THE SCOPE OF ORAL HEALTH PRACTICE AND NEEDS OF CHILD HEALTH CARE MEDICAL PROVIDERS IN FLORIDA Michelle Valdes, Hilma Benjamin, M.D., Maja Marinkovic, M.D., and Rani S Gereige, M.D., MPH. Department of Pediatrics, University of South Florida, Tampa, Florida, United States. Partially supported by a resident’s planning CATCH Grant from the American Academy of Pediatrics APA School and Community Health SIG

Disclosures  Rani Gereige and the co-authors of the abstract have documented that they have no relevant financial relationships to disclose or conflict of interests to resolve

Background  Dental caries are the most common infectious disease in the U.S. (CDC)  The AAP adopted Oral Health as one of its focus areas for  The AAP goal is to train child health professionals to incorporate oral health risk assessment (OHRA) as part of well visits especially for children 0-3y  There is a great deal of variability in the oral health training and scope of practice of child health care professionals  No study has previously described how much Oral Health care child providers routinely perform (particularly in the State of Florida).

Objectives  Provide an indepth look at the pediatric oral health scope of practice of primary care providers (PCP) (Pediatrics, Med-Peds and Family Practice) and residents in the State of Florida  Assess current practice barriers and training issues

Design/Methods  Web-based survey was sent to the AAP Florida Chapter listserv and resident section  The survey link was placed in the Florida Academy of Family Physicians (FAFP) electronic newsletter  Over the span of three months, four reminder s we sent  The survey collected demographic data, oral health training data and practice patterns

Results

Characteristics of Respondents% Gender Male Female Ethnicity Caucasian Hispanic African-American Asian/Pacific Islander Other Geographic setting of Practice/ Residency Rural Urban Suburban Training institution has an affiliated dental school Yes No Oral Health curriculum in residency No Yes Didactics 38% 62% 64% 12% 11% 7% 6% 2% 63% 35% 40% 60% 71% 29% (79%) Results

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Limitations and Challenges  Limitations inherent to the study design Survey: Reporter bias  Small sample size did not allow stratification by specialty, year of practice, or training exposure  Residents sample limited by the number of residents in the State of Florida

Future Directions  Use the pilot data to design a larger scale study  Chart audits rather than reporting as a measure of practice pattern  More efforts to include Family Medicine residents  Will be used by Florida DOH

Conclusions  Overall, most PCPs and residents, despite inadequate oral health training, include OHRA as part of health maintenance visits  The oral health scope of practice could be improved with more needed training, Fluoride varnish application, and increased awareness of the role parent/caregiver oral health plays among others

References  Florida Health Insurance Study, Insurance Coverage Updates, Fact Sheet No. 2, August  U.S. Department of Health and Human Services. A National Call to Action to Promote Oral Health. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention and the National Institutes of Public Health, National Institute of Dental and Craniofacial Research. NIH Publication No , May  U.S. Department of Health and Human Services, A National Call to Action to Promote Oral Health, Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Center for Disease Control and Craniofacial Research. NIH Publication NO, , May  Oral Health Resources,  Florida Department of Health, floridacharts.com, Access to Dental Care by Low Income Persons  Florida Department of Health, floridacharts.com, Percent of Access to Dental Care at 200% below the Federal Poverty Level by county  Oral Disease: A Crisis Amount Children of Poverty, National Maternal and Child Oral Health Resource Center, May 1998.

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