Patients in intensive care units (ICU) are more commonly diagnosed with ventilator-associated pneumonia (VAP). Bacteria from the oral cavity may be aspirated into the lungs causing more severe infection. Reducing bacterial load in the oral cavity may decrease the chance of sepsis, heart conditions, stroke, and mortality rates by 33-50% for ICU patients. Xerostomia is prevalent along with oral lesions due to medications, difficulty swallowing, and reduced ability to personally care for their mouth. Nurses agree that oral care for ICU patients is critical, however, many nurses receive less than five hours of oral health training within the nursing curriculum. Barriers do exist for nurses such as an increase in critical care needs, time constraints, and patient’s lack of cooperation. With proper training and guidance through interdisciplinary education, nurses may feel more prepared and confident performing the task of oral care for ICU patients. The standard of care for ICU patients is brushing all soft tissues either with a manual or rotary toothbrush at least twice daily and moisturizing every two to four hours. Chlorhexidine gluconate (CHG) rinses or gels produce mixed reviews in the literature due to side effects. Nurses who are effectively trained by oral health professionals in reducing plaque, bacteria, and who can initially assess individual needs for ICU patients provide a gateway to comprehensive care and improve overall outcomes.

Background: Chinese American (CA) children in Sunset Park, also known as “Brooklyn’s Chinatown,” experience challenges to accessing oral health care due to structural and social determinants of health. To address these disparities, culturally-tailored and linguistically appropriate oral health educational resources were developed using a community-based participatory approach. This project aims to evaluate the implementation of the designed resources within a university-affiliated federally qualified health center (FQHC) primarily serving the CA patient population in Sunset Park, utilizing the RE-AIM framework.

Methods: We conducted a literature review of Chinese-language materials from Asia and the U.S., interviews and member-check validations with FQHC providers and community stakeholders (n=8), CA parents (n=6), and CA community health workers (n=7) to design the resources. Surveys and interviews are being conducted with CA parents (n=30) and providers (n=6) to assess the implementation of oral health education in the FQHC setting.

Results: The needs assessment and multiple user-reviews have refined and finalized the design of the resources in different media formats, including brochures tailored for different age groups (0-2 and 2-4 years old) and videos on brushing and flossing, which incorporate components relevant to Chinese cultures and language. Results from implementation evaluation will provide insights into the actual use and satisfaction with education at different levels (e.g., individual and clinic level).

Conclusions: Applying a participatory and culture-centered health communication approach is essential for developing meaningful and actionable education materials for this patient population. Findings will inform the implementation of the educational materials across various environments and inform future applications.

Introduction: Human papillomavirus (HPV) can cause approximately 70% of oropharyngeal cancers, but many of these cancers can be prevented through timely HPV vaccination. Dental hygienists (DHs) can play a critical role in HPV-related cancer prevention and are in a pivotal position to recommend HPV vaccination to patients. To facilitate this, we implemented a continuing education course to provide DH students with skills to integrate HPV vaccination efforts effectively. HPV vaccine-related health history documentation and health promotion were evaluated before and after the training through clinical records.

Methods: Data were collected at a university-affiliated DH community clinic in the Fall (pre-training, n=184 visits) and Spring (post-training, n=120 visits). Electronic dental record data were used to evaluate 1) inclusion and review of HPV information on the patient’s health history, 2) documentation of the patient’s HPV vaccine status, and 3) HPV vaccine-related health promotion activities.

Results: Before the training, 9% of DH students reviewed HPV-related information on patient’s health history, which increased to 14% post-training (p=.250). Pre-training, 40% of DH students documented patients’ HPV vaccination status compared to 38% (p=.441) post-training. HPV vaccine promotion occurred at 6% of patient interactions pre-training but significantly increased to 37% (p<.001) post-training.

Discussion: HPV vaccine-related health promotion with patients increased following training, indicating potential improvements in confidence in engaging patients and providing crucial information about HPV vaccination. Despite this progress, the overall level of health promotion remains low, suggesting future efforts should focus on understanding and addressing the barriers to implementing HPV vaccine recommendations into DH practice.

Significant portions of the United States have been designated as oral healthcare shortage areas. One way to increase access to care for these underserved populations is to include Community Healthcare Workers (CHWs) as members of a dental team.

