California Oral Health Education and Training Initiative: Increasing Dental and Medical Provider Willingness to See Kids Age 0-5 for Oral Health

Too few dental professionals are comfortable seeing children age 0-5. Primary care providers play an important role but lack training in oral health. First Smiles was a 4-year, $7 million oral health education and training initiative funded by First 5 California, implemented in 2004-2008. The statewide program, co-administered by California Dental Association recognized the link between a child's oral health and overall health—and the critical gap in access based in part on provider knowledge, attitudes and practice behaviors. The objective was to increase the number of providers willing to provide quality oral health education and preventive services for ages 0-5, including children with special needs. Training strategies will be discussed and included various formats: conferences, in-office and web-based. Data were collected through interviews and posttests/surveys (immediate post-course and 6-month follow-up) uniquely developed for this program. Outcomes included 15,785 dental and primary care professionals trained; knowledge gain in many curricular areas; high course satisfaction; self-perceived skill level increase; 15% general DDSs seeing more children aged 0 to 5 six months later; increased dental-medical collaborations for pregnant patients; a general trend for DDSs (but not MDs) to lose information and skills learned from the course 6 months later. 29% of primary care providers perceived as a barrier colleagues' opinion that oral health is a DDS not MD responsibility. Exposure California and U.S. dental students get to the 0-5 age group, particularly for special needs, is still relatively small. Additional practice behaviors, systems and policy changes and recommendations will be presented.