Faculty Bibliography

BACKGROUND: Given the rising trend in early childhood caries (ECC) and the wide disparities that exist in pediatric oral health, risk assessment for ECC has become increasingly important. The purpose of this paper is to describe lessons learned from an Interprofessional Collaboration (IPC) approach in the planning, development, and pilot testing of an electronic interactive ECC risk assessment application--My Smile Buddy (MSB). METHODS: Five focus groups were conducted during the assessment and development phases of MSB. Community Health Workers (CHW) then facilitated MSB with 35 mothers from the local community. RESULTS: MSB was well accepted by mothers and scored well in usability and usefulness by CHWs. Lessons learned during MSB development included recognizing CHW understanding of local community attitudes regarding oral health and access to dental care and that power-sharing is required in order to create an intervention that is both engaging and accepted by the community.

PURPOSE: Study purposes were to: (1) validate information of New York State (NYS) pediatric dental Medicaid/CHIP providers registered on InsureKidsNow.gov (IKN); and (2) compare dental access to available IKN pediatric dental Medicaid provider locations by NYS region and population density of young children in poverty Methods: Information on 4,634 dental provider locations was obtained by collapsing 21,921 listings; 160 locations were randomly telephoned to verify consistency and provision of pediatric restorative treatment. Dental provider locations to poor child population ratios were compared. RESULTS: Over 90 percent of locations were in less than a third of NYS counties. New York City/Long Island locations had 5.68 higher odds of accepting new pediatric patients compared to locations in the rest of NYS. Of phone numbers called, 22 percent were invalid. Nearly 40 percent of valid calls were inconsistent with IKN. Over 90 percent of counties had at least one IKN dentist. The median child-in-poverty to provider ratio was 85:1. CONCLUSIONS: Improved oversight of InsureKidsNow.gov is required to ensure validity and usefulness. Research on the quantity and type of child Medicaid/CHIP dental procedures in private practice is needed to accurately assess dental access.

This experimental study determined if a "report card-like" oral health action plan was effective in improving oral health behaviors in a sample of 69 patients, ages 1 to 6 years. Participants were divided randomly into control and intervention groups. Data collected included dmft, plaque score, Streptococcus mutans levels and oral health behaviors. Participants in the intervention group received an oral health action plan that included: 1. child's current caries-risk status; 2. identification issues of concern; and 3. one "goal" to improve on for the next visit. All participants returned after two months for follow-up examination and data collection.

PURPOSE: Head Start and Early Head Start (HS/EHS) programs have partnered with the American Academy of Pediatric Dentistry to promote oral health and increase access to dental homes. Preparing HS/EHS staff for issues related to pediatric oral health promises to improve effectiveness of this collaboration. This paper's purpose was to describe the Columbia Head Start Oral Health Program (C-HSOHP) and changes in HS/EHS staff pediatric oral health knowledge and competencies after participating in C-HSOHP. METHODS: Four HS/EHS grantees in New York City engaged in the 2008-09 C-HSOHP. A convenience sample of 61 staff completed pre- and postself assessments of knowledge and competencies. RESULTS: Significant paired mean improvements were found for staff-reported level of preparation to explain dental issues during pregnancy, the tooth decay process, and preparing parents for their child's first dental visit. Significant improvements were found in staff confidence in teaching parents about children's oral health issues, referring for pediatric dental services, and talking to a dentist about a concern. CONCLUSIONS: The Columbia Head Start Oral Health Program was effective in improving Head Start/Early Head Start staff self-confidence and self-perceived preparedness in teaching parents about oral health, applying oral health knowledge to HS/EHS programs, communicating with dental professionals, and improving access to pediatric dental services.

There is little research on the oral health status of Chinese-American (CA) children in the U.S. and Asian/Pacific Islanders in general. The purpose of this study was to characterize the dental caries experience of a CA child population in Manhattan Chinatown, New York City. A five-year chart review of 545 initial dental exams of patients aged 2 to 11 was conducted at a community clinic serving an immigrant CA population. DMFT/dft were compared to National Health and Nutrition Examination Survey (NHANES) and analyzed for associations among birthplace, language and untreated tooth decay at recall. Subject mean dft was higher compared to NHANES data both in aggregate and ethnic/race subgroups. Subjects had lower DMFT ccmpared to the national data. Significant difference was found between U.S. and non-U.S.-born mean dft. Asian Pacific Islander Americans include a fast-growing immigrant pediatric population at high risk for tooth decay.