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Dental Tribune Middle East & Africa Edition | 2/2017 HYGIENE TRIBUNE C6 Effective School Dental Health Program, step towards making “Little Oral Health Champions” #YearOfGiving By Dr. Aparna Sharma, UAE Introduction Good dental health habits in our children can give them a lifetime of better health. Schools can play a key role in preventing or identifying children’s oral problems before they become serious and helping families obtain dental care services that are accessible and affordable. Little Smile Officers are in real need… Children with severe untreated dental decay often are in pain, can’t sleep at night, can’t concentrate and get poor grades. Young children and children with special needs often are unable to communicate about their oral problem or pain. Teachers may notice a child having difficulty while completing tasks by showing the ef- fects of pain – anxiety, fatigue, irri- tability, depression and withdrawal from normal activities. Children who have a toothache when they take tests are unlikely to score as well as children who are not distracted by pain. When children’s acute oral health problems are treated and they are not experiencing pain, their learning and school attendance re- cords improve. Children and adolescents with spe- cial health care needs compared to all other health care services, oral health care is the most prevalent unmet health care need. Unmet oral health care needs affect about twice as many children and adolescents as unmet mental health care needs. According to parents, children and adolescents with special health care needs without insurance and from families with low incomes are more likely not to receive the health care services they need. More than half of dental schools provide students with less than 5 hours of classroom in- struction, and less than 5 percent of clinical time, related to children and adolescents with special health care needs. Hands-on educational experi- ences in dental school significantly impact dentists’ perceptions of bar- riers to care for children and adoles- cents with special health care needs. WHO Child Oral Health Fact File: Dental cavities Worldwide, 60–90% of school chil- diseases or injuries can suffer from inadequate nutritional intake, im- paired growth and development, speech problems from missing teeth, or poor self-esteem. Planned Services to be of- fered in School-based Dental Program In school-based dental programs pre- ventive care services can be offered at the school. Programs may pro- vide services in school clinics with stationary equipment, in a room in the school building using portable equipment, or in mobile vans parked at the school. Four common school- based dental service models include: 1. Dental screening programs: Students in any grade level may be seen. No treatment is provided at the school; thus, students with dental needs can be referred to a local den- tal clinic. 2. Dental sealant programs: Dental screenings are done and seal- ants are placed on students in se- lected grades (typically 2nd and 6th grade) to reach children at a time when the first or second molars typi- cally erupt. 3. Dental preventive services program: The provided include screening, prophy (cleaning), fluo- ride treatment, and sealants. This type of program will generally serve and benefit students in all grades. 4. Basic preventive and restorative dental services program: This type of program would include the full range of preventive services along with restorative services, such as basic fillings and simple extrac- tions. Students in all grades are of- fered services. services Follow-up and case manage- ment handling There are many questions, being asked by the school when will we plan to conduct an Oral Health pro- gram. Will the program be provided by the program or will the school be responsible for this? Who will ad- dress parent questions or concerns after treatment has been provided? All programs will encounter chil- dren who need restorative care. Case manager’s duty should be helping children and families find a dental home, locate dental clinics that will provide services to students. Also for uninsured students, ensure that appointments are made and kept, and will make sure treatment plans are completed. All programs need to synchronize with dental offices so students can quickly receive needed care. Case management is important to ensure the child receives neces- sary restorative care. The program should have a plan for following up on students with den- tal decay. It is important to have a clear understanding regarding who ultimately has the responsibility of following up with students and/or parents on needed dental care. In addition, once the program has fin- ished providing services at school, there should be established protocol for how parents’ questions or con- cerns will be addressed. How often and for how long will the program be at school site– for instance, once a year, once a week, or some other arrangement? For better impact the program should be conducted at least once every year. The program’s length at the school can vary based upon the number of students needed