Coyne, Cathy A, PhD, MPH

Kender, Amanda R, BS

Nerino, Anthony

Niclaus, Erin E, MS

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksDepartment of MedicineSchool Based Oral Health Needs AssessmentAmanda R. Kender BSLehigh Valley Health NetworkCathy A. Coyne PhD, MPHLehigh Valley Health Network, Cathy_A.Coyne@lvhn.orgAnthony NerinoLehigh Valley Health NetworkErin E. Niclaus MSLehigh Valley Health NetworkFollow this and additional works at: http://scholarlyworks.lvhn.org/medicinePart of the Medical Sciences CommonsThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtKender, A. R., Nicalaus, E. E., Coyne, C. A., Nerino, A. (2010, April 26- 28). School Based Oral Health Needs Assessment. Posterpresented at the National Oral Health Conference: Pursuing Excellence in Dental Public Health, St, Louis, MO.2nd 3rd 4 th 5 thGradeO ne Tooth 2-3 Teeth 4 or M ore Teeth010203040%ofStudents2nd 3rd 4 th 5 thGrade010203040%ofStudentsO ne Tooth 2-3 Teeth 4 or M ore TeethThe Lehigh Valley is the third most populated region in Pennsylvania.  Although there are several large hospitals in the region and two city health departments, regional coordination and access to health care is deficient.  A collaborative task force, Greater Lehigh Valley Access to Care (GLVAC), was formed to develop strategies for optimizing access to quality care for all members of the Lehigh Valley community, with special emphasis on the underinsured and underserved.  Although there have been a few scattered initiatives, oral health has continued to be a major concern.  In the fall of 2006, oral health, particularly children’s oral health, was identified by GLVAC and several funders as a priority.  With the help of local and national oral health colleagues and two partnering urban school districts, the idea of a school-based dental sealant program, with an associated five year research study, was envisioned.  The study would examine the relationship between oral health, student academic performance and attendance.  A steering committee was formed and eventually established the Greater Lehigh Valley Oral Health Partnership (GLVOHP).School Based Oral Health Needs AssessmentAmanda R. Kender, BS; Cathy A. Coyne, PhD, MPH; Anthony Nerino, MA; Erin E. Niclaus, MS; Division of Community Health and Health StudiesLehigh Valley Health Network, Allentown, PennsylvaniaIntroduction1.	 	Basic	Screening	Surveys:	An	Approach	To	Monitoring	Community	Oral	Health,	Best	Practice	Approaches	for	State	and	Community	Oral	Health	Programs,	Assessing	Oral	Health	Needs:	ASTDD	Seven	–Step	Model	(2003).	Retrieved	June	17,	2008,	from	Association	of	State	and	Territorial	Dental	Directors.2.	 	National	School	Lunch	Program.	United	State	Department	of	Agriculture,	Food	and	Nutrition	Service	,	10/29/2009.	Web.	March	31,	2010.	<http://www.fns.usda.gov/cnd/Lunch/>.3.	 Health	People	2010.	U.	S.	Department	of	Health	and	Human	Services,	01/01/2005.	Web.	31	Mar	2010.	<http://www.healthypeople.gov/publications/>.References:Funding for this study is made possible by a grant from the Dorothy Rider Pool Health Care Trust. The primary objectives of the needs assessment were to determine the burden of disease for planning and implementation of oral health programs and to gather baseline oral health data for the study.  In addition, information gathered during the assessment and pursuant interventions were to be used to support collaboration and a continuum of quality services, build a constituency and educate decision makers and the community. ObjectivesPreliminary focus groups and pilot programs ensured design of materials, assessment and pursuant intervention.  Materials, needs assessment strategies and full study plan were submitted to and approved by the Lehigh Valley Health Network’s Insitutional Review Board.  All materials sent home to parents were printed in both English and Spanish.  Second through fifth grade students from two urban school districts, with parental consent, received oral health screenings.  Dental hygienists performing the screenings were trained for consistency using an adapted version of the Basic Screening Survey1.  Parental consent forms included questions regarding dental services.  Individual tooth information was recorded and entered into an electronic data base.  Electronic tooth data was provided to the school districts where it was linked with demographic information using district-assigned unique identification numbers.MethodsA total of 3,472 students were screened between November 2007 and June 2008.  School district A had 2,497 students participate and school district B had 975 students participate.  