1. Assuring Healthy Smiles for Early Head Start/Head Start Children Region I Head Start Oral Health Consultant Project Director, Perinatal & Infant Oral Health Ms. Mary E. Foley, RDH, MPH

2. When children’s oral health suffers, so does their ability to learn.* *HRSA

3. How can we help?

4. It’s about “Systems Integration”

5. Head Start Program Effective Program- “systems approach” Long history Supports overall child development Empowers parents and caretakers Service oriented with Program Specialists: Education Child Development PreventionEarly Learning/Literacy HealthDisabilities Family/Community Partner Program Support TA System in place (Regional and Local Oral Health Consultant)

6. Dental Services Delivery System Fragmented Private and Safety-net –Approximately 67% Americans access dental care services –Somewhat effective for those able to access care –Less so for low-income and Head Start children Enter system too late, disease has progressed, and treatment is extensive and costly How do we take the effective dental service models and integrate them into the Head Start system to meet the needs of these children?

7. #1 Increase Awareness Need to be aware of what’s happening on the National and Federal level: –National Call to Action “Oral health is more than healthy teeth.” “You can’t be healthy without oral health.” –Service Expansion –ACF and HRSA: Head Start Intra-Agency Agreement Prioritizing Oral Health –ACF/HS, HRSA and CDC re-allocating dollars for dental health –Medicaid is being cut 10B in the FY’06 Budget

8. #2 Keep up with Science and Oral Health Policies Need to stay current on the scientific literature –Evidence based practices –Aggressive prevention and “caries management” –Partner with medical community and non-dental health professionals to integrate OH more readily Need to stay abreast of state regulations and professional policies as they relate to practice –AAP and AAPD – First year dental visit –EPSDT

9. #3 Establish Partnerships We (the dental community) can’t do it alone So long as we think we can—we’ll keep chasing the disease We need to get ahead of the disease process by partnering with those other professionals groups who see our clients (very young children and pregnant moms before we do) We need to establish systems for service delivery that engage all health and child development professionals

10. # 4 Dental Care for Early Head Start and Head Start Children “Dental Home” –Continuous source of dental care services” Traditional New Models – Times have changed –Environment that people live in, science, and the way we practice –Portable dental equipment –On-site services Parental Responsibilities No more shaking the finger

11. Massachusetts Head Start Oral Health Initiative

12. Oral Health Consultant MDPH, Office of Oral Health hired RDH –Massachusetts Head Start Oral Health Consultant Role: –Oral Health Assessment/Survey of HS children –Provide technical assistance related to oral health education, prevention and access to care to HS admin., parents and other key child health providers

13. Head Start Oral Health Partners Massachusetts Department of Public Health Federal (HRSA) and NE Regional Partners Massachusetts Dental Society/Dental Hygienists’ Association Massachusetts Head Start Agencies Head Start Parent Groups Dental Services of Massachusetts (Delta Dental) Tufts Dental Facilities Community Program Boston University Dental School CAMOHS Program -Commonwealth Adol. Mobile Oral Health Services Program

14. 2004 Massachusetts Head Start Oral Health Survey  February to September 2004  Total enrollment of 12,007 Head Start Children  20/31 Head Start Grantees  1,756 Children were screened

15. Results 2004 Head Start Oral Health Survey 1,756/12,007 Children Screened 37.6%Evidence of Decalcification 37.9% History of Dental Disease 13.9% Restorations 29.7%Untreated Disease 8.1% Urgent Treatment

18. Access to Preventive Services Office of Oral Health linked the Tufts Dental Facilities to HS agencies Seven regional dental hygienists Portable dental equipment Screening, dental prophylaxis and fluoride varnish treatments Referral for restorative

19. Access to Restorative Dental Services Office of Oral Health linked the Commonwealth Adolescent Mobile Oral Health Services (CAMOHS) Program to HS agencies and other CHC dental clincis Dentists and dental assistants Portable dental equipment Providing comprehensive on-site dental services Private dentists

20. Adopt a Smile Office of Oral Health and Massachusetts Dental Hygienists’ Association are partnering to provide anticipatory guidance and oral health education to Head Start families. This education/mentoring model links one dental hygienist to one Head Start family.

21. Education Services Teach and work individually with parents Increase awareness of importance of oral health and link between oral health and general health Demonstrate to parents (on child) how they should brush and floss their child’s teeth Explain importance of fluoride for the prevention of dental disease (tablets, varnish, and fl. water) Explain what dental sealants are Encourage parents to seek routine dental services for both their children and themselves

22. Clinical Services Dental screening services ‘Look and See’ screening to identify any obvious dental needs When necessary, assist parents in obtaining dental services (assist in appointment making or helping a family find a dentist) Teach parents what to look for and then what to do...(i.e. plaque, white spot lesions-how to call dentist- what fluoride varnish treatments are)

23. Mary E. Foley, RDH, MPH Region I Head Start Oral Health Consultant Project Director, Perinatal and Infant Oral Health Children’s Dental Health Project Washington DC, 20036 Email: mfoley@cdhp.orgmfoley@cdhp.org Telephone: 617-899-1355