Georgia Smiles for School Nurses Health Department s Oral Health Prevention Program for Schools

Georgia Smiles for School Nurses Health Department s Oral Health Prevention Program for Schools Jennie M. Fleming, RDH, BS, MEd, Editor INSIDE: PREVENTING SPORTS INJURIES 1 CHILDREN S HEALTHCARE OF ATLANTA Safe Child Week WHY SHOULD I WEAR A MOUTHGUARD? CAN MY MOUTHGUARD Make Me SICK? CHOA Sports Parents SAFETY CHECKLIST Parents and Coaches SPORTS SAFETY-TIP Sheet 2 3 4 5 Orofacial TRAUMA 6 In the NEWS: ASTHMA AWARENESS ASTHMA and ORAL HEALTH FACT SHEET In the NEWS FREE Dental App Parent Awareness No DRILL? TEXTING for OH Unmet NEED 7% Infants & Tod- 7 8 9 10 East Metro Health District s Oral Health Prevention Program April and May have many observances for children's health and wellbeing. Just a few include National Facial Safety Month, National Child Abuse Prevention Month, National Save Kids Week, Sports Eye Safety Awareness Month, Better Hearing and Speech Month, National Asthma and Allergy Month, Child s Mental Health Awareness Week, and Heat Safety Awareness Day. More than 3.5 million children and adolescents suffer sports-related injuries every year. Although, most of these injuries will be minor sprains or strains, others will be more severe injuries including heat-related illnesses and concussions. Many can be prevented or lessened by wearing helmets and mouthguards, even for sports you might not consider dangerous. These protective items are now being recommended for both male and female sports activities. According to the National Youth Sports Foundation for the Prevention of Athletic Injuries, Inc., the most common orofacial injury from sports is dental-related. Mouth guards help prevent an estimate of over 200,000 injuries a year. Tooth loss and avulsions where the teeth have not been preserved properly or replanted may result in a lifetime of dental problems, possibly costing $10,000 to $15,000 a tooth. Periodontal disease may result. Keeping our children safe and healthy, and teaching them how to do the same, includes providing protection from possible face and head injuries especially now that Spring is here Safe Smiles are Happy Smiles! Preventing Sports Injuries With more in the news about the dangers of Traumatic Brain Injury (TBI), a leading cause of acquired disability, every possible precaution should be taken to prevent a lifetime of physical, cognitive, emotional and behavioral complications. All types of sports are considered risks for injuries including football, baseball, basketball, skiing, soccer, skate and snowboarding, lacrosse, ice and field hockey, wrestling, and boxing. rugby, water polo, karate, judo, gymnastics, and horseback riding should include helmets and mouthguards, just to name a few. TEACH Children FIRST-AID ACTIVITIES 11

Page 2 Spring 2012 Children s Healthcare of Atlanta to Celebrate Safe Kids Week Children s Healthcare of Atlanta will be hold Safe Kids Week this year from April 21-28th. Highlights and focus will be on Sports Safety. Each year, more than 3.5 million children ages 14 years and under receive medical treatment for sports injuries. The rate and severity of sports-related injury increases with a child s age. Safe Kids Georgia is working to empower parents, coaches and caregivers with the knowledge to help protect their children from these injuries. Here are some proven interventions: Coaches should be trained in first aid and CPR, and should have a plan for responding to emergencies. Proper hydration and recognition of heat illness signs and symptoms (such as nausea, dizziness and elevated body temperature) can help reduce the risk of severe sports-related heat illness. Recent studies show that a significant number of both parents and coaches are not familiar with concussions, recognition of concussion signs and when to keep young athletes from returning to play. To improve care for young athletes, the CDC has published educational Heads Up toolkits for parents, coaches and teachers. www.cdc.gov Helmets have been shown to reduce the risk of concussion, particularly in sports such as football, skiing and snowboarding. Among bicyclists, skateboarders and scooter riders, wrist guards can reduce wrist injuries by up to 87 percent, elbow pads can reduce elbow injuries by 82 percent and knee pads can reduce the number of knee injuries by 32 percent. The American Academy of Pediatrics recommends that children take at least one day off from organized physical activity each week and at least two to three months off from a particular sport per year to avoid overtraining or burnout. Sports programs with adults on staff who are Certified Athletic Trainers are ideal because they are trained to prevent or provide immediate care for athletic injuries. Printed with permission from Terri Miller Program Coordinator Safe Kids Georgia Children s Healthcare of Atlanta Why Should I Wear a Mouthguard? A mouthguard can prevent serious injuries such as broken teeth, jaw fractures, cerebral hemorrhage and neck injuries by helping to avoid situations where the lower jaw gets jammed into the upper jaw. Mouthguards are effective in moving soft tissue in the oral cavity away from the teeth, preventing laceration and bruising of the lips and cheeks, especially for those who wear orthodontic appliances. They may also reduce the severity and incidence of concussions. ~Academy of General Dentistry http://www.agd.org/public/oralhealth/default.asp?issid=313&topic=m&artid=1269#body

