The Centers for Disease Control and Prevention CDC supports states in their efforts to reduce oral disease and improve oral health by using effective interventions. CDC provides state and territorial health departments with funding, guidance, and technical assistance to monitor oral disease across populations and to implement and evaluate oral health interventions.
Skip directly to site content Skip directly to page options Skip directly to A-Z link. Oral Health. Section Navigation. Facebook Twitter LinkedIn Syndicate. Common tooth brushing habits among children included brushing in the morning and evening and brushing after their child eats candy. The two biggest factors affecting tooth brushing were bad taste of toothpaste and children being scared of the toothbrush.
Singing and playing music were reported as strategies for calming children down so parents could brush their teeth. She also brushes at night time. Focus group participants described cavities as being black stains, spots, or holes.
The most common responses regarding causes of cavities were drinking milk especially during night if a child sleeps with a bottle , mother giving cavities to their child, and not brushing your child's teeth consistently. Most participants knew that cavities in baby teeth could affect adult teeth. If cavities were not treated early enough, participants were aware that children could become toothless or get sick.
When asked what to do if a young child's tooth hurts or is knocked out, responses included: take them to the emergency room if it happens at night, place something cold on the area, and place the tooth in a glass of milk and take it to the emergency room. The germs in mouth at night can form cavities. They will check with radiographs to start treating cavities early. It is important to not miss these appointments because if we miss them because we get lazy, we can be harming our child.
Most participants reported drinking filtered or bottled water. Some were concerned that bottled water was not good because it did not have fluoride while others were concerned about drinking water that had too much fluoride. Most did not know whether their drinking water had fluoride. Most participants wanted dentists to provide them with more information about what was going to happen to their child during the dental visit. They also wanted the dentist to speak with the child to explain what would be happening to them during the visit.
A few participants thought receptionists at dental clinics should be nicer to patients and more knowledgeable about insurance coverage. I had prepared her beforehand asking her to be ready to open her mouth big for the dentist, but when the dentist entered the room fully gowned with mask, it wasted all the preparation I did with my child.
I was very frustrated about that. I did not like that they did not explain my options for treatment. I would rather that my child be put to sleep for the treatment, and even though they put her to sleep, they didn't tell me they were going to do that. Some dental office will try to over diagnose or treat you.
When I took my child to the dentist that didn't have a lot of experience with children, they said she needed nerve treatment and a crown. I asked why because she was only 3 years old, they said that we should go see a specialist.
When we went for a second opinion with the pediatric dentist they said that all the patient needed was a small filling. They referred me to another clinic and the number they gave me was not even to a dental clinic. Focus group participants had several unanswered questions about oral health. Results from the focus group were used to revise the COHW training curriculum. There were significant increases in 2 of the 14 knowledge questions from pre- to post-test among COHWs in the training.
As a composite score for all 14 knowledge questions combined for all 13 COHWs responses, the mean number of correct responses increased from 7. There were no significant increases from pre-test to post-test on the belief questions, although two showed a positive trend.
Please refer to Supplementary Datasheet 1 survey instrument to view all knowledge and belief questions and their respective response categories. Additionally, the COHWs reported that the mean age they took their children to the dentist for the first time was at 13 months of age the general recommendation is to take your child to the dentist by the time the child is 12 months of age or earlier.
The mean number of children reported by caregivers was 2. Table 3. Table 4 presents the pre-test and post-test comparisons for changes in five of the eight knowledge questions and all three belief questions that were statistically significant. As a composite score for all eight knowledge questions combined for all caregiver responses, the mean number of correct responses increased from 2.
To see the complete list of the knowledge and belief questions with their respective response categories, please refer to the questionnaire in Supplementary Datasheet 2, 3. Table 4. Over three quarters of caregivers Oral health education interventions framed in a culturally appropriate and sensitive manner have a much higher likelihood of modifying participants' oral health risk behaviors than those developed generically and translated for other target populations 9 , 27 , 40 , Our study demonstrated that the use of COHWs to deliver oral health workshops to members of their community resulted in positive changes in oral health-related knowledge and beliefs following a 1 h workshop.
