Evaluation of the effectiveness of promotoras in oral health promotion for preschool children

A 1994 study of California preschoolers found that 27% had untreated dental caries, twice the national average. California's Head Start children had caries rates that were 19% to 30% higher than other pre-school settings, with Latino children having a prevalence of 66% with untreated decay. The Intervention: UCLA collaborated with Head Start and School Readiness Programs in a Latino community of Los Angeles. Trained bi-lingual Promotoras provided caries prevention education and services individually to families of preschool children. Services included an annual screening and oral inspection, referral for dental treatment, quarterly topical fluoride varnish, distribution of oral hygiene supplies, and targeted glass ionomer sealants, individualized oral hygiene instruction and toothbrush prophylaxis and diet counseling. Evaluation Methods: 4700 services records of 1500 children were inspected to determine the scope and amount of services provided. Pre and post evaluations of oral health status for 305 children were assessed to determine the oral health impact of the program. Thirty parents were interviewed to evaluate the behavioral and social impact of the program. Results: Oral inspection and topical fluoride application services were delivered to a greater percentage of children than individualized oral hygiene instruction with toothbrush prophylaxis and diet modification. The treatment records and parent reports are in agreement on this. For parents, oral hygiene instruction was the most important component of the program. Overall, children's oral hygiene improved. Conclusion: Promotoras are effective agents to change oral hygiene behavior of preschool children's parents through the clinical services including individualized oral hygiene instruction.