Hillsborough County Health Department Community Dental Health Program Kim Herremans, RDH, MS Karen Hodge, RDH, MHSc

What is ‘WIC Smiles 4 U’ ?  Community based preventive dental program developed to address the oral health needs of vulnerable women, infants and children enrolled in WIC

Objectives:  Reduce caries incidence of infants, children in high risk, vulnerable populations.  Target: Evidence supports engaging pregnant women who are most receptive to follow advice/education for care of their child.

Who are key stakeholders?  Hillsborough County Health Department and local Federally Qualified Health Centers: Suncoast CHC and Tampa Family HC.  Collaboration of private and public agencies.

Plan  Integrate systems of care - increase access and reduce oral health disparities of women and children enrolled in WIC.  Expand effective bio- behavioral interventions that can be delivered by social workers, community health workers and nutritionists. Action  Establish a partnership with local community health centers to provide early preventive dental health services onsite at WIC clinics for vulnerable pregnant women and children  Developed an online course to meet the educational needs of WIC staff/nutritionists on the importance of children’s dental health and overall health.

Oral Health Champions! 98% WIC staff participation! HCHD WIC staff completed a 1 hour ‘WIC Smiles 4 U’ CME course in TRAK IT other DOH employees from around the state have logged in to complete the course.

Training for dental providers  Oral risk assessment,  Latest on fluoride varnish,  Didactic and “hands on” training for glass ionomer sealants  Education and information on reducing vertical transmission of the caries from caregiver to child.

Launched October 11, 2011 (10 months) 900 Clients served to date WIC smiles 4

Dental Services onsite:  Oral risk assessment  Oral hygiene instructions and nutritional counseling  Fluoride varnish  Sealants (primary and permanent teeth)  Prophylaxis  Referral to a health home

WIC ‘Smiles 4 U’ clients receive dental products and educational materials

Referral into a health home…

Other things to smile about:  Clients are encouraged to continue breast feeding  Parents get guidance to obtain Florida Kidcare coverage for their children  Clients are counseled by dental providers to reduce frequency of sugar consumption  Mothers receive education to reduce incidence of early childhood caries

WIC Smiles 4 U Preschool Survey Results  No obvious problems. Your child should see a dentist for a comprehensive examination and radiographs (x-rays).  Early dental care is needed. Care is needed soon. Your child has a dental problem that should be treated within the next 6 weeks.  Urgent care is needed. Your child has a dental problem that needs to be treated immediately.  54% No obvious problem  30% Early care is needed  16% Urgent care is needed

Hillsborough County 46% Unmet Needs vs. National 23% for Unmet Needs

Lessons learned  Start small – think big  Start early and involve all  Assure oral health literacy  Maximize the utility of science  Fix public program  Empower families and enhance their capabilities Burton Edelstein, Children Dental Health Project Improving Delivery Systems Through Workforce Innovations: Options and Opportunities for the Dental Safety Net

Challenges that we met:  Buy in from WIC staff and community health centers  Patient no show – Developed a Walk in system for clients as they arrive at mobile dental coach  Contracts between health department and community health centers  Language barrier  Resource guide/brochure for clients looking for medical/dental care.  Referral system for urgent dental care services required  Receiving copies of referral forms from CHC’s on a timely basis  Receiving invoices for services rendered on a timely basis  Dental staff communicating with WIC staff  Parking mobile coach near clinic

Best practices:  Online interactive children’s dental health course for WIC  Dental ‘event’ calendar  Hosted “Dinner and Learn” training  Messaging

 Designated WIC employee as ‘key contact’ for dental events  Versatility of bilingual dental coach staff.  1 week prior to dental event - CHC’s collect medical histories and appointment sheets.  2 days prior to event confirm client appointments. Best practices: (continued)

Future program plans may lead to: Expansion to other safety net providers and health agencies. Expansion across the state and to the nation. NOHC/Oral Health Florida/ FPHA/ FDHA/ APHA/ Robert Woods Foundation/ASTDD

Questions?