Working with native-speakers from the community drew on the value of the community and created a comfortable and safe environment for participants to learn about oral health care. In order to best tailor and refine the oral health curriculum content and activities for our COHW and community participants, qualitative information was gathered from a focus group which included participants with the same demographics as the target population.
While the focus group participants appeared to have a fair amount of oral health knowledge, including being aware of key health promoting oral health concepts, they still had several unanswered questions about oral health care practices such as flossing, use of mouthwash, and at what age to start using toothpaste with fluoride for children.
Dental providers who treat children should be better trained to work with children and their families. Communication strategies used by dental providers must be culturally and linguistically appropriate, and increasing the standards for dental training and practice with regards to treating young children is crucial.
The 13 COHW participating in the training showed significant increases from pre-test to post-test on the knowledge questions regarding the age when children can brush their teeth well alone and what a pregnant women with morning sickness can do to protect her teeth. Although only a few items showed statistical significance after the four training sessions, it should be noted that these 13 COHWs had a high oral health IQ before the training started. Thus, the lack of more statistically significant findings might be due to a ceiling effect where the COHWs had already high scores on questions at pre-test so there was little room to increase scores on the post-test.
Among the caregivers who participated in the 1 h COHW-led oral health workshops, there was a significant increase from pre- to posttest in knowledge and beliefs regarding oral health care. Significant increases in knowledge were obtained regarding when a child can brush their teeth well alone, the age when fluoridated toothpaste can be used, ways tooth decay can be prevented, when a child's first dental visit should be, and what a pregnant woman with morning sickness can do to protect her teeth.
Significant positive improvements were found regarding caregiver's beliefs toward agreeing that fluoridated water can help prevent cavities, disagreeing that tap water is dangerous, and agreeing that a parent's dental health affects their children's dental health. Findings from our study are in agreement with previous findings from the Contra Caries Oral Health Education Program which found their program was effective at improving low-income Spanish-speaking parents' oral hygiene knowledge and self-reported behaviors for their young children This study had limitations.
First and foremost, this study was not a cause and effect study. All responses to the questionnaires were self-reported and therefore subject to social desirability. This study was based on a convenience sample, thus the results may not be generalizable. Three of the COHWs training sessions were conducted by a pediatric dental resident and two nurse practitioner students.
We did not calibrate the trainers, so we were not able to account for inter-trainer reliability. Administering the post-test immediately following the 1 h workshop limits our ability to assess the reliability of the study findings and effectiveness of the program. Additionally, the short time frame between pre-test and post-test did not allow us to assess behavior change. While increasing knowledge and changing beliefs regarding oral health care is an important step in changing behavior, it does not always translate into behavior change Although this study did not have a control group, within-person comparisons for the pre- and post-test statistical analysis helped minimize the risk of confounding from individual characteristics and threats to validity.
Few culturally and linguistically appropriate oral health promotion programs have been developed for low-income Spanish-speaking caregivers of young children 12 , 37 , 43 — Our study showed that a COHW-led oral health promotion workshop resulted in significant improvements in caregivers oral health-related knowledge and beliefs. The COHWs could be responsible for connecting families with the right type of care.
They could also provide referrals to patients in person and offer to assist them in setting up appointments to help ensure children actually see a provider and obtain needed follow up care, as opposed to just receiving a piece of paper with a referral written on it. Navigating the health care system is not as straightforward as many assume.
Thus, viewing COHWs as an important link between the community and utilization of oral health care services, especially for high-risk and vulnerable populations, should be a priority. Investing in COHWs to provide oral health promotion in the future will require long-term studies to validate best practice approaches that promote oral health within the context of the overall social determinants of health access to a dental home, transportation, insurance coverage, access to healthy food options, etc.
A nationwide, streamlined, consistent training curriculum such as the American Dental Association's Community Dental Health Coordinator Curriculum with core competencies that are evidence-based and tested 46 as well as scope of practice and oversight will be needed. It is crucial to design long-term clinical studies to examine the oral health status of the children of trained COHWs and the workshop attendees to determine if short-term improvements actually translate into positive clinical health outcomes in children.
Previous studies have shown that caregivers have a fair amount of knowledge regarding oral health care, yet this knowledge is not necessarily translated into improvements in oral health care practices 12 , There continues to be a disconnect between oral health care knowledge and actual oral health care practices and clinical outcomes similar to other chronic diseases , especially among minority and underserved populations.
