SCHOOL DENTAL HEALTH PROGRAMMES.pptx power point presentation

school dental health program

1. SCHOOL DENTAL HEALTH PROGRAMMES

2. CONTENTS Introduction History Definition Objectives Ideal requirements Models of school health programs Aspects of school dental health programs Advantages Elements/components School dental health programs Incremental care Comprehensive care Conclusion References

3. INTRODUCTION Good oral health is fundamental to general health and well-being . Tooth decay & gum disease - most common and least treated I nterferes with eating, sleeping, speaking, playing, learning and smiling. More than 50 MILLION active school hous are lost annually because of oral health problems which affect children's performance at school. Vinej S. School Dental Health Programs - A Way to Meet the Unmet Oral Health Needs. Adv Dent & Oral Health. 2017; 6(2): 555685. DOI: 10.19080/ADOH.2017.06.55568

4. Children who suffer from poor oral health are  12 times more likely to have restricted-activity days than those who do not. O ral diseases or conditions in children - preventable or treatable WHO information series on school health, Oral health promotion: An essential element of a Health-Promoting School. World Health Organization: Geneva; 2003

5. Schools - ideal setting for promoting oral health Schools lay down the base for education, developmental and behavioural patterns of a child Provide an important background for health promotion, as they reach around 200 million school children across I ndia. School oral health programs improved children’s oral health by teaching good habits, providing fluoride and sealants, and offering dental treatment when needed. Shekhawat KS, Chauhan A, Priya H. Planning and implementing school oral health programs: A scoping review. J Indian Assoc Public Health Dent 2016;14:237-40.

6. HISTORY 1840 - R hode Island - 1 st legislation 1850 - the Sanitary Commission Of Massachusetts, headed by Lemuel Shattuck - produced a report - significant influence on school health. 1885 - William Fisher - high caries experience - Compulsory Inspection And Treatment In School Children July 23rd 1898 - School Dentists Society was formed in London Allensworth D, Wyche J, Lawson E, Nicholson L. Defining a Comprehensive School Health Program: An Interim Statement. Division of Health Sciences Policy. Washington (DC): National Academies Press (US); 1995.

7. 20th century - Benjamin Franklin – Healthful situation and promoted physical exercise School health service in India began in 1909, with the first medical examination in Baroda city World war I (1914–1918) - changing focus from inspections, hygiene and didactic messages to broader health promotion philosophies and movements. January 1982- Task Force by Government of India July 19th, 2001 - "Tokyo Declaration" - 1st Asian conference on oral health promotion for school children, held in Tokyo. Allensworth D, Wyche J, Lawson E, Nicholson L. Defining a Comprehensive School Health Program: An Interim Statement. Division of Health Sciences Policy. Washington (DC): National Academies Press (US); 1995.

8. February 23rd, 2003 - "Ayutthaya Declaration" - 2nd Asian Conference Of Oral Health Promotion For School Children Held in Ayutthaya, Thailand. These declaration called national authorities in health and education to ensure the implementation of systemic school health programs for promoting oral health and general health in children based on the WHO’S health promoting school initiative. January 28th, 2005 - “Bangalore Declaration" - CAMHADD/ WHO workshop on prevention and promotion of oral health through schools.

9. 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". - The committee on terminology of The American Association For Health, Physical Education, And Recreation, 1951)

10. OBJECTIVES Importance of a healthy mouth. D ental health ↔ general health and appearance. D ental health practices ( personal care, professional care, proper diet and oral habits)

11. To enlist the aid of all groups and agencies interested in the promotion of school health. D ental health activities ↔ t otal school health program. To stimulate the development of resources To stimulate dentists to perform adequate health services for children. .

12. IDEAL REQUIREMENTS A school oral health program should A dministratively sound A vailable to all children Provide the facts about Dentistry and Dental care Development of favorable attitudes toward dental health Environment for the development of psychomotor skills Include Primary Preventive dentistry programs Provide screening methods Ensure that all discerned pathology is expeditiously treated

13. MODELS OF SCHOOL HEALTH Review Article : Schools as opportunity for oral health promotion: Existing status in India Puneet Chahar1 , Meena Jain2 , Ankur Sharma3 , Nisha Yadav1 , Parul Mutneja4 , Vishal Jain ,   Indian Journal of Child Health · August 2018

14. Three component model (1900-1980s) Traditional “three Legged stool” of school health. Consists Health Education, Health Services, and A Healthful Environment. Family-School-Community Model (1990) Nader (1990)

15. Eight Component Model 1980 - Referred to as a “comprehensive school health program (CSHP)” – consisting of multiple domains called Bubbles .

16. ACCESS - Administration, Community, Curricula, Environment, School and Services – all constitute a microcosm of society where students spend much of their developmental years (Stone, 1990). This model focuses on the development of administration and community keystones first and remaining are added later on with optimal effect . Full-Service Schools (Dryfoos, 1994) - Described as a “one-stop center” for educational, physical, psychological and social requirements of students and their families Chahar P, Jain M, Sharma A, Yadav N, Mutneja P, Jain V. Schools as opportunity for oral health promotion: Existing status in India. Indian J Child Health. 2018; August 25

17. Health promoting schools (HPS) (1995) WHO school health initiative was launched in 1995 with the objective to create HPSs . Four key strategies :

18. 7. Complementary Ecological Model of the CSHP Lohrmann - role of ecology in health behavior combined concepts from multiple ecological models with eight components to formulate complementary ecological model of CSHP. Lohrmann DK. A complementary ecological model of the coordinated school health program. Public Health Reports. 2008;123(6):695–703. doi:10.1177/003335490812300605

19. ASPECTS OF SCHOOL HEALTH SERVICE

20. D efined as "the process of determining the total health status of the child through such means as health histories, teacher and nurse observations, screening test ; and medical, dental and psychological examinations". Periodic dental examination Prevention & long term oral hygiene practices. S chool curriculum - dental health instruction HEALTH APPRAISAL

21. D efined as "the nurse, teachers, personnel, and others interpret to pupils and parents, the nature and significance of the health problem and aid them in formulating a plan of action which will lead to solution of the problem". HEALTH COUNSELLING

22. T eachers - trained in handling simple emