Amelia Gonzalez

Helen Brown
Health Promotion
14 April, 2017

Children 0-5 Oral Health Intervention

Intervention Website Review

Childrens Healthy Smile Project - http://www.childrenssmileproject.org/home/index

Builder, D. F. (n.d.). Childrens Healthy Smile Project. Retrieved April 14, 2017.

The Childrens Healthy Smile Project explains how many disadvantage children, infant to
elementary school age, lack good oral hygiene care due to access to community water
fluoridation and lack of dental insurance. And thus, many children especially the disadvantage
are affected by a progression of tooth diseases, overall health, and even self-esteem. As a result,
the Childrens Healthy Smile Project suggest early interventions with education for both parents
and child.
Children Healthy Smile Project has multiple teaching and training intervention tools and
resources. Oral hygiene and educational materials are available to children who are need.
Starting with promoting a healthy Smile Kit. Age appropriate Smile Kits are available for
baby, toddler, and kids from kindergarten to elementary school children which include a tooth
brush, tooth paste, and floss/flossers.
Baby Smiles, emphasis on early care (before eruption of infants first tooth) by offering
dental hygiene information to new moms. Information that is include is the effects of baby
bottle syndrome, thumb sucking, pacifiers, and diet are included in information kit. Toddler
Smiles, emphasis on establishing a healthy oral hygiene routine and healthy diet for children
since teeth are beginning to form at this age and are prone to dental diseases. Toothpaste and
toothbrush are provided to design a proper brushing routine. Kids Smiles, emphasis on oral
hygiene education and providing Smile Kits for Head Start, low income kindergartens and
elementary school children. This age group of children are the most vulnerable to dental disease.
 Addition to Smile Kits, Childrens Healthy Smile Project provides educational text books
relating to dental health issues both in English and Spanish. Teacher read them to their classroom
and allow children to take them home and have their parents read for them.
Childrens Healthy Smile Project also works with each Head Start to provide material to
support dental education and make children comfortable with going to the dentist. Children are
provided with teaching aids (lab coat, bibs, masks) so they can role play being the dentist, the
patient, and practice good oral hygiene. The overall experience has improved childrens
knowledge and created healthy oral hygiene habits.
The project will soon introduce the Toothfairy Rx app which allow to take pictures of
childrens problem area and be sent to a referral dentist and reviewed by licensed dentist to
provide feedback for children with minimal access to dentist.
1) Out of the all the intervention activities Childrens Healthy Smile Project offers I feel each one
could perfectly fit my project. The idea of giving children the appropriate gear to role play the
dentist office setting is perfect for children not to only gain knowledge but make it fun and
exciting going to the dentist.
2) Useful resources and tools I can apply are the Smile Kits and children textbooks. The
Smile Kits will be helpful for children who are unable to afford for a new toothbrush, in need of
tooth paste, and floss. The text books will be useful for children and parents to enhance their
knowledge on oral health literacy.
3) Resource 1: A report of the Surgeon General addresses a call of action to promote oral health for
Americans. The cite, provides scientific information to improve health and reduce risk of
diseases and illnesses. This report was helpful by giving details on how oral health is promoted,
how oral diseases and conditions are prevented, and what needs and opportunities exist to
enhance oral health. For example, the report suggested to raise peoples awareness so people
beliefs and attitudes about oral health are paramount. https://www.surgeongeneral.gov ,
https://www.ncbi.nlm.nih.gov/books/NBK47478/.

Resource 2: 1Dental provides mothers with information for how to care for infants gums
and their primary teeth. The site provides mothers quotes on how effective caring for their
children teeth is based on the sites suggestions. This site was helpful to overview what is and
what isnt working for mothers therefore I can alter future interventions to be affective.
http://www.1dental.com/about-us/.

General Intervention Consideration

Health Behavior Theory

The Health Belief Model theory may be useful during guiding my interventions. The
Health Belief Model will help guide my interventions by helping parents to take action for the
care of their childs teeth. The theory will help me in understanding parents current belief of
their child risk of cavities. Therefore, identifying what parents still need knowledge on and
change their perspective of their childs risk for tooth decay. I am then able to recommend action
by explaining how, where, and when to take action for childs oral hygiene. Barriers are
identified where I will then aid parents where they can access to a dentist office and offer
resources for underprivileged families. Cues to action will help provide education resources to
both parents and child, increasing awareness and creating a reminder system. Lastly the theory
identifies self-efficacy where at this level parents and child feel confident enough to carry out
recommend action by providing training and guidance interventions to take action.

Spectrum of Prevention
The level of prevention that is important for childs oral hygiene is promoting community
education. At this level, it is important to increase tooth decay awareness for children 0 to 5 years
of age for not only the child but their parents, childcare workers, and teachers. This level of
change will change the caregivers perception of how important it is to maintain good oral
hygiene for children early as babys first days of life to prevent decay.

