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Community Dentistry Oral Hygiene Program

C. Jefferson & J. De La Garza


DHYG 1315 Spring 2016
Oral Health Program Development
Needs Assessment: The Port Arthur Housing Agency
1. General Data
The Port Arthur Housing Agency is located at 920 Dequeen in Port Arthur Texas. The Port Arthur
Housing Agency is a public agency that provides subsidized housing for low to moderate income
individuals and families. The housing authority of the city of Port Author manages 302 units of public
housing. It is the goal of Port Author Housing Authority to promote adequate and affordable housing,
economic opportunity and a suitable living environment.
2. Description of Target Group
The target population is 15 -20 adult women ranging in ages of 25-45. The ethnicities of the residents
are multi-cultural. This particular housing community is fairly new. There are about fifty families that
are current residents.
3. The Description of Staff Population
There are three people that work at the housing site; the social service coordinator who oversees the
facility operation and residential involvement; the manager, who cares for the needs of the residents and
property, and, the assistant manager who helps the support staff.
4. Description of Services Provided
The social services coordinator has informed that the program is to be planned for 15- 20 adult women
who will be participating in the program. The social services coordinator is responsible for all the
activities for the residents. She has scheduled some upcoming events with health plan companies for the
residents. The social service coordinator also has future plans to help the residents there find work and
get registered in skill-building programs.
5. Information Related to Dental Health
The residents do not receive public health services, and no additional preventive measures are being
utilized. The families are low income minority families. They are in need of education on good oral
health and preventive measures. The needs of the residents at the housing site were assessed in
coordination with the social service coordinator. Port Arthur Housing is located in Jefferson County
which has a population of 56,694. The water fluoridation levels are a.70mg/L. Taking into account the
residents social and economic standing we determined the residents could benefit from a dental public
health program at this site. The social services coordinator oversees the project to assist the need for
long-term planning; she is enthusiastic about the community program being implemented. The main
dental health needs that need to be addressed are oral health education, motivation and prevention

measures. The social service coordinator understands and embraces the concept of improving the
residents knowledge and benefits of dental health program.
6. Dental Health Status
The prevalence of disease and dental care for these groups is as follows: Port Arthur Housing Agency is
located in Jefferson County which has a population of 56,694. The water fluoridation levels are
a.70mg/L According to the Center for Disease Control and Prevention the statistics for women of ages
65+ that have lost 6 or more teeth due to tooth decay or gum disease are as follows: In 1999, 46.6% of
women vs. 44.5% men lost 6 or more teeth. In 2004, 42.5% women vs. 41.1% of men lost 6 or more
teeth. In 2006, 42.6% women vs. 42.2% of men lost six or more teeth. In 2008, 41.3% women vs.
36.9% men lost six or more teeth. In 2010, 39.2% women vs. 34.7% men lost six or more teeth.
According to Center for Disease Control and Prevention the percentage of women aged 18 + that have
visited the dentist for a prophylaxis has stayed within the range of 61%. In 1999 62.4% of women vs.
58.0% of men had their teeth cleaned. In 2002 60.7% of women vs. 55.2% of men had their teeth
cleaned. In 2004, 58.9% women vs. 58.5% of men had their teeth cleaned. In 2006, 60.3% of women
vs. 60.2% of men had their teeth cleaned. In 2008, 60.3% women vs. 58.6% men had their teeth
cleaned. In 2010, 61.9% of women vs. 57.8% of men had their teeth cleaned. This is the latest
information provided by the CDC.
Oral cancer Incidence (New Cases) in women aged 20-59 years old is as follows:
According to the National Institute of dental and craniofacial research, 10.5 adults per 100,000 will
develop oral cancer. Although oral cancer rates are higher for males than for females, it is important to
always be alert and pro-active. Oral cancer rates are higher for Hispanics and blacks than for whites.
Oral cancer rates increase with age and becomes more rapid after the age of 50. Oral cancer peaks
between ages 60 and 70.
The following incidence rate is based on the Surveillance Research Program Cancer Statistics Branch,
released April 2009, but based on the information submission of November 2008. The incidence of oral
cancer in women aged 20 to 29 is 0.9 for every 100,000. The incidence for oral cancer in women aged
30 to 39 is 1.9 for every 100,000. The incidence for oral cancer in women aged 40 to 49 is 4.7 for every
100,000. The incidence for oral cancer on women aged 50 to 59 is an astounding 10.2 for every
100,000.
7. Utilization of Dental Services
The Port Arthur Housing Agency does not provide the residents with dental services. Most of the
residents qualify for Medicaid provided by the government; however these programs do not provide
adults with funding for the dental care. Most of the time residents go to the dentist when they need to
go; usually during an emergency. A private dentist must be contacted for routine dental care or the
resident can now have the option to become a patient at the LIT dental hygiene clinic.
Goal Statement
The goal of this project is to increase the knowledge and skills on oral hygiene of the Port Arthur Housing
residents and to teach them about the benefits of a healthy oral cavity and how it is correlated to improve their
overall health.