School Smiles Page 3 Can Your Mouthguard Make You Sick? Taking care of your mouthguard is very important. Mouthguards as well as toothbrushes harbor large numbers of bacteria, yeasts and molds that can possibly lead to life and health-threatening infectious / inflammatory diseases, according to a study that appears in the September/October 2007 issue of General Dentistry. "Everything that a microorganism needs to survive, including food and water, can be found in a mouthguard," says Thomas Glass, DDS, PhD, lead author of the study. "While mouthguards appear solid, they are very porous, like a sponge, and with use, microorganisms invade these porosities." "These concerns are similar to using an infected toothbrush repeatedly or using silverware that has not been cleaned properly," says AGD spokesperson Bruce Burton, DMD, MAGD, ABGD. "Although a mouthguard is recommended to prevent permanent damage to the mouth and teeth, we know it also has the potential to be a reservoir for bacteria that can cause gum infections or the bacteria that help promote tooth decay." Warning signs that can alert athletes that he or she may be suffering from a contaminated mouthguard, include "difficulty breathing, wheezing, diarrhea and nausea to the point of vomiting," says Dr. Glass. Poor mouthguard habits were noticed by Dr. Burton as a high school football coach for 25 years. "Chewing on the mouthguard until it no longer serves the purpose of protecting the dentition is one poor habit," says Dr. Burton. "In addition, some athletes throw the mouthguard in with dirty, sweaty gear and never clean it.. Mouthguard maintenance includes: Brush teeth before wearing a mouthguard and clean it before storing. Never share a mouthguard with teammates. During sporting events, have a backup mouthguard. Purchase disposable mouthguards. http://www.agd.org/public/oralhealth/default.asp?issid=313&topic=m&artid=3075#body Your County Health Department s In-School Dental Program Does your school have a dental program for your students? Does it only treat students whose parents or insurance can pay? Many of the county health departments have school dental programs. Contact your local health department and they will be happy to share information regarding their services with you! Your health department may have a school program especially for those children without access to care who are left without a safety net by some dental programs. If so, they would be happy to make an appointment to visit your school and provide oral screenings, cleanings, dental sealants, and fluoride treatments regardless of ability to pay. If one of your students should have an emergency or just needs a dentist, the health department dental clinic is right there. For program contact information: http://health.state.ga.us/pdfs/familyhealth/oral/oralhealthcontacts.pdf

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Page 6 Spring 2012 Orofacial Trauma Information in this program was adapted from a series on oral health for healthcare professionals by the American Academy of Pediatric Dentistry, and Proctor and Gamble Oral Health Products. http://www.dentalresourcenet.ca/en-us/olcourse/sft/rnoro1.jspx Fracture Displacement Avulsion Site Avulsion Site Tongue Laceration Palate Soft Tissue Trauma Lip Laceration with 8 stitches * Frenum Laceration Lip Laceration Remember, the most common orofacial injury from sports is dental-related. Mouth guards help prevent an estimate of over 200,000 injuries a year. Tooth loss and avulsions where the teeth have not been preserved properly or replanted may result in a lifetime of dental problems, possibly costing $10,000 to $15,000 a tooth. Periodontal disease may result. * Photograph of lacerated lip with 8 stitches courtesy of Megan Hill, RDH.

