MINNESOTA’S MINNESOTA’S EARLY HEAD START EARLY HEAD START

ORAL HEALTH CAMPAIGNORAL HEALTH CAMPAIGN

PREVENTING TOOTH DECAY PREVENTING TOOTH DECAY AT THE EARLIEST STAGE OF A AT THE EARLIEST STAGE OF A

CHILD’S DEVELOPMENTCHILD’S DEVELOPMENT

Oral PresentationOral Presentation

Presented at the 2006 National Oral Health Presented at the 2006 National Oral Health Conference on May 2, 2006 in Little Rock, Conference on May 2, 2006 in Little Rock, ArkansasArkansas

Authored by David Born PhD, University of Authored by David Born PhD, University of Minnesota School of Dentistry, Christopher Minnesota School of Dentistry, Christopher Okunseri, BDS, MSc, Marquette School of Okunseri, BDS, MSc, Marquette School of Dentistry and Gayle Kelly, BS, MS, Dentistry and Gayle Kelly, BS, MS, Minnesota Head Start Association, Inc.Minnesota Head Start Association, Inc.

Minnesota Head Start Minnesota Head Start Association in partnership withAssociation in partnership with

MN State Head Start Collaboration OfficeMN State Head Start Collaboration Office

Dental Consultants from theDental Consultants from the

University of MN School of DentistryUniversity of MN School of Dentistry

Marquette University School of Marquette University School of DentistryDentistry

Minnesota’s Early Head Start ProgramsMinnesota’s Early Head Start Programs

And with funding and support from And with funding and support from

Head Start and Early Head Head Start and Early Head StartStartGoalsGoals

To help low-income To help low-income families prepare their families prepare their children for school and children for school and life success:life success:

Improving their child's:Improving their child's: - Health - Health - Social Competence- Social Competence - School Readiness - School Readiness

Promoting self-Promoting self-sufficiency for parents sufficiency for parents

Early Head Start Early Head Start Eligibility Guidelines Eligibility Guidelines

Serves children 0-3 Serves children 0-3 and pregnant womenand pregnant women

At least 90% of At least 90% of enrolled children must enrolled children must come from families come from families

- at or below the - at or below the federal poverty level federal poverty level or or

- eligible to receive - eligible to receive public assistance. public assistance.

10 % of enrollment in 10 % of enrollment in Head Start is reserved Head Start is reserved for children with for children with diagnosed disabilitiesdiagnosed disabilities

In 2005:In 2005: 21 federally designated and state-21 federally designated and state-

funded Early Head Start grantees funded Early Head Start grantees served Minnesota served Minnesota

MN Early Head Start grantees served MN Early Head Start grantees served 1,295 children and 129 pregnant 1,295 children and 129 pregnant womenwomen

FOR MORE INFO...

Head Start Program Information Report for the 2004-2005 Head Start Program Information Report for the 2004-2005 Program Year – Wayne Kuklinski, MDE 651-582-8385Program Year – Wayne Kuklinski, MDE 651-582-8385

MN Early Head Start Oral MN Early Head Start Oral Health Campaign Goals, 2003-Health Campaign Goals, 2003-

20052005Family EducationFamily Education

Help young families value their children's oral Help young families value their children's oral health and adopt habits that prevent tooth health and adopt habits that prevent tooth decay.decay.

Staff TrainingStaff Training Prepare Early Head Start (EHS) Home visitors to Prepare Early Head Start (EHS) Home visitors to

perform simple oral risk assessment to prioritize perform simple oral risk assessment to prioritize children for oral health prevention and dental children for oral health prevention and dental referrals.referrals.

Oral Risk AssessmentOral Risk AssessmentOffer regular and consistent oral risk assessment Offer regular and consistent oral risk assessment

and follow-up of EHS children (0-3) to prevent and follow-up of EHS children (0-3) to prevent caries and refer children for treatment services.caries and refer children for treatment services.

Family EducationFamily Education

The Tooth BookThe Tooth Book is MN Head is MN Head Start’s oral health guide Start’s oral health guide for families and educators.for families and educators.