CHWs fill a unique role in rural healthcare where dentists (DDSs) and registered dental hygienists (RDHs) may travel among many counties. As a trusted neighbor, the CHW’s primary role is community engagement. They act as an educator, promoter, and patient advocate. CHW duties include patient education, setting future appointments and helping with referrals, gathering consents, assisting patients with insurance submission and Medicaid/Medicare enrollment, and getting community feedback. If properly trained, CHWs can also assist during examinations and use intraoral cameras. They are the liaison between community needs and health professionals.

Not only do CHWs improve the patient’s experience by being an advocate for the region, it makes dental teams more efficient. RDHs and DDSs can focus on treating patients while the CHW helps patients with all other aspects of a dental visit. The expanded workforce team model also increases the efficacy of virtual consultations and teledentistry by breaking down geographical barriers. CHWs epitomize the patient-centered model of care. Adding a community member to a dental team improves the patient experience in any setting, but it plays a critical role for the 79,000,000 people who live in dental healthcare shortage areas.

Oral health is crucial to overall well-being. However, specific populations, such as children and pregnant individuals, face disparities in accessing oral healthcare services. Oral health education has been shown to improve the overall health of children and families. Oral health access programs serve as a preventative method for future health problems among these populations.

Paterson, New Jersey has concerning rates regarding adult dental visits and the percentage of the population with dental insurance. There are numerous barriers to improving oral health outcomes among residents, including a lack of health insurance coverage, knowledge of oral health needs, and access to quality care. We propose a community-centered program targeting children, pregnant individuals, and families in Paterson, to improve access to oral healthcare and education and address the barriers above.

The Oral Health Education and Access Program (OHEAP) aims to promote oral health equity by addressing barriers to oral healthcare access, enhancing oral health education, and empowering communities to prioritize oral health. We aim to apply the Strategic Prevention Framework (SPF) (e.g., assessment, capacity building, planning, implementation, and evaluation) to adapt an existing oral health access and education program to meet the needs of this population through nontraditional partnerships with organizations including Family Success Centers, educational institutions, and faith-based organizations. Our goal is to integrate oral health education and resources into the community to improve self-efficacy. OHEAP aims to increase access to oral health and reduce barriers among pregnant individuals, children, and families, thereby improving oral health outcomes.

Introduction: This study examines the Virtual Dental Home (VDH) program's impact on dental care delivery to elementary school children in Tuolumne County, emphasizing clinical outcomes. By utilizing remote evaluations from pediatric dental providers, the VDH facilitates on-site preventive and minimally invasive care (SDF/ITR) by dental auxiliaries (RDA/RDHAP) or refers children to local dentists.

Methods: Conducted from 2021-2023, this study assessed the VDH's ability to provide comprehensive care on-site, necessity for referrals to local dentists, and types of services rendered. The assessment included categorization of dental needs during the new patient exam (NPE) and at subsequent six-month periodic oral exams (POE).

Results: Involving 333 visits for 52 children, services included evaluations, fluoride varnish applications, sealants, SDF and ITR. Changes in dental needs were observed between the NPE and the second POE, one-year later. At the NPE, 54% of children could have their dental needs met on-site, this increased to 62.4% of children at their second POE one year later. The need for sealants decreased from 19.2% to 6.3% and referrals to local dentists reduced from 32.7% to 18.8%. The percent of children receiving minimally invasive care increased over the study period from 15.4% to 31.3%.

Conclusion: The VDH model is effective in providing dental services to rural schoolchildren, meeting a significant portion of their preventive and minimally invasive care needs within the school environment. This initiative underlines the value of integrating telehealth into school-based health programs to lessen oral health disparities in underserved communities.

Introduction

In San Diego County, 13,000 students missed at least one day of school due to dental problems from 2021-2022. School-based oral health programs can identify students with urgent dental needs, provide onsite preventive services, and refer to dental clinics to increase access to dental services and reduce oral health disparities in rural areas.

Approach

Julian Pathways, Inc. is a local nonprofit organization embedded in the Julian Union Elementary School District that promotes well-being for the rural community. The County of San Diego Local Oral Health Program partnered with Julian Pathways, Inc. to coordinate onsite oral health screenings for K-8^th grade students in 2022 and 2023. Screening results were shared with families and promoted onsite preventive services. In 2023, referral processes were developed to link children with urgent needs to a local Federally Qualified Health Center (FQHC).

