1. Paul Glassman DDS, MA, MBA Christine Miller RDH, MHS, MA
The Role of the General Health and Social Service Professionals in Identifying Infants and Toddlers at Risk for Oral Health Problems
Paul Glassman DDS, MA, MBA
Christine Miller RDH, MHS, MA

2. California Dental Association Journal
August/September 2005

4. Oral Health Care Delivery System
Services delivered in locations where people
live, work, play, go to school, receive social services
Prevention services - Fl varnish,
sealants, medical model treatments
minor dental procedures
screening, triage,
prevention education
Complex dental procedures
Dental office
Safety net
clinic
Hospital

7. The California Early Start Program: Integrating Oral Health
Department of Developmental Services
0-3 year olds “at risk” for having a developmental disability
Health screening, referral for intensive intervention services
Did not include attention to oral health

8. Project Details Two-year project – funded by CA 1st 5 Commission
Identify 7-10 Social Service or General Health Professionals from each of 8 sites
Integrate “Oral Health Risk Assessment” into ongoing assessment
Training on assessment and intervention
Work collaboratively with Dental Coordinator who can provide:
Training and intervention for families, caregivers and other professionals

9. Project Details Training Early Childhood Caries Risk assessment
Traditional prevention practices
Medical model prevention activities

10. Early Childhood Caries
Most prevalent chronic disease of childhood
5 times more prevalent than asthma
7 times more prevalent than hay fever
Tooth decay is the single, most prevalent chronic disease of childhood. It is five times more prevalent than asthma and seven times more prevalent than hay fever. About one-third of California preschool children have untreated tooth decay.

11. Severe ECC
Distinctive pattern of tooth decay that begins on upper primary teeth
Rapidly progressing to other teeth as they erupt
Severe ECC is characterized by a distinctive pattern of tooth decay in infants and young children, often beginning on the maxillary anterior teeth and rapidly progressing to the other primary teeth as they erupt. ECC can begin to develop as soon as teeth erupt into the mouth at 6-10 months of age which is why an early oral health assessment is so important.

12. The effects of ECC Pain Infection Self-esteem
How does ECC affect young children?

13. Early Signs of Decay: White Spot Lesions
The first visible sign of tooth decay
Reversible
Parents can lift the lip and look
The first visible sign of tooth decay or demineralization is a chalky “white spot” lesion.

14. The Caries Balance aliva adequate nti- microbial luoride ffective diet
ad Bacteria
bsence saliva
ietary habits poor
So this is a reminder that Xylitol can be an effective part of the tipping the “Caries Balance,” a concept that you were introduced to previously, toward remineralization and health.,
Demineralization
Remineralization

15. Project Details Assessment Intervention Risk Assessment Tool
Companion Brochure
Counseling Guide

16. The Oral Health Risk Assessment Form

23. The Oral Health Risk Assessment Form

32. Service Coordinator Oral Health Activity
8 sites, ~ 40 Service Coordinators
~2500 oral health assessments
800 require dental coordinator follow-up
400 require referral to dentist

33. Service Coordinator Focus Groups
Initial concerns – time, unfamiliar, not a priority, family concerned about other issues
Service Coordinators now consider it “part of what we do – should have been doing this all along”
Feel good about giving family something they can actually do something about