to be seen. To ensure that all children who sign up for the program receive treatment, we must present paper- work to the school looking for words such as “if time allows” or “as time permits.” These words often indicate that the program is scheduled to be at the school for a set number of days even if not all the children who are signed up for care can be seen. Children are the future pillars of our nation. As a healthcare provider we should always contribute for a bet- terment of society. With this positive step we can improve awareness in our children and give them a happy and healthy smile. Assimilating factors of productive “Oral Health Program” occur during childhood and adoles- cence, and the teeth most frequently affected are the highly visible front teeth. Nearly 3% of children ages 6–8, 11% of children ages 9–11, 18% of ado- lescents ages 12–15, and 23% of ado- lescents ages 16–19 experience oral injuries. Emergency room admis- sion studies reveal that more than 50% of oral injuries are the result of a fall. Trauma to the head and mouth can occur during school-sponsored physical activities, especially contact sports, as well as on the playground from accidents or fights. Studies indicate that about 33% of all den- tal injuries and about 19% of head and face injuries are sports related. Loss of primary (baby) teeth from injuries or severe dental decay can result in permanent teeth that are crooked, trapped under other teeth or over-crowded, making them more susceptible to decay and periodontal (gum) disease. A single injury to a tooth may not heal completely and may create expensive, long-term problems. Children who have untreated oral dren and nearly 100% of adults have dental cavities, often leading to pain and discomfort. Oro-dental trauma Across the world, 16-40% of children in the age range 6 to 12 years old are affected by dental trauma due to unsafe playgrounds, unsafe schools, road accidents, or violence. Noma Noma is a gangrenous lesion that affects young children living in ex- treme poverty primarily in Africa and Asia. Lesions are severe gingival disease followed by necrosis (pre- mature death of cells in living tis- sue) of lips and chin. Many children affected by noma suffer from other infections such as measles and HIV. Without any treatment, about 90% of these children die. Cleft lip and palate Birth defects such as cleft lip and pal- ate occur in about one per 500–700 of all births. This rate varies substan- tially across different ethnic groups and geographical areas. Impact of poor oral health on physical, social and emotion- al health Tooth decay is an infection caused by bacteria that are transmitted via sa- liva. Without proper care, the infec- tion progresses to become a cavity and maybe an abscess, thus not just affecting the tooth but the rest of the mouth and even the rest of the body, leaving the child prone to many oth- er childhood infections such as ear or sinus infections.1 Oral injuries often 5 stages of Adoption, as part of Effectual School Health Program Participants wanted for trial testing to explore painless caries treatment By DTI BIRMINGHAM, Ala., USA: The Uni- versity of Alabama at Birmingham School of Dentistry has announced that it will be offering patients with interdental caries a new, less painful treatment option as part of a new clinical trial. The new treatment, which entails infiltrating a prepa- ration gel and then a liquid resin through a perforated plastic sheet between the teeth, allows dentists to treat cavities without administering local anesthesia or drilling, which is conventionally unavoidable to ac- cess the cavity. The resin infiltration system is a commercially available product made in Germany and approved by the Food and Drug Administration, but is mostly being used only in clin- ical trials in the U.S. The university’s clinical research center is conducting the largest U.S. clinical trial of this product, enrolling 150 patients in the study. “When we develop cavities between teeth, sometimes we have to go through the tooth, and we end up damaging healthy tooth structure,” said Dr. Augusto Robles, assistant professor and director of the op- erative dentistry curriculum at the university. “This new system allows us to skip the drilling and helps us preserve that structure.” With the new procedure, the cavity is first cleaned by pushing a gel that prepares the surface to accept the resin infiltrant through the perfo- rated sheet. The tooth is then filled by pushing a liquid resin through the perforated sheet. Finally, a den- tal curing light is then applied to the tooth to cure the resin. Despite the apparent simplicity of the procedure, the treatment works only in between teeth or on smooth surfaces with small cavities. Some large lesions or those on the occlusal surfaces are not suited for this kind of system because the liquid resin cannot be used to build up shapes. Therefore, its application has to be very specific, Robles highlighted. Dentists with patients interested in participating can advise their pa- tients to make an appointment for a free 20-minute radiographic and screening assessment by email. Par- ticipation is free of charge.