Results

In 2023, 62% of students received screenings, compared to 54% in 2022. Nearly one in four screened in 2023 (23%) had untreated decay and 15% had urgent dental needs. Julian Pathways, Inc. followed up with students with urgent needs and linked the majority that had not already visited the dentist to the FQHC for dental services. Fourteen students received onsite preventive services in 2023, with the majority receiving exams, cleaning, and fluoride varnish, and less than half receiving sealants.

Discussion

Additional community engagement is needed to identify and address challenges to increasing uptake of onsite preventive services. Best practices will be shared to explore expanding services to additional rural school districts.

Nutritional habits have been shown to have a direct impact on oral health and the overall well being and physical health of individuals across cultures and regions. However, there is a growing body of evidence examining the impacts of culture on oral health and specifically the impact of consuming cultural foods on oral health and dental hygiene. The scientific and clinical literature base contains information on the potential oral health impacts of certain food items; however, a gap in understanding has been identified regarding how to create culturally competent and inclusive programming for addressing the potential oral health and physical health impacts of certain cultural foods. The purpose of this research is to gather information on what current evidence exists regarding oral health outcomes and cultural food consumption.

A scoping review of published literature regarding oral health and the consumption of cultural foods was conducted to inform the creation of an oral health program serving diverse populations in East Tennessee. Studies and oral health outcomes measured were categorized based on criteria including food types (dishes and recipes) and cultures examined, oral health outcomes studied, and intervention recommendations provided. The research team included studies performed from 2000 through 2023 to capture the broadest base of knowledge possible. This information will aid the development of recommendations for oral health health education and dental programs in East Tennessee.

Introduction:

This study explores the demographic factors associated with fluoride varnish consent form returns in the San Francisco Unified School District's (SFUSD) pre-kindergarten (pre-K) and transitional kindergarten (TK) populations. It aimed to identify whether disparities exist in consent rates based on race/ethnicity and other demographic factors, vital for enhancing preventive oral health equity.

Methods:

The project utilized a comparative analysis approach, examining consent form returns for fluoride varnish applications against the entire pre-K and TK demographic data in the 2023-2024 school year. The consent process was categorized as active, requiring explicit parental approval. Data was collected from school records, and the analysis was focused on identifying trends in consent rates across different demographics, specifically racial and ethnic backgrounds.

Results:

Initial findings reveal a varied return of consent forms across racial and ethnic groups, suggesting an underlying disparity in engagement with school-based oral health programs. These trends indicate potential barriers to participation, which may include language, cultural perceptions of preventive care, or awareness of the program's availability.

Conclusion:

There is a potential disparity in consent rates for fluoride varnish applications among the diverse racial and ethnic demographics of the SFUSD pre-K and TK families. This calls for a targeted public health response to address the identified barriers and to improve equity in oral health preventive care.

Background: CATCH Healthy Smiles (CHS) is a cluster randomized-controlled trial that aims to evaluate the efficacy of a school-based oral health intervention in reducing dental caries incidence among kindergarten to 2nd grade children enrolled in 34 schools where >70% of the children are on the free/reduced lunch program. CHS intervention components include teacher training, staff-supported teacher-led classroom lessons, tabletop toothbrushing, Physical Education, extension activities, and parent education. The trial is ongoing, and we present the approaches implemented to support CHS implementation fidelity and lessons learned.

Methods: Using a human-centered approach, study intervention specialists and school staff co-created tailored strategies and action plans per school-specific needs for implementation. These strategies included: setting implementation fidelity benchmarks, trust building and maintenance, sensitive and ongoing communicating methods, solutions for logistical challenges, and co-creating school-specific action plans with school staff. Process data from the CRCT is used to monitor intervention fidelity (teacher surveys and direct observation).

Results: During the 2023-2024 school year, the CRCT worked with 112 school staff across 17 participating schools in Houston, TX to implement the program in 54 K, 1 and 2 grade classrooms and completed 589 CHS activities with a fidelity score of 100% for classroom sessions and 92% for toothbrushing sessions. Among all strategies employed, trust building and maintenance was reportedly the most effective and critical to ensure implementation success.

Conclusion: By prioritizing relationship, tailoring support, providing creative solutions, and ongoing monitoring, the requirements of the CRCT implementation fidelity were supported as well as needs of the school.