Objectives
1. Increase the oral health knowledge of the residents by 25%, by interacting in dental based word games.
2. Decrease plaque of the residents 15%, through brushing modification instructions and implementing a
daily plaque control routine and teaching proper flossing techniques.
3. Teach residents about the effects of tobacco in the oral cavity and system.
4. Provide an oral/head and neck cancer screening, by teaching visual inspection and teaching self
assessment.
5. Establish a daily routine of proper oral hygiene for the residents that can be easily remembered and
followed.
6. Provide a dental resource list to help residents find low cost dental providers in their area.
7. Provide details about all careers LIT has to offer including the DH program.
Rationale
The residents of Port Arthur, Texas; have fluoridated water provided by the public health system, and serves as a
tooth decay preventive measure. The purpose of developing this oral health program is to address the need for
more frequent professional prophylaxis, the prevention of gum disease, and effects of tobacco use in this
community. Low income populations are less likely to seek routine dental care; as a result they are more likely
to suffer from tooth decay. There are barriers that exist, for instance lack of insurance, or lack of transportation.
Adults with low income lack resources to help offset the cost of dental care. Inadequate resources, lack of
practitioners, lack of funding, and lack of dental knowledge in general also contribute to the inevitable barriers
to care. At the conclusion of this oral health program, they will be properly educated regarding disease
prevention, oral cancer, fluoride, and plaque control. With this new knowledge, they will be able to reach good
oral health if not optimum.
Program Design
This program has been designed to educate the residents of the Port Arthur Housing Authority. The housing
residents are low income families, but our target groups are women ages 25-45 as well as any staff member that
are involved with the residents. The program will consist of five educational sessions each lasting one hour.
Each session will have a different topic and educational activity that will educate the residents about gum
disease, proper oral hygiene practices, implementation of a daily oral routine and the effects of tobacco.
Session 1 (week 1)
1.
2.
3.
4.
5.
6.
7.

We will introduce ourselves and represent LIT.


Discuss the need for a preventive oral health program.
Discuss the importance of good oral hygiene.
Provide a pre-test to assess the residents oral health knowledge.
Introduction to plaque.
We will provide disclosing tablets in order to take plaque scores.
Introduction to gum disease, specifically gingivitis, and how to prevent it. If the resident already has
gingivitis we will teach her how to reverse it.
8. Introduce a daily plaque control routine and persuade the residents to implement it daily.
9. We will develop an oral health based educational game that will entertain and educate the resident.
Session 2 (week 2)

1. Welcome everyone back.


2. Today we will introduce our group to Periodontitis and its negative effects in the oral cavity.
3. Our lesson for today will be to teach our group about Floss and its importance.
4. Our activity will be to teach them how to floss.
5. We will assess their knowledge by providing a game of matching.
Session 3 (week 3)
1. Todays session will consist of teaching our group about the caries process and prevention.
2. We will teach the residents how brushing is an important tool in caries prevention.
3. We will teach about nutrition and how certain foods affect the oral pH, specifically sugar.
4. We will continue our session with a word find game to increase the groups knowledge in
a fun, and interesting way.
5. The session will end with a prize for the winner and a moment to answer any questions that may arise.
Session 4 (week 4)
1.
2.
3.
4.
5.

Today we will introduce the effects of Smoking and Tobacco to the oral cavity.
We will teach them how to perform a cancer-screening on themselves.
Incorporate a learning game to assess their knowledge about Smoking/Tobacco and its effects.
We will give a prize to the person with the most knowledge.
Allow a moment for any questions.