School Smiles Page 7 ASTHMA in the NEWS Asthma Remains Largely Uncontrolled in the United States, Lara C. Pullen, PhD, Medscape February 28, 2012. US national asthma management targets find that asthma control falls far short according to a new survey. This study takes into account both asthma control and asthma severity, using methods from the Expert Panel Report III (EPR 3). The results were published by Gene L. Colice, MD, from Washington Hospital Center and the George Washington University School of Medicine in Washington, DC, and his colleagues. The Comprehensive Survey of Healthcare Professionals and Asthma Patients Offering Insight on Current Treatment Gaps and Emerging Device Options (CHOICE) is featured in the March issue of the Annals of Allergy, Asthma and Immunology. The purpose was to assess asthma severity before the use of long-term controllers using the CHOICE survey incorporating the EPR 3 recommendations. The survey revealed that although a respondent often described their disease as either completely or well-controlled, they might also indicate a high burden of disease via the answers to survey questions. This may possibly been the reason that many surveyed (49%) were not using controller medication, even in the presence of persistent disease. "According to survey results, 79 percent of these patients had persistent asthma and should have been on controllers," said Dr. Colice in a news release. "Of the 51 percent on controllers, 86 percent were inadequately treated as their asthma was not well or very poorly controlled." This was a telephone survey of 1000 patients diagnosed with asthma and was vulnerable to the limitations of responder bias and inaccurate recall. Asthma is a common illness, affecting 7 million children (10% of children in the United States) and 17.5 million adults (8% of adults in the United States). http://www.medscape.com/viewarticle/759344_print NOTE: Asthmatics with poor oral health have higher risks of aspirating bacteria from their teeth, which may lead to respiratory problems including pneumonia. The EPA among thousands of organizations join together each May for Asthma Awareness Month hoping to increase public awareness of the asthma epidemic, as well as, to take action to get it under control in communities across the US. This Event Planning Kit was developed by the EPA to hold community-based asthma awareness and action events. Among many items, the kit includes: Ideas for Asthma Awareness Activities Plan an Asthma Education Event in Your School Ten Ways to Manage Asthma in Your School Asthma Facts, Resources and references, etc. For more information: http://www.epa.gov/asthma/awareness.html To download a copy of the kit: http://www.epa.gov/asthma/pdfs/awm/event_planning_kit.pdf CDC Fact: the past three decades, tooth decay remains the most common chronic disease of children aged 6 to 11 years (25%), and of adolescents aged 12 to 19 years (59%). Tooth decay is four times more common than asthma among adolescents aged 14 to 17 years (15%). For more information and a copy of the Fact sheet on page 7: http://www.cdc.gov/fluoridation/fact_sheets/fl_caries.htm and http://www.cde.state.co.us/ cdeprevention/download/pdf/asthma%20%20oral%20health%20fact%20sheet.pdf Although there have been notable declines in tooth decay among children and adults over

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School Smiles Page 9 IN The NEWS, continued FREE Dental App for Kids - DentistryIQ, March 6, 2012 - Orca Health announced on March 6, 2012, that its KidsDental App for ipad is now available on the App Store. The KidsDental App is divided into four sections designed to teach young users about basic tooth care: Explore -- takes advantage of Orca's 3D engine to enable 360-degree examination, with full zoom, of the jaw and teeth. Conditions -- uses animation and interactivity to teach users about cavities, early tooth loss, abscessed teeth, broken teeth, late loss of teeth, and gum disease. Learn -- the touch interface of the ipad is used to learn to floss, understand the impact of healthy foods on dental health, practice good habits, learn to brush, and finally practice brushing. The rich animation of makes this app entertaining and educational. My Teeth -- a customizable "My Teeth" section that allows children and their parents to input data about their teeth and significant events, such as losing their first tooth, into a calendar. They can also use emoticons to select "How they feel" about a given event. Additionally, users can take and share pictures via email. "We are excited to launch our eleventh app on the App Store, providing children and their parents with an entertaining and educational dental app," said Matt Berry, founder and CEO of Orca Health. "Dental health and oral hygiene are important components of a child's development. Pamphlets and dentists' lectures are clearly not getting the job done; we believe KidsDental, with its beautiful animations, will do a better job of teaching children to take care of their teeth."http://www.dentistryiq.com/index/display/article-display/3625017812/ articles/dentisryiq/hygiene-department/2012/march/orca_ipad_kids.html The KidsDental App is available for FREE from the App Store on ipad or at http://www.itunes.com/appstore/. Parents Have Limited Awareness of Recommended Pediatric Dental Care - Dentistry IQ, February 6 - Many parents may be overly optimistic as 97% who have dental insurance would rate their child s oral health (ages 5 and younger) as excellent or good. A new MetLife study reveals that many parents are not following recommended guidelines for optimal pediatric oral health for their child s brushing, flossing, and other habits. Twenty-three percent (23%) of the parents surveyed have been told by a dentist or hygienist that their child was at risk for tooth decay. Approximately half may not be making the connection between their child s oral health and overall health and had not spoken to their pediatrician about their child s teeth. Parents should be speaking to their pediatricians to learn more about how their child s oral health can affect their overall health, says Dr. David Guarrera, vice president of MetLife Dental Products. With the help of their dentist, parents can take a few simple steps to introduce healthy oral hygiene habits at an early age and to make sure their children s teeth are protected. http://www.dentistryiq.com/index/display/article-display/6548211503/ articles/dentisryiq/hygiene-department/2012/february/metlife-study_pediatrics.html CDC Fact: Tooth decay affects children in the United States more than any other chronic infectious disease. Untreated tooth decay causes pain and infections that may lead to problems such as eating, speaking, playing, and learning. http://www.cdc.gov/oralhealth/topics/child.htm