Over 90% of second grade students from both districts had at least one first year molar potentially eligible to receive a sealant, supporting the feasibility of a sealant program.ResultsCaption. Students at both school districts presented with a significant amount of decay in deciduous teeth, particularly school district A. These results demonstrate a need not only for preventive intervention but also restorative care.The proportion of students already being treated with pit and fissure sealants is well below the Healthy People 2010 goal of 50%3.  In fact, only 23% of students not participating in the federal lunch program have sealants.  Access to care, lack of oral health education and the increasing number of families opting out of dental insurance coverage may provide some explanation.The need for both preventive and restorative dental programs in Lehigh Valley is evident and has been recognized by various regional stakeholders.  Over the past three years, addressing access to dental services, particularly for low income children, has become a priority.  In addition to the dental sealant program, two new dental vans have been put into operation.ConclusionCaption. The level of care needed by students in both districts demonstrated the importance for an improved continuum of care; including early education, preventive and restorative services.Since completion of this assessment, a dental sealant intervention and education program was initiated in both school districts.  All second grade students (1,494) attended a forty minute oral health education program and 579 received sealants.Caption. School district B had a lower overall percentage of students participating in the national free and reduced lunch program2. In addition, school-based restorative services have been made available, on a limited basis, to studnets in school district B. These two factors are a possible explanation for a lower proportion of untreated decay in permanent molars.Note. Eligibility guideline include families with incomes at or below 185% of the poverty level2.Percentage of Students, Grade 2-5 by Ethnic Group     American IndianAsian/Pac Islander Black Hispanic WhiteSchool District A 0.20 1.36 15.13 65.23 18.07School District B 0.10 6.57 17.86 19.51 55.85Percentage of Students Eligible for Free & Reduced Lunch     Free Reduced TotalSchool District A 75.80 8.92 84.72School District B 31.08 6.56 37.642008/2009 Results - First Year Sealant Phase     % Positive Consent# Receiving Sealants% Receiving SealantsUrgent or Early Care Referred for TreatmentSchool District A 54.60% 423 44.20% 149School District B 41.70% 220 32.25% 86District A - Students with Untreated DecayDeciduous TeethDistrict B - Students with Untreated DecayDeciduous Teeth2nd 3rd 4 th 5 thGrade010203040%ofStudentsO ne Tooth 2-3 Teeth 4 or M ore Teeth2nd 3rd 4 th 5 thGrade010203040%ofStudentsO ne Tooth 2-3 Teeth 4 or M ore TeethDistrict A - Students with Untreated DecayPermanent TeethDistrict B - Students with Untreated DecayPermanent TeethDistrict A - Level of Care Needed District B - Level of Care Needed1Grade010%ofStudentsN o O bvious Prob lemE arly D enta l C areU rgent D enta l C are2 3 42030405060701Grade010%ofStudents2 3 42030405060708090N o O bvious Prob lemE arly D enta l C areU rgent D enta l C areDistribution of decayed, missing and filled first molars, among all students participating in the federal school lunch program, showed little significance               (< 4.5%) compared to students not participating in the lunch program.  Of students participating in the federal lunch program the Asian/Pacific Islander and Black subgroups presented with the highest proportion of decay.  Additionally, only 5% fewer students participating in the federal lunch program, compared to students not participating, were identified as having at least one pit and fissure sealant. 555554444433333222222011 - 20122010 - 20112009 - 20102008 - 20092007 - 2008SchoolYearYear 04Year 03Year 02Year 01AssessmentS ea lan ts and Post A ssessm entR eten tion checkS ea lan ts app liedB ase line A ssessm entD iffe rences in ora l hea lthD iffe rences in a ttendance / perfo rm anceD iffe rences in a ttendance /perfo rm ance andora l hea lth be tw een studen ts w ith sea lan tsand those w ithou t sea lan tsData analysis planSchool-based Oral Health Study Design

School Based Oral Health Needs Assessment

https://scholarlyworks.lvhn.org/cgi/viewcontent.cgi?article=1050&context=medicine

School Based Oral Health Needs Assessment

Abstract

Similar works

Full text

Available Versions

Lehigh Valley Health Network: LVHN Scholarly Works