Session 5 (week 5)
1.
2.
3.
4.
5.
6.
7.

Today we will begin by taking the final plaque score in order to asses/evaluate if our OHP succeeded
Today we will talk about dental hygiene and what we do as professionals.
We will give a presentation about other professions LIT offers.
Allow a moment for questions.
We will review everything that we have taught for the past four weeks.
We will invite everyone to the LIT dental hygiene clinic and pass out flyers.
We will provide a Health Resource List to all the residents so that they may continue to seek affordable
dental care.
8. We will end todays session with a raffle; grand prize drawing and thank everyone for their attention
9. Finally we will test the residents with a post-test to assess their learning.

Constraints and Alternative Strategies


1. Constraint: There could be an issue with attendance, depending of the time of day we make it to the
housing site.
Alternative: Schedule visits that are conducive to the group
2. Constraint: There could be lack of interest if the information is not presented in an interesting manner
to the pupil.
Alternative: Keep the group engaged by interacting and asking them questions about oral health and
using visuals because everyone has a different method to learning.

Resources:
Personnel:

Social service coordinator, the manager, who cares for the needs of the residents,
and, the assistant manager who helps the support staff.

Location:

The Port Arthur Housing Agency, 920 Dequeen in Port Author Texas, a residential
housing facility, where we will be using the recreation room.

Equipment:

Poster board display of the days topic, Interactive oral health games, typodont and
toothbrush, pencils, worksheet materials.

Supplies:

Toothbrushes, toothpaste, floss, safety glasses, gloves, masks, cups, disclosing


tablets, mouth rinse, pamphlets, paper napkins, plastic hand mirrors, typodonts, pre
and post-tests, hand mirrors, plaque score sheets, and patient education flip charts.

Audio/Visual Aids: Educational Poster Board, Pamphlets, Handouts, Typodonts, Disclosing tablets,
and Patient Education Flip Charts.
Evaluation Supplies: Pre and Post-test, Plaque score sheet, and Engagement Ministries Coordinator
evaluation.
Budget:

Toothbrushes Donated by Colgate


Toothpaste - Donated by Colgate
Floss - Donated by Colgate
Safety Glasses - Provided by presenters
Gloves - Provided by presenters
Masks - Provided by presenters
Cups Provided by presenters
Disclosing tablets Donated by Colgate
Paper Napkins - Provided by presenters
Plastic Hand Mirrors - Provided by presenters
Typodonts - Provided by presenters
Pre and Post-test - Provided by presenters
Plaque Score Sheet Provided by presenters
Patient education flip charts - Provided by presenters
Dental related activity color sheets and games Provided by presenters
Mouth rinse Provided by Crest
Grand Prize Give-away (electric/battery operated toothbrush) Provided by presenters

Estimated Total for OH Program:


$40.00 (electric/battery operated toothbrush/prizes)
Timetable:
This oral hygiene program will last five weeks. The days we plan to implement will be as follows:

Implementation of OH Program Session 1 will be Tuesday, March 22, 2016

Implementation of OH Program Session 2 will be Thursday, March 28, 2016

Implementation of OH Program Session 3 will be Tuesday, April 5, 2016

Implementation of OH Program Session 4 will be Tuesday, April 12, 2016

Implementation of OH Program Session 5 will be Tuesday, April 19, 2016

Evaluation:
Formative:
Pre-test of general oral health knowledge at the first session to evaluate the residents knowledge
about oral hygiene.

Residents plaque indices will be measured and recorded weekly to evaluate progress.

Teach about Tobacco and its detrimental effects in the oral cavity.

Teach oral/head and neck cancer screening for self assessment.

Weekly review with the residents about what was taught on the previous session to promote optimal
understanding and retention of the material.

Provide information/resources for low dental clinics in the area including LIT dental hygiene clinic.

Meet with Engagement Ministries Coordinator weekly to discuss progress, ensure satisfaction and
answer any lingering questions or concerns.

Summative:
The women residents of the Port Aruthur Housing Site will be given a pre and post-test in order to
measure their dental knowledge thus far.

A lesson plan will be provided to the social service coordinator of the program to establish
implementation of the oral health program annually.

