school oral health program
TRANSCRIPT
BHAVANA MARRI
DEFINITION School health services are defined as the procedures
established To appraise the health status of pupils and school
personnel To counsel pupils, parents, and others concerning
appraisal findings To encourage the correction of remediable defects To assist in the identification and education of
handicapped children To help prevent and control disease and To provide emergency service for injury or sudden
sickness
ASPECTS OF SCHOOL HEALTH SERVICE
1. Health appraisal2. Health counseling 3. Emergency care and first aid4. School health education5. Maintenance of school health
records6. Curative services
OBJECTIVES To help every school child appreciate the importance of a
healthy mouth and relationship of dental health to general health and appearance
To encourage the observance of dental health practices, including personal care, professional care, proper diet, and oral habits
To enlist the aid of all groups and agencies interested in the promotion of school health
To correlate dental health activities with the total school health program
To stimulate the development of resources to make dental care available to al children and youth
To stimulate dentists to perform adequate health services for children
IDEAL REQUIREMENTSSchool health program should be Be administratively sound Be available to all children Provide the facts about dentistry and dental care, especially
about self-care preventive services Aid in the development of favorable attitudes toward dental
health Provide the environment for the development of
psychomotor skills necessary for tooth brushing and flossing
Include primary preventive dentistry programs-prophylaxis, and fluoride programs, and use of pit and fissure sealants
Provide screening methods for the early identification and referral of pathology
Ensure that all discerned pathology is expeditiously treated
ADVANTAGES
School oral health programs can bring comprehensive dental care
Students can be accessed during their formative years School clinics are less threatening than private offices
since the children are in familiar surroundings It will be relatively easy to maintain the dental health
of children in their adult life Can facilitate valuable consultation on medico dental
problems Expenses involved and time used in transportation
can be saved Utilizing dental auxiliaries can further reduce the cost
ELEMENTS/COMPONENTS OF SCHOOL ORAL HEALTH PROGRAM
1. Improving school community relations
2. Conducting dental inspections3. Conducting dental health education4. Performing specific programs5. Referral for dental care 6. Follow-up
Improving school community relationOne of the first steps in organizing a dental health
program is the formation of advisory committee. It should include broad representation from parents, teachers, school administrators, dental professionals, health officers and community leaders.
The task of these committees is To appraise and publicize the dental needs of
school children To address the school administration’s concern
in the promotion of oral health To make people realize the importance of dental
health
Conducting dental inspections It serves as a basis for school dental health
instruction. Every child unless provide otherwise is considered to
be free from dental disease, the positive findings, on such children will provide greater motivation towards dental health
It builds a positive attitude in the child towards the dentist and dental care
The child and the parent are motivated to seek adequate professional care
Teacher, students and dentists concerned with dental health may use the dental inspection as a fact-finding experience
Provide information as to the status of dental needs to plan a sound dental health program
Conducting dental health education The dentist serves as the expert
resource person to strengthen the teacher’s classroom education program
He should give each teacher sincere attention
This is important in developing proper attitudes and personal dental health practices by the teacher which can be passed on to the classroom
Performing specific programsTOOTH BRUSHING PROGRAMS At the end In a classroom, 6-8 children can be taught as a group.
Each is given a cup, a napkin, and a kit containing a disclosing tablet, a toothbrush, and a tube of fluoride dentifrice.
The mastery of the 45 degree angulations and the short vibratory strokes can then be repeated on an oversized dentoform model.
Next, the children are asked to chew a disclosing tablet and to swish it around the mouth for 30 seconds. They are then encouraged to look at each other’s teeth with appropriate emphasis on the fact that the red stain colors the plaque in which the bacteria live.
Next a magnifying mirror is passed around so the participants can note that their teeth are no different from those of their neighbor i.e. all people have plaque.
Guided brushing can then begin, with the instructor establishing the sequence of teeth to be brushed.
At the end the mirror is again passed around to show that progress has been made.