In light of the current high prevalence of ECC in Latino children, future studies are needed to further examine the relationship between the high prevalence of ECC among young children in underserved populations and oral health care knowledge and practices.
The raw data supporting the conclusions of this manuscript will be made available by the authors, without undue reservation, to any qualified researcher. FR-G was the principal investigator and senior advisor of the study. JV was the co-principal investigator and contributed to the study design and study implementation. HA contributed to the study design, study implementation, data evaluation, and manuscript preparation. IV contributed to the study design and manuscript preparation.
VK contributed to the study design and was the site cohort director. JK contributed to the manuscript preparation. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
UCCOH is a multidisciplinary initiative utilizing evidence-based research translated into training in clinical care and to aid in policy development and oral health advocacy. The main goal of UCCOH is to improve children's oral health at the local level as well as nationally and internationally. The Center aims to build, strengthen, develop, and integrate activities in children's oral health through interprofessional education in a pediatric oral health training program in coordination with the UCLA Schools of Medicine, Nursing, Public Policy, and Public Health.
Spring Trimester COHa Capstone Project 2 units Instructs ways to successfully conduct a systematic review by covering the 5 steps: Formulating the research question, searching the literature, assessing the quality, summarizing the evidence and interpreting the findings. COH Social and Behavioral Sciences 2 units Explores the social and behavioral factors of diverse groups that can affect the health status and choices of communities.
COH Research and Biostatistics in Healthcare 2 units Healthcare research encompasses a wide range of research disciplines including basic and applied research. COH Practicum 2 1 unit The practicum provides the opportunity to apply the acquired competencies to real world settings, and to provide to the community with tools to improve health promotion and disease prevention.
COH Health Education and Promotion 2 units Develops an action plan for health education and promotion including the planning, designing and evaluation of the instruction and materials. COH Community Health Funding and Support 2 units Presents the approaches to the generation and allocation of financial support for community health policies, programs and systems. Summer Trimester COHb Capstone Project 2 unit The student will conduct a systematic review as the research capstone experience of the program.
COH Community Health Program Planning and Implementation 2 units Introduction to the concepts and processes used in evidence-based community oral health program development. COH Environmental Health Sciences 3 units Environmental factors affecting community health and evidence-based approaches to control or reduce the risks of these health problems. COH Community Health Practice Standards 2 unit Examines the scopes and standards of practice, regulations, policies and ethical principles that affect healthcare providers, payers and other stakeholders in community healthcare settings.
COH Healthcare Communication Technology 2 unit Reviews systems and applications of the emerging technology of Telehealth for patient and professional health-related education and applications for patient access to care. COH Practicum 3 1 unit The practicum provides the opportunity to apply the acquired competencies to real world settings, and to provide to the community with tools to improve health promotion and disease prevention.
Courses outlined by trimester are completed throughout the 12 month period. Spring Trimester COH Social and Behavioral Sciences 2 units Explores the social and behavioral factors of diverse groups that can affect the health status and choices of communities. Summer Trimester COH Community Health Program Planning and Implementation 2 units Introduction to the concepts and processes used in evidence-based community oral health program development.
Where can your degree take you? Academic Faculty positions in public and community health academic programs with additional knowledge of current oral health issues.
Administration Leadership and interpersonal skills for workplace advancement opportunities in federal, state, local, private, non-profit and non-governmental organizations. Advocacy Specialized knowledge to provide the depth needed to promote and address the oral health crises, health care challenges, and current health disparity issues to promote improved community health.
Clinical Practice Diverse opportunities with advanced community and oral health knowledge as a public health clinician to address the needs of vulnerable populations in hospitals, universities, governmental agencies and private businesses.
Community Clinic Health and oral education and instructional positions are available in schools and universities, non-profit organizations, medical centers, community health centers as well as local and state departments.
Industry Private companies and governmental organizations seek those with knowledge on emerging importance for oral health in all communities. Research Analytical and problem-solving skills can assist research being conducted related to community and oral health at health institutes, local and national public health departments and private companies.
Others Initial preparation for eligibility as a Certified Health Education Specialist qualification for national credentialing. Pin It on Pinterest.
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