An evaluation/review will be submitted by social service coordinator of the Port Arthur Housing to
our Community Dentistry professor in order to determine/measure the overall success of the
implemented program.

References
CDC.gov, C. for D. C. and P. MWF - my waters fluoride home. Retrieved March 16, 2016, from My Waters
Fluoride, https://nccd.cdc.gov/DOH_MWF/Default/WaterSystemDetails.aspx
CDC.gov. (2016, March 16). Oral health data: Explore by location. Retrieved February 16, 2016, from Centers
for Disease Control, http://nccd.cdc.gov/OralHealthData/rdPage.aspx?
rdReport=DOH_DATA.ExploreByLocation&rdProcessAction=&SaveFileGenerated=1&rdCSRFKey=f809
7e52-6c4e-4e5b-acf762bd2a4ab2e6&islLocation=48&iclTopic_rdExpandedCollapsedHistory=&iclTopic=ADT%2cCHD
%2cWFR&islYear=2012&hidLocation=48&hidTopic=ADT%2cCHD
%2cWFR&hidYear=2012&irbShowFootnotes=Show&iclIndicators_rdExpandedCollapsedHistory=&iclIndi
cators=ADT1_1%2cADT1_2%2cADT1_3%2cADT1_4%2cCHD1_1%2cCHD1_2%2cCHD1_3%2cWFR1
_1&hidPreviouslySelectedIndicators=&DashboardColumnCount=2&rdShowElementHistory=&rdScrollX=
0&rdScrollY=0&rdRnd=84774
CDC.gov. (2016, February 22). Oral and dental health. Retrieved March 16, 2016, from
http://www.cdc.gov/nchs/fastats/dental.htm
Oral cancer incidence (new cases) by age, race, and gender. (2014, May 28). Retrieved March 16, 2016, from
National Institute of Dental and Craniofacial Research,
http://www.nidcr.nih.gov/DataStatistics/FindDataByTopic/OralCancer/OralCancerIncidence.htm#
National Cancer Institute. Fast stats. Retrieved March 16, 2016, from Oral Cavity & Pharynx,
http://seer.cancer.gov/faststats/selections.php?#Output

Appendix:
Plaque Scores:
(to be turned in independently)

Community Dentistry

Pre-Test Assessment

1)

Plaque can only form on your teeth after you eat something:
a) True
b) False

2)

What is a cavity?
a) A piece of dirt on your tooth
b) A hole in your tooth
c) A bad tooth that has to be removed

3)

It is not necessary to brush your tongue:


a) True
b) False

4)

What type of snack is the best for keeping your teeth healthy?
a) A sugarless snack like string cheese
b) A cold snack like ice cream
c) A chewy snack like a candy bar
d) All of the above

5)

How often should you brush your teeth?


a) Whenever you feel like it
b) Once a day
c) Twice per day
d) Once every few days

Community Dentistry

Post-Test Assessment

1)

Plaque can only form on your teeth after you eat something:
a) True
b) False

2)

How often should you brush your teeth?


a) Whenever you feel like it
b) Once a day
c) Twice per day
d) Once every few days

3)

What type of snack is the best for keeping your teeth healthy:
a) A sugarless snack like string cheese
b) A cold snack like ice cream
c) A chewy snack like a candy bar
d) All of the above

4)

___________ is a mineral that can be found in toothpastes, mouth rinses, and even tap
water that helps strengthen the enamel of your teeth and prevents cavities:
a) alcohol
b) zinc
c) fluoride

5)

What is a cavity?
a) A piece of dirt on your tooth
b) A hole in your tooth
c) A bad tooth that has to be removed

6)

Once plaque remains on the teeth for extended periods of time, it hardens and forms
tartar. Tartar can be removed from the teeth with proper brushing and flossing.

a) Both statements are true.


b) Both statements are false.
c) The first statement is false, but the second statement is true.
d) The first statement is true, but the second statement is false.
7)

It is not necessary to brush your tongue:


a) True
b) False

8)

It is important to always use a __________ bristle toothbrush when brushing your teeth
and gums:
a) soft
b) medium
c) hard

9)

How long should you brush your teeth?


a) 30 seconds
b) 1 minute
c) 2 minutes

10)

Energy drinks dont cause cavities:


a) True
b) False