CLASSROOM BASED FLUORIDE PROGRAMS:Two effective fluoride programs –Fluoride moth rinse program: A once-a-week mouth rinse can be expected to result in 20% to
40% reduction in dental caries. The dispenser is graduated so that 2.0 gm. Of packaged
sodium fluoride powder can be placed in a jug and water is added to the 1000ml mark.
The rinse should be non-sweetened and non-flavored to discourage swallowing.
Rinsing programs are advised for grades 1 to 12 but not below. Five ml of the rinse is dispensed in to each cup and all the
children are instructed to rinse the solution in the mouth for 1 minute, after which they are to spit carefully into the cup.
The napkin is used to wipe the mouth, after which it is forced into the bottom of the cup to absorb all fluid.
Fluoride mouth-rinse programs received official recognition of safety from the FDA in 1974 and by council on dental therapeutics of the ADA in 1975.
Fluoride tablet program: One tablet is given to each student. The student then
chews and swishes the 2.2mg sodium fluoride (1mg fluoride) tablet in the mouth for a minute and then swallows. The swish-and-swallow technique provides the optimum systemic benefit during the period of tooth development and maturation.
The daily tablet is more effective than the weekly rinse.School water fluoridation programs: The amount of fluoride added to school drinking water
must be greater than that used in communal water supplies, i.e. 4.5 times the optimum concentration since children are in school for shorter hours and less water is consumed during that time.
Study have shown a reduction in dental caries prevalence by about 40% among children attending school that support school water fluoride programs a major advantage is that children do not receive benefits until they begin school.
Nutrition as apart of school preventive dentistry programs:School lunch programs are designed to provide the
child with a intake of nutrients that approximate one third of the daily intake of essential carbohydrates, proteins, fat, minerals and vitamins.
Mid day meal program of government of India The program of providing hot cooked meal was
introduced in 7 north eastern districts of the state during 2002-2003
The scheme consisted of providing free food grains at 3kg per child or per months to children of class 1 to 5 of govt schools on the basis of 80% attendance in a month
The scheme was extended from classes 1 to 5 in govt aided schools from 1-9-2004
Sealant placement
The placement of pit and fissure sealants is ideally suited for a school program
1st , 2nd , 6th and 7th standards would be desirable levels to selectively intervene pits and fissure lesions
1st and 2nd standards, because first permanent molars are sufficiently erupted to place the sealant. 6th and 7th standards- 2nd permanent molars.
Science fairs
Science fair not only helps in educating and motivating the school children to improve their oral health but also provides an excellent opportunity for dentistry to contribute substantially to the building of a growing reservoir of students who may some day choose a career in dentistry
Referral for dental care In few schools dental care is provided at the
school itself. However if only emergency treatment is provided, for eg: the dental auxiliary places eugenol-soaked cotton in a child’s cavity to relieve the pain the parent does not see the child in pain and might conclude that the school has taken care of the dental problem.
Therefore the parent should be informed and made to understand that such emergency treatment is not a cure and she will have to visit the dentist of her choice for proper treatment.
Blanket referral
A program that has proved to be effective in many schools is blanket referral of all children to their family dentists
In this program all children are given referral cards to take home and subsequently to the dentist, who sign the cards upon completion of examination, treatment, or both.
Follow up
SCHOOL ORAL HEALTH PROGRAMS
Learning about your oral health Tattletooth program ASKOV dental demonstration North Carolina statewide preventive dental
health program Head start preschool dental health program School health additional referral program Teenage health education teaching assistants
program Colgate’s bright smiles, bright futures WHO’s global school health initiative
“TATTLETOOTH PROGRAM”- TEXAS STATEWIDE PREVENTIVE DENTISTRY PROGRAMThe tattletooth program was developed in 1974-
1976 as a cooperative effort between texas dental health professional organizations.
In 1989 the Bureau of dental health developed a new program to replace the existing program. This was called tattletooth II – A New Generation for Grades K-6.
