First Tooth: Statewide expansion of preventive oral health services to Oregon's pediatric providers

Objective: Despite being a preventable disease, early childhood caries has become a significant public health problem in Oregon. According to the 2007 Oregon Smile Survey of children in grades 1-3, nearly 2 of every 3 first graders already have a cavity. The Oregon Health Authority's Oral Health Program in collaboration with the Oregon Oral Health Coalition launched a three-year workforce development project called “First Tooth” with the goal to reduce early childhood caries by training medical providers and general dentists to implement evidence-based preventive oral health services for children ages 0-3. “First Tooth” moves beyond the clinical intervention of fluoride varnish by involving the entire staff, not just the providers, in integrating oral health preventive services into their practice.

Methods: “First Tooth” comprises in-person training, ongoing technical assistance, and a comprehensive, web-based oral health resource and training site. Evaluation principles were integrated into each stage of the project.

Results: The “First Tooth” project has expanded outreach and training statewide to: 1) Engage both medical and dental providers in providing culturally appropriate early childhood caries prevention activities; 2) Facilitate referral relationships between dentists and medical providers to ensure all Oregon children have a dental home; 3) Collaborate with community partners such as Head Start and the WIC Program; and 4) Report evaluation results on process and outcome measures.

Conclusion: Both medical and dental communities can become experts in children's oral health prevention strategies and advocates for oral health as part of the continuum of care across the lifespan.