Incorporating dental care into well-child visits significantly improved oral health awareness at a rural Federally Qualified Health Center, according to findings presented at the National Association of Pediatric Nurse Practitioners (NAPNAP) National Conference on Pediatric Health Care held March 15 to 18, 2023, in Tampa, Florida.

Educating parents on the importance of oral health and how it relates to systemic health was an important goal of the study, which serves an area with a high rate of poor oral care (Table). “The referral between medical and dental provided a smooth transition of care and is a valuable approach for reaching underserved families, increasing access to care,” reported Kelly J. Betts, EdD, APRN-NP, CPNP-PC, CNE, and Lisa J. Moravec, RDH, MSDH, PHRDH of the University of Nebraska Medical Center.

Table. Oral Health Among Children at a Federally Qualified Health Center

42% had never seen a dentist
47% did not brush their teeth twice per day
82% did not take fluoride supplements or drink fluorinated water
Source: Betts et al.

To be included in the pilot program, caregivers of 99 children completed an oral health risk-screening questionnaire. All of the children received oral hygiene education, nutritional counseling, intraoral photographs, fluoride varnish, oral hygiene kits, and referral to a dentist. The intervention included 2 cohorts of dental hygiene and nursing students who underwent Interprofessional Education (IPE) training and completed pre- and post-training questionnaires to evaluate their knowledge, skills, and attitudes.

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The study streamlined access to care by providing both medical and dental care in one patient visit. This helped to remove barriers for parents who live in rural communities where access to a pediatric dentist may be difficult. Some special equipment was needed to incorporate the oral health check, including intraoral cameras, oral hygiene kits, and printed educational materials.

Nearly Half of Children Had Never Been to a Dentist

A large proportion of children (42%) had never seen a dentist, 58% did not have an established dentist, and 47% did not brush their teeth twice per day. Overall, use of fluoride was poor: 82% did not take supplements or drink fluorinated water and 73% did not use fluoride in the last 6 months.

Poor dental hygiene ran in families: the majority of caregivers (53%) had active tooth decay in the previous 12 months, 40% did not have a dentist, 17% smoked, and 17% consumed energy drinks. Most of the caregivers (73%) gave their child sugar-sweetened beverages and 35% gave their child 1 or more sugary beverages every day.

Referral between medical to dental care “provided a smooth transition of care and is a valuable approach for reaching underserved families, increasing access to care,” the authors said.

“Our findings show that incorporating dental care into well-child visits significantly increased oral health awareness,” the study authors concluded. After the intervention, nearly all caregivers (98%) were aware of the relationship between oral and systemic health.

Dr Betts plans to continue this model of integrating oral health screening, intervention, and referral into daily practice as part of the routine well-child visit. “My hope of that my other colleagues who see children for well-child visits will adopt this model of care. I also plan to apply for expanded funding to support a larger study with other pediatric providers in Federally Qualified Health Centers across Nebraska using our model of care,” Dr Betts said.

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Betts KJ, Moravec LJ. Integrating oral health care into primary care well child visits: an interprofessional model. Presented at: NAPNAP National Conference; March 15-18, 2023; Tampa, FL.