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

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.