180974 Utilizing the WIC program model to provide preventive oral health care beginning at age one

Monday, October 27, 2008

Tracey A. Andrews, RDH, BS , Stamford Health Department, Coordinator of Oral Health Program at Stamford WIC, Stamford, CT
Rona B. Marotta, MS, RD, CD-N , Stamford Department of Health and Social Services, Coordinator, Stamford WIC Program, Stamford, CT
Johnnie A. Lee, MD, MPH, FACP , Stamford Department of Health and Social Services, Director of Health & Social Services and Medical Advisor, Stamford, CT
A program, targeted at 1-5 year old children, expanding access to preventive oral health utilizing the WIC Program model, operates at the Stamford DPH in the Government Center, Stamford, Connecticut. The RDH provides ongoing in-services to WIC staff that screen children for oral health program participation. Beginning at age one, during the WIC recertification visit, the RDH assesses the child for early childhood caries (ecc) risk while educating the parent on the child's oral home care with a demonstration of brushing or wiping teeth. Using the knee to knee treatment method, the parent can observe correct brushing instruction and be educated of ecc demineralization or other anomalies. In this position, fluoride varnish applications are well received by children. Interactive mirrors, flashlights, brushing games and toys are used to distract, teach and promote trust. Rewards include books and stickers. Children weaning off the bottle receive cups. The RDH and WIC Nutritionist collaborate on improving dietary practices which are high risk to oral health. Every six months, coordinated with WIC recertification appointments, the RDH provides preventive services (anticipatory guidance, screenings, brushing and flossing instruction, fluoride varnish application, prophylaxis, and sealants applied on primary teeth). High ecc risk children are reassessed and receive fluoride applications every 3 months, the mid recertification interval being coordinated with WIC Nutrition Education visits. This integrated approach establishes early, frequent, proactive interventions in a non-threatening, trust building environment. The benefits of this model include improvement of oral health skills, parent education and positive reinforcement of nutritional concepts.

Learning Objectives:
1. Easily describe the WIC model of appointment and see how it coincides for recommended dental visits and follow ups. 2. Recognize a non-threatening, healthy nutrition based atmosphere in which to introduce good dental habits while incorporating methods of instruction which teach large and small motor skills. 3. Demonstrate use of techniques/strategies such as knee to knee, fluoride varnish application, to administer procedures and successfully treat children under age five. 4. Describe an alternative access to oral health care setting and utilize information presented to treat children in a similar setting.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have Twenty four years of experience as a Registered Dental Hygienist(RDH, BS) specializing in children's oral health in various settings including; private practice, public health programs such as WIC, public school systems, and as a clinical instructor in community health dental hygiene school rotations. I expanded an education based public oral health screening program to provide preventive oral health services in an alternative care setting(WIC)and ran the program from April 2005 through December 2007. I am a member of ADHA and serve as president of our local public health component CAPDHA. I currently serve on the CT State Advisory Committee for Infant Oral Health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Oral Health Poster Session IV
See more of: Oral Health