The Impact of Early Head Start on Children's Oral Health

Background. Early Head Start (EHS) is a publicly-funded comprehensive education program for low-income children under three years-old and their families. It is known to improve physical, cognitive and developmental child outcomes over the life course. While EHS impacts general health outcomes, little is known about its effect on oral health. This study assesses the effects of EHS on dental use and oral health-related quality of life (OHRQoL); as well as how the effect of EHS on dental use is modified by parents’ health literacy. Methods. This study examines oral health outcomes in children enrolled in North Carolina EHS programs where staff participated in an educational intervention known as Zero Out Early Childhood Caries (ZOE) and compares these results to Medicaid-matched controls. Parent interviews were conducted at baseline and 24-month follow-up for 1,178 parent-child dyads. Propensity score analysis was used to control for selection bias between the EHS and the control group. Logistic regression, marginalized zero-inflated negative binomial and marginalized semicontinuous two-part modeling with direct adjustment for propensity scores and random effects were used to examine the association between EHS and dental outcomes. Results. EHS children had increased odds of having any dental visit (aOR=2.5; 95% CI=1.74-3.48) and any preventive dental visits (aOR=2.6; 95% CI=1.84-3.63) compared to non-EHS children. Children in EHS had 1.3 times (95% CI=1.17-1.55) the adjusted mean number of dental visits compared to the children not in EHS. EHS families had a lower odds ratio of having any negative impacts to OHRQoL compared to non-EHS children (aOR=0.65; 95% CI=0.48, 0.87). In the adjusted logit models on the effect of EHS on having any dental visits, the interaction effect between EHS and parent’s health literacy was not significant (P>0.05). Conclusions. This study is the first to demonstrate that EHS provides services that increase child dental use and improve OHRQoL for disadvantaged young children and their families. Moreover, our findings provide evidence that EHS results in similar improvements in dental use regardless of parents’ health literacy levels. These results document the effectiveness of comprehensive early education programs in improving dental use and quality of life for low-resource, low-literacy families.Doctor of Philosoph

Perspectives on the future of dissemination and implementation research in oral and craniofacial sciences

Dissemination and implementation science is a field of research that promotes the adoption and maintenance of evidence-based interventions in healthcare delivery and community settings and seeks to understand the processes by which such adoption and maintenance occur. While dissemination and implementation science is an established field in health services research, it is relatively new and making inroads in dental, oral and craniofacial research. This article summarizes the proceedings from a scientific panel on ‘Dissemination and Implementation Science for Oral and Craniofacial Health’ that was held during the international Behavioral and Social Oral Health Sciences Summit. The panelists were four experts on dissemination and implementation science in dental and non-dental academic settings in the United States and Scotland, with affiliations ranging from schools of dentistry and public health to the National Institutes of Health and a healthcare system with integrated dental services. The panel discussion addressed how dissemination and implementation science can be used to further oral health research. The narrative report presented here aims to describe the panelists' reflections and insights on their current initiatives in dissemination and implementation research to inform future research endeavors within the oral and craniofacial sciences. Specifically, this article focuses on six discussion topics: (1) how organizational determinants can serve as facilitators or barriers to the implementation of evidence-based dental practice; (2) how dentistry can ‘de-implement’ practices that are not effective; (3) how implementation science can support the delivery of evidence-based dental practice using adaptation; (4) how to get started in implementation science; (5) how the broader environment can support large-scale implementation efforts; and (6) how oral and craniofacial science is well suited for advancing dissemination and implementation research

Healthy Teeth, Healthy Me: Utilizing community engaged research to develop a community generated and interprofessional infant oral health program in Homewood

Researchers partnered with the Homewood Community Engagement Center to develop a community driven infant oral health program, “Healthy Teeth, Healthy Me”, that met community needs by utilizing collaborator involvement and building community partnerships. The intervention was two-fold. Firstly, interprofessional training sessions for dentistry, medicine, nurse practitioner and social work trainees in infant oral health and dental caries prevention were developed and conducted. Secondly, interprofessional trainees had the opportunity to observe virtual televisits for families with children under 3 years living in Homewood. The interprofessional training sessions and family televisit provided education specific to the needs identified by the community partners