Improving oral health in children is everyone’s responsibility

Drs Dickson and Fontana’s article, “How to bring oral health to primary care,” is an exemplary and replicable approach to improving the oral health status of the pediatric population through inclusion of oral health assessments, interventions, and evaluation of the effectiveness of these practices within pediatric primary care practices. I recommend reviewing and strongly considering the implementation of their pilot project including the six-step approach for oral health care in pediatric practices.   

Our oral health journey

In 2007, I joined New York University (NYU) Meyers College of Nursing as Director of the Pediatric Nurse Practitioners (PNP) Program in New York City. At that time, the College of Nursing was part of NYU College of Dentistry. As part of my role, I worked with the faculty in pediatric dentistry to begin the development of interprofessional collaborations between pediatric dental faculty, dental residents, and dental students with PNP faculty and PNP students. We were very successful in our initial endeavors, as the students together performed oral health assessments and fluoride varnishes for children in many preschool centers throughout New York City. In addition, the PNP students participated in the pediatric dental clinic and gained a clear understanding of the meaning of oral-systemic health and disease status, and measures that could be implemented in their pediatric primary care clinical practices with their NP preceptors to improve the oral health status of infants and children.

Quick Question to Consider: Has your college of nursing developed interprofessional relationships with dental colleges or community dental providers, if a college of dentistry is not near your clinical practice?

Faculty Collaborations

Pediatric nurse practitioners and dental faculty also collaborated on research initiatives including 1 study in which we investigated the effectiveness of teaching mothers on the postpartum unit about oral healthcare for their newborns before any ‘bad habits’ were developed. The results of the study support oral health education for the mothers on the postpartum unit as part of routine maternal/newborn.^1,2

Quick Question to Consider: Do you know if an oral health education program is included as part of routine care in the hospitals or birthing centers for the infants in your pediatric practice?

NYU Meyers College of Nursing oral health initiatives

Judith Haber PhD, APRN, RN, is the Executive Director for the Oral Health Nursing Education and Practice (OHNEP) program (www.ohnep.org) at NYU Meyers College of Nursing.  Dr Haber’s OHNEP initiatives, which began in 2011, are nationally recognized as exemplary interprofessional oral health educational curricular and practice initiatives. The website hosts a variety of educational activities including faculty oral health toolkits, webinars, narrated videos, and virtual teaching strategies.

Quick Question to Consider: Have you used the OHNEP resources as part of interprofessional education and/or within nursing, nurse practitioner, and midwife education?

Let’s keep the momentum in motion

Interprofessional oral health education and implementation in primary care practices is critical to achieve nationwide improvement in the oral health status of our children. We need to hold our interprofessional students accountable for knowledge acquisition and demonstration of oral health clinical competencies during their educational program, as well as demonstration of competence on national licensure and certification examinations. These educational and testing strategies should lead to an educated workforce that values interprofessional collaborations and is committed to practices that support ‘cavity free’ early childhood and life-long dental health.  Let’s continue Dr Dickson’s father’s dental office practice goal to “stamp our tooth decay” by including evidence-based practices in our pediatric primary care practices and in all dental practices. 

References:

1. Hallas, D., Fernandez, J.B., Lim, L.J., & Carobene, M.  (2011). Nursing strategies to reduce the incidence of early childhood caries in culturally diverse populations.  Journal of Pediatric Nursing, 26, 248-256. Published on the web: Doi:10.1016/j.pedn.2009.07.010.

2. Hallas, D. Fernandez, J.B., Lim, L.L., Catapano, P., Dickson, S.K., Blouin, K.R., Schmidt, T.M., Acal-Jiminez, R., Ali, N., Figueroa, K.E., Jiwani, N.M., Sharma, A. (2015). OHEP: Oral health education program for mothers of newborns. Journal of Pediatric Health Care, 29, 181-90. doi: 10.1016/j.pedhc.2014.11.004. Epub 2014 Dec 26.