The predisposing factors I learned that are associate with childs tooth decay are due to
bad teeth care and poor dietary habits. Many parents dont value childs primary teeth and dont
consider caring for teeth until child is older. Therefore, changing parents perspective on babys
teeth is highly important. Parents dont consider feeding habits to be a predicator of tooth decay.
The sugar content in juice and milk in a bottle while left in babys mouth while sleeping will feed
the bacteria in babys enamel (Colak et al., 2013). The enabling factors include financial hardship
to access a dentist office and pay for new teeth cleaning supplies. And the reinforcing factor is
benefited by underprivileged families with teeth cleaning supplies for children who are unable to
afford new toothbrushes and toothpaste.

Research Articles

American Academy of Pediatrics. (2008). Preventive Oral Health Intervention. Pediatrics,

122(6), 138794.

Participants: Primary Care Pediatric Practitioner.

Pediatric practitioner are reached due to the youngest age patient population visits the
pediatrician more than the dentist. The research focuses on addressing the issue of dental caries
risk and general oral health information as a foundation for creating and deciding which
preventive and intervention strategies needed to be used by pediatrician. The article focused on
primary and secondary prevention to control risk factors before disease occurs will help prevent
future tooth decay. Primary prevention begins by optimizing of maternal dental flora of the infant
during eruption of the primary dentition. This mode of prevention help decreased the childs risk
of dental decay and is recommend for baby up to one year of age by various medical and dental
organizations. Secondary prevention strategies consist of dietary counseling, oral hygiene
instructions, and judicious administration of fluoride modalities. Preventive strategies for oral
health required a comprehensive and multifocal approach beginning with caries risk assessment.
In this article the host-defense system was used to shape the intervention to prevent the disease
from ever occurring for newly erupted teeth.
Their first intervention used is a community-based intervention by optimizing the level of
fluoride in drinking water and self-administered fluorides to protect the pre-eruptive and post-
eruption of infants teeth. This intervention is the cheapest and most effective way to deliver
anticaries benefits to communities. The article also suggested establishing a dental home for the
ongoing relationship between dentist and child is a successful intervention to prevent dental
disease by beginning within the first year of life. The authors main conclusion made was
pediatrician can contribute considerably to the health of infants by applying prevention and
intervention strategies for a part of their pediatrics daily practice. Also, to be successful
intervention must begin within the first year of life.
I learned from this intervention study that can be applied to my intervention project is I
can utilize other health or non-health providers the child might foresee through its developing
process so dental education is integrated into their practice. As in this article the pediatric
profession was used to educate parents on oral health as an integral part of the overall health and
well-being of children. What I would need to do to adapt the intervention to fit my population is
nothing. The intervention fits well with my population and are inexpensive making the
intervention possible for underprivileged families.

Article 2

Collins, C. C., Villa-Torres, L., Sams, L. D., Zeldin, L. P., & Divaris, K. (2016). Framing young
childrens oral health: A participatory action research project. PLoS ONE, 11(8), 119.

Participants: Parents

This article intervention incorporated gaining insight into what parents consider influential
community agents and important strategies to be used in health education context and
community intervention. For example, modeling oral hygiene behavior of older siblings, sticking
to a routine for proper oral hygiene, and school based oral health preventive services.
Researchers used photographs to identify issues and factors related to childrens oral health.
Community mapping was used for collecting data to allow participants to identify their
community resources to be used for community health promotion interventions. Their findings
concluded that daily life issues of financial hardship and time constraint, access to care, and
knowledge gaps or misconception of oral hygiene are the reasoning for high rate on child tooth
decay. These insights of issues are helpful to utilized interventions. What I learned about the
interventions suggestions are familys environment is an important factor in shaping oral health
behavior in their children. Little information is available for specific, actionable community
intervention to improve childrens oral health. There results, although suggest that interventions
must be based on the culture and understanding of each community. A major determent of
intervention success besides community water fluoridation is aimed at increasing early
preventive dental visits by increasing parent and community awareness campaigns. Limitations
conclude for low income families are time, child exhaustion/frustration, lack of support network
and day care.
I learned through this research article that I must take into consideration the role of
families and communities they live in and take advantage of local stakeholders for them to
realize their influence on oral and general health promotion. For my population, I want to make
sure I have a good understanding of the community and use my resources within the community
to promote oral health for underprivileged families.

Article 3

Hallas, D., Fernandez, J., Lim, L., & Carobene, M. (2011). Nursing Strategies to Reduce the
Incidence of Early Childhood Caries in Culturally Diverse Populations. Journal of Pediatric
Nursing, 26(3), 248-256.