Produced in English, Produced in English, Spanish, Somali and Spanish, Somali and HmongHmong

Training and tools were Training and tools were available to all Head Start available to all Head Start and Early Head Start and Early Head Start Health ManagersHealth Managers

View an Electronic copy @www.mnheadstart.org/toothbooken.pdf

Staff TrainingStaff TrainingIntensive one-day workshop taught by dental Intensive one-day workshop taught by dental

school professors covering:school professors covering: Early Childhood Dental Caries and GuidanceEarly Childhood Dental Caries and Guidance Oral Risk Assessment and Referral Oral Risk Assessment and Referral Cultural PerspectivesCultural Perspectives

Teaching Objectives were to enable Home Teaching Objectives were to enable Home Visitors to:Visitors to:

Explain basic tooth development and Explain basic tooth development and appropriate oral health practicesappropriate oral health practices

Conduct an oral health risk assessment of Conduct an oral health risk assessment of children up to age threechildren up to age three

Oral Risk AssessmentOral Risk Assessment

Home visitors met with EHS families in Home visitors met with EHS families in their home at a frequency determined their home at a frequency determined by the families’ risks to assess:by the families’ risks to assess:

Environmental Risks (brushing, diet, Environmental Risks (brushing, diet, bottle feeding practices, water source)bottle feeding practices, water source)

Family Risks (Caregiver oral health, Family Risks (Caregiver oral health, SES, general health)SES, general health)

Oral Risk Assessment Oral Risk Assessment (continued)(continued)

Observe the child’s Observe the child’s mouth (tooth mouth (tooth development, decay, development, decay, white spots, red or white spots, red or swollen gums, swollen gums, cleanliness of the cleanliness of the teeth)teeth)

Provide oral health Provide oral health education and skill education and skill building with family building with family membersmembers

ResultsResultsFAMILY EDUCATION: 2003 -FAMILY EDUCATION: 2003 -

20052005 100% of 48 HS and EHS Health managers 100% of 48 HS and EHS Health managers

had access to parent education toolshad access to parent education tools

88% of 48 HS and EHS Health managers 88% of 48 HS and EHS Health managers participated in group instruction on oral participated in group instruction on oral healthhealth

40,000 copies of 40,000 copies of The Tooth BookThe Tooth Book distributed from 2003-2005distributed from 2003-2005

69% of 15,227 HS and EHS families 69% of 15,227 HS and EHS families participated in oral health education.participated in oral health education.

ResultsResultsStaff Training: 2003-2005Staff Training: 2003-2005

90% of 90 EHS Home Visiting Staff 90% of 90 EHS Home Visiting Staff participated in one of three oral risk participated in one of three oral risk assessment workshopsassessment workshops

Knowledge assessments conducted prior and Knowledge assessments conducted prior and one month after the training showed gains for one month after the training showed gains for all three groups (p<.001) all three groups (p<.001)

Program evaluation results showed high level Program evaluation results showed high level of satisfaction and strong desire for more of satisfaction and strong desire for more trainingtraining

Results: Oral Risk Results: Oral Risk AssessmentAssessment

87% of 1,014 EHS clients received 87% of 1,014 EHS clients received one or more oral risk assessment and one or more oral risk assessment and educationeducation

““Reliability Check” showed home Reliability Check” showed home visitors identified most potential visitors identified most potential problems and missed very fewproblems and missed very few

Results: Parent Attitude Results: Parent Attitude Survey Survey

Measured pre/post changes in EHS Measured pre/post changes in EHS parent attitudes about early parent attitudes about early childhood oral health risks.childhood oral health risks.

Increase in parent’s awareness of Increase in parent’s awareness of oral health risks (p<.008)oral health risks (p<.008)

More education needed:More education needed:1) Parent’s role in disease 1) Parent’s role in disease

transmissiontransmission2) Oral health during pregnancy2) Oral health during pregnancy3) Age for first dental visit 3) Age for first dental visit

Impact on Dental Treatment Impact on Dental Treatment AccessAccess

Minnesota Head Start Children Receiving Dental Examinations, 2002-2005

0

10

20

30

40

50

60

70

80

90

100

2002 2003 2004 2005

Years

Pe

rce

nta

ge

of

Ch

ild

ren

Se

rve

d

Head Start

Early Head Start

Flat ~73%

Increased by 50%

Next Steps: 2006 - beyondNext Steps: 2006 - beyond

Offering statewide training via ITV Offering statewide training via ITV

Exploring best approaches to Exploring best approaches to outreach to culturally diverse clientsoutreach to culturally diverse clients

Considering the feasibility of fluoride Considering the feasibility of fluoride varnish and xylitol gum as Center-varnish and xylitol gum as Center-based strategies based strategies