Building the infrastructure to address oral health of Head Start Children

Due to passing of legislation in Ohio, a dental hygienist was selected for the implementation of a comprehensive oral health care program for Head Start. 197 children participated in the program by returning consent forms. After enrollment, 10 children dropped from the site. Dental exam and preventive services were provided on-site including toothbrush prophy and fluoride application. 25% of the 3- to 5-year-old Head Start children screened had dental caries. 6% required immediate dental care due to history of pain. 24% of children with dental caries needed treatment in a hospital setting under general anesthesia due to extent of the disease. Another 36% needed referral to pediatric dentist for treatment completion. 24 dentists were identified in the county with only 8 accepting children on Medicaid. Peer-to-Peer contacts were made with those dentists and a network of 4 general dentists and 2 pediatric dentists was established with access to hospital services at a major Children's Hospital. The program was successful in helping 40% of children complete the needed treatment after 6 months. Another 36% are currently in treatment with dental appointments scheduled. Challenges identified by the hygienist included inability to reach parents with disconnected phone numbers, refusing case management assistance by the caregivers, dental practices dropping patients from the practice due to multiple broken appointments, and caregiver's unwillingness to travel for care when hospital services were recommended. A significant positive factor was the availability of stable and supportive Head Start staff to move the program forward.