Population: Nurses and Parents

The research focused on nurses role working with newborns can positively influence a
change in the epidemic of early childhood caries. Interventions suggestions include education, a
cultural sensitive caries risk assessment, fluoride treatment and establishing a dental home for
infants by 12 months. Intervention begins early while baby is still in mothers womb. Primary
prevention requires early counseling of new mothers. Nursing intervention suggests providing
parents with information of oral care during their postpartum and time of discharge.
The intervention is shaped by Leiningers theory of cultural care. The theory focuses on
the relationship between culture and care on the health and wellness of an individual in this case
parents and infant. The theory is helpful in shaping intervention by understanding the beliefs
related to oral care from individuals and members within the culture standpoint. Nurses play a
role by helping parents to establish a dental home and providing information while also taking
their beliefs and values into consideration (Leininger, 2013). Currently dental visits and care are
not valued for childrens overall health and wellness and cavities arent viewed as a stage of
illness according to the literature. Therefore, until health care professions design a care to
overcome these barriers then will there be a decrease in early child caries.
I learned from this intervention study along with the previous two articles is I can
collaborate with other health care profession and the dental profession for making affective
interventions to combat against early child tooth decay. That also agrees with familys culture
beliefs and values to fit the population Im trying to adapt good oral hygiene.

Pulling It All Together

1. Reduce the proportion of children age birth to five year with dental caries and with
untreated dental decay in their primary teeth from 33% to 30% by 2020.

2. Intervention Strategies
Community Advocacy

o Promote interdisciplinary training of medical, oral health, and allied

health professional personnel in counseling patients about how to reduce
risk factors common to oral and general health.

o Parents conduct a parenting group to discuss childs oral health and

overall health and well-being. A safe zone where parents can talk about
issue regulations and implement solutions to meet their oral health care
needs.
o Teachers intergrade oral health care into their lesson plan and practice
good oral care.
o Day cares intergrade oral health care into their facilities and practice
good oral care before and after meals.
Educational Activities
o Provide educational gear in day cares and elementary classrooms for
children to role play the dentist offices. Children are encouraging to take
each part as the dentist, assistance, and patient to make the experiment
not only fun but to take away the stereotype of going to the dentist is
scary.
 o Teacher are provided with educational text books relating to oral health
and can lend to children to take home. Parent and child interact through
reading the book together and both are informed.
o Educational parenting group meetings at public service such as WIC.
Incorporate dental health care into overall care for children. Parents are
informed about childs primary teeth and ways to prevent cavities.
o Coloring books and online games related to oral health. Convincing
child oral hygiene is fun and exciting.
Environmental change
o Remove barriers to the use of services by simplifying forms, letting
individuals know when and how to obtain services, and providing
transportation and child care as needed.
o Maintain community water with fluoridation.
o Oral hygiene products contain fluoride
o Create campaigns to promote oral health for children throughout the
community. Poster, child teeth cleaning kits, brochures, ect.
o Assist low-income patients in arranging and keeping oral health
appointments by creating a app reminder for their dental home.
o Dental homes availabilities within the community and child requirement
to be placed in a dental home before 12 months.

3. Potential for Success

The intervention strategies would work for the approach of keeping children birth
to five years of age cavity free by raising awareness within communities in hope to
change their perspective on childs primary teeth care. Support groups and educational
groups are beneficial because it gives parents and healthcare providers a place to
communicate and collaborate ideas for future interventions. Keeping in mind each others
values and beliefs (Hallas, Fernandez, Lim, & Carobene, 2011). Providing children with
educational activities such as the role play and coloring will teach children about the
important of keeping their teeth clean, avoid surgery foods, and not be frightened to go to
the dentist. Providing children with teeth cleaning supplies will help low-income families
and not cause a burden (Builder, 2017).
Environmental changes by keeping community water fluoridation and products
with fluoride will help prevent cavity formation ((Collins et al., 2016). Transport
 availability will help families access to dentist offices and keep their appointments.
Dental homes availability within community works to create relationship with dentist and
patient, as early as possible before 12 months (Hallas et al., 2011). This will ensure
children with regulatory checkups for monitoring of future oral diseases.
This work can be maintained with parents, caregivers, and healthcare providers
dedication to promote and intergrade good dietary habits and oral dental hygiene into
their child and/or clients daily lives.

Reference
American Academy of Pediatrics. (2008). Preventive Oral Health Intervention. Pediatrics,
122(6), 138794.
Collins, C. C., Villa-Torres, L., Sams, L. D., Zeldin, L. P., & Divaris, K. (2016). Framing young
 childrens oral health: A participatory action research project. PLoS ONE, 11(8), 119.
Builder, D. F. (n.d.). Childrens Healthy Smile Project. Retrieved April 14, 2017.
Hallas, D., Fernandez, J., Lim, L., & Carobene, M. (2011). Nursing Strategies to Reduce the
Incidence of Early Childhood Caries in Culturally Diverse Populations. Journal of
Pediatric Nursing, 26(3), 248256.
Office of the Surgeon General (US). (1970, January 01). The Actions. Retrieved April 18, 2017,

par- ents education and socioeconomic status.1