Management encourages the parents to schedule an appointment with the families preferred dentist or can assist in scheduling an appointment with an Advantage Dental provider in their area. Secondary dates are also set with schools so that the EPDH can follow-up with the students that were identified as having urgent dental care needs. Impact Progress was made in establishing the Healthy, Happy Smiles program and providing free services to students, many who otherwise would not have received services, and we re proud that more kids in Eastern Oregon will have healthy, happy smiles. However, there are mixed results overall, where participation was strong in Grant and Harney County and low in Baker and Malheur. Overall, 32% of students returned parent consent forms; 31% of students received dental screenings; at least 21% of students received preventative services; and 242 students received 486 individual dental sealants. 43.6% of students received oral health education through the learning lab; 71% of students received free toothbrush kits; and 42 students were referred to their provider for urgent dental care needs. At the time of this report, nine schools do not have sealant data yet due to scheduling and their remote locations. They will be served before the end of the school year. Baker County 2 schools 16% consent form return rate 19% students screened 5% preventative services Harney County 10 schools 54% consent form return rate 54% students screened 49% preventative services Grant County 3 schools 63% consent form return rate 52% students screened 38% preventative services Malheur County 8 schools 19% consent form return rate 15% students screened 3% preventative services 2 P a g e

4 Baker County Baker County had low participation rates in the program. Overall 15.75% of students returned parent consent forms in, far below the benchmark. As a result the screenings and preventative services rates are lower. of students Baker County s Baker Middle % Yes South Baker Intermediate % Yes Total % 19% 5% Grant County Grant County was the highest performing county. 63% of students returned parent consent forms, exceeding the benchmark. Due to the parent consent form return rate being higher, the screenings and preventative services were higher, including 52% of students receiving dental screenings, 38% of students receiving fluoride varnish application, and 62 students receiving 159 sealants. of students Grant County s Prairie City 99 28% No Seneca Elementary 42 74% Yes Humbolt % No Total % 52% 38% 3 P a g e

5 Harney County Harney County was the second highest performing county. 55% of students returned parent consent forms, also meeting the benchmark. Again, due to the parent consent return rate being higher, the screenings and preventative services were higher, including 55% of students receiving dental screenings, 49% of students receiving fluoride varnish application, and 58 students receiving 192 sealants. Harney County s of Double O Elementary 3 67% 2 2 TBD Yes Drewsey Elementary 9 100% 9 9 TBD Frenchglen Elementary 11 45% 5 5 TBD Yes Silvies River Charter 179 1% 3 3 TBD Yes Hines Middle % TBD No Henry L Slater Elementary % Yes Pine Creek Elementary 5 40% 2 2 TBD Yes Fields Elementary 12 50% 6 6 TBD Yes Suntex Elementary 10 TBD TBD TBD Yes Crane Elementary 74 27% TBD No Total % 55% 49% Malheur County Malheur County, like Baker County, had low participation rates in the program. Only 18.7% of students returned parent consent forms, far below the benchmark. As a result the screenings and preventative services rates are lower as well. of students Malheur County s Jordan Valley Elementary 23 17% Yes Jordan Valley High 12 0% No Rockville Elementary 4 75% No Ontario Middle 347 4% No Vale Elementary % Yes Vale Middle % Yes Willowcreek Elementary 99 13% Yes Nyssa Middle 256 7% No Total % 15% 3% 4 P a g e

6 Challenges A number of factors contribute to the low rates in Baker and Malheur Counties. Several schools did not have a strong plan in the spring, prior to summer vacation, to provide parent consent forms in fall school registration. In several schools we were not fully integrated within their registration process, limiting parent consent return rates. Also, relationships were not forged with key administrators and staff with the Malheur Education Service District and the Baker District 5J until later in the year. Baker Middle and Vale Middle have both scheduled second service dates in an effort to increase the number of students served within the current school year. Successes Grant County had a high success rate because the largest school was previously served by the OHA dental sealant program and had the protocol in place to have a strong return rate on parent consent forms. Additionally, the EPDH had relationships with the other schools and was able to work closely with administrators and schools staff to collect forms and provide services. how to floss Harney County, the second highest performing county, had successful implementation for a number of reasons. A couple of the larger schools in Harney County previously participated in OHA dental sealant programs and were familiar with the protocol, including parent consent forms at school registration. Also, Healthy, Happy Smiles steering committee member, Carolyn Bauer, with Burns Dental Group, volunteered her time to staff outreach tables at school registration with multiple schools. Finally, we worked closely with Harney Education Service District to provide the program to all of the schools in the county. Their support helped to legitimize the program, and we worked closely to implement the program. Program Coordinator, Alanna Chamulak, can recall a couple of impactful moments while providing the program. At the Baker Middle learning lab and service day, an 8th grade student informed Alanna that she had never been to the dentist before. On another occasion at South Baker Intermediate, a student told Alanna that he does not have a toothbrush at home, because his family does not have enough money to buy one. The child was very excited when he was told he would be receiving a free toothbrush. Stories like these reaffirms how important Healthy, Happy Smiles program is to children in frontier communities and encourages the EOHLA staff to work even harder. Moving Forward EOHLA plans to continue to provide the Healthy, Happy Smiles program and achieve its goal to reduce cavity rates by 3% through EOHLA has been awarded a $70K grant through the Oregon Children s Dental Health Initiative to provide the program in the school year. Moving forward, we will continue to strengthen our relationships with school districts, administrators and additional agencies. We plan to provide incentives for students and teachers to return parent consent forms, and we are preparing to be fully integrated into fall school registration. We anticipate this will result in higher consent form return rates and in turn result in more students receiving services. 5 P a g e

7 References 1. Oregon Health Authority (OHA). Oregon Smile Survey pdf 6 P a g e