Page 10 Spring 2012 IN The NEWS, continued Blast of Gas That Could Replace Dentist's Drill and Make Fillings Stronger, Daily Mail, January 23 - A pain-free gas-firing device may offer a new alternative to the dentist s drill and could make fillings even more hard-wearing. The device cleans out cavities in rotten teeth in only 30 seconds and resembles an electric toothbrush. High-energy gas and liquid particles are generated to kill bacteria and blast out the decayed pulp of the tooth. Researchers at the University of Missouri who developed the device say it does not affect the highly sensitive nerves in the teeth which means less discomfort for patients. If clinical trials go well, researchers believe the plasma brush could be available to dentists by the end of next year. http://www.dailymail.co.uk/health/article-2090764/blast-gas-replace-dentists-drillmake-fillings-stronger.html?ito=feeds-newsxml Patient Texting Study to Promote Oral Health, DrBicuspid.com, January 18 - CellTrust is working with A.T. Still University Arizona School of Dentistry & Oral Health to launch a text messaging study. The pilot study, Text2Floss series of text message programs, is intended to improve patient compliance with oral health. It will be designed to reach and educate current patients and the underserved by promoting preventive and ongoing health and wellness initiatives. They believe that by directly providing a secure SMS solution with required patient information, physicians and clinicians will be able to make informed decisions and will improve the quality of health care with decreased response times and accurate decision making. This will allow for quicker interventions and improved patient outcomes. http:// www.drbicuspid.com/index.aspx?d=1&sec=sup&sub=pmt&pag=dis&itemid=309591 Unmet Dental Need: 7% of US Children, ADA.org, January 18 - Seven percent (7%) of American children 17 years old and younger had unmet dental need in 2010 because their families could not afford dental care. According to a National Center for Health Statistics report, this includes an estimate of about 4.3 million children ages 2-17 years and is representative of the civilian noninstitutionalized population in the US. Children in single-mother families were more likely to have had unmet dental need (9%) than in two-parent families (6%). Uninsured children were more than 4 times as likely as children with Medicaid or other public coverage and more than 6 times as likely to have unmet dental need as children with private health insurance. The report is one in a set from the 2010 National Health Interview Survey, conducted annually for the CDC s National Center for Health Statistics. http://www.ada.org/news/6700.aspx Infants and Toddlers Should See Dentist, United Press International, December 29 - According to Paul Casamassimo, chief of dentistry at Nationwide Children's Hospital in Columbus, OH, Infant oral health is the foundation for preventing future tooth decay. If a child experiences tooth decay at an early age, it is a very difficult process to stop. The purpose of this initial visit is not only to introduce these toddlers to visiting the dentist, but also to provide preventative information to prevent tooth decay. The American Academy of Pediatric Dentistry's revised guidelines on infant oral health recommend infants 6 to 12 months old should be seen by a dentist. http://www.upi.com/health_news/2011/12/29/infants-andtoddlers-should-see-dentist/upi-99051325213102/ The revised guidelines on infant oral health may be viewed at: http://www.aapd.org/media/ policies_guidelines/g_infantoralhealthcare.pdf

School Smiles Page 11 Teaching Children First Aid Children trained in the basics of first aid can prevent and assist with dangerous/life threatening situations. News reports are filled with articles praising children who have saved a parent, sibling, or friend s life by having been taught the basics early on. Children should be shown where first aid kits are kept and be given instructions about the contents, how and when to use them, and to call 911. Important and emergency phone numbers ought to be next to every phone. Adults teaching first aid should explain certain concepts regarding simple first aid care and what to do in the case of broken bones, head injuries, burns, bleeding, choking, heart attacks and lack of breathing. Children should know: broken bones should not be moved or straightened and the victim should be kept warm and quiet. In the case of head injuries, which signs necessitate 911, including massive swelling, vomiting, pupil contraction or dilation, speech changes and dizziness. burns with blistered or red skin need to be submerged in cold water and in cases of advanced degree burns, they are not to touch the skin, but quickly call 911. in case of bleeding, elevate the affected body part and apply steady and firm pressure with their hands over the wound. For choking, heart attacks or lack of breathing, children can and should be taught proper CPR protocol and procedures by emergency personnel. Read more: Children's First Aid Training ehow.com http:// www.ehow.com/about_6361625_children_s-first-aid-training.html#ixzz1ryjdyigk First Aid Games and Activities First Aid Activities and Games including: Making a First aid Kit First aid Bingo First aid Maze Red Light-Green Light Fireman s Drag These can be found at: http://www.ehow.com/facts_5030670_first-aid-activities-children.html Activities for safe play and safety protection: Mouthguard Activities and Quizzes Mouthguard coloring sheet: http://www.ada.org/sections/publicresources/pdfs/ teeth_materials_mouthguard.pdf Why wear a mouthguard quiz: http://www.mouthguardawareness.info/downloads/activity-whywear-a-mouthguard.pdf First aid for a Knocked-out Tooth: http://www.mouthguardawareness.info/downloads/activity-first- Aid.pdf