Separate lesson plans were developed for each grade and a systems approach was used to develop all educational material.
Three video tapes were produced as part of the teacher-training package
The first video tape familiarizes the teachers with the lesson format and content
A second video tape, “brushing and flossing” was developed for the dual purpose of teacher training and as an educational unit to be used by the teacher with students
A third video tape provides teachers with additional background information as a means of preparing them to teach the lessons
The materials that were developed to aid in the implementation of the program consisted of
- a brochure that provided an overview of the program
- a school nurse’s brochure
PROGRAM PHILOSOPHY AND GOALS
The program embraces the six elements of effective lesson design, anticipatory set, setting the objective, input modelling, checking for understanding, guided practice and independent practice.
The basic goal of the program is to reduce dental disease and develop positive dental habits to last a lifetime. The major thrust of tattletooth is to convince students that preventing dental disease is important and that they can do it.
PROGRAM IMPLEMENTATIONThe Texas department of health employs 16 hygienists in the
eight public health regions to implement the tattletooth program.
The hygienists instruct teachers using videotapes designed for teacher training and provide them with a copy of the curriculum
Health promotion activities are encouraged and publicized within the school community
Teachers are encouraged to invite a dental professional to demonstrate brushing and flossing in the classroom
A field trip to a dental office is strongly recommended for kindergarten children
Bulletin board suggestions, a book list, films and videotapes are available on a free loan for appropriate grade levels
Other resources used are a list of companies providing supplementary classroom resources and a comprehensive glossary of vocabulary words written for the teacher in English or Spanish that are used in all grade levels
PROGRAM EVALUATIONThe students in grades 3, 5, 7, 9 and 11 were
given the Texas Assessment of Academic skills [TAAS] by the Texas education agency, to satisfy the legislative requirement that student performance be assessed.
Teacher evaluation is done annually by principals and supervisors using a 65-item checklist.
A major field test conducted in 1975 studied 15000 children in 18 educational service regions. Results of single exposure to the program revealed that-
Dental health knowledge was significantly increased at all grade levels
Plaque levels were decreased by approximately 15% in a randomly selected sample of 2142 children
Over 8o% of the teachers judged the program to be helpful ad effective , but evaluation questions suggested that they felt a need for additional technical help in brushing and flossing
INCREMENTAL CARE It may be defined as periodic care so spaced that
increments of dental disease are treated at the earliest time cosistent with proper diagnosis and operating efficiency, in such a way that there is no accumulation of dental needs beyond the minimum
In private practice, six months is the commonest, though not the only interval between visits. In public health programs, one year intervals are usually implemented.
This represents the ideal pattern for care where appreciable incidence of new dental disease is to be expected each year.
Treatment programs can be gotten of the ground by taking the youngest available group the first year and carrying it forward in subsequent years as far as funds permit, each year adding a new class of children at the next earliest available age until an entire child population is being served to as high an age as available resources permit.
Advantages : Lesions of dental caries are treated before
there has been a chance for pulpal involvement Periodontal disease is intercepted at or near
the beginning Topical and other preventive measures are
maintained on a periodic basis Bills for dental services are equalized and
regularly spaced The program avoids the high expenditure of
late dental care It confines dental disease to small early
increments, thus reducing loss of teeth It inculcates a habit of periodic return to the
dental office in subsequent years
Disadvantages :
Time consuming Attention to deciduous teeth Increasing likelihood of interruption
in children’s dental health programs
COMPREHENSIVE CAREComprehensive dental care is the meeting of
accumulated dental needs at the time a population group is taken into the program [initial care] and the detection and correction of dental disease on a semiannual or other periodic basis[maintenance care]
Services are provided not only to eliminate pain and infection but also to
Restore serviceable teeth to good functional form Replace missing teeth Provide maintenance care for the control of early
lesions of dental disease Provide preventive measures, educational and
otherwise, so that the population may experience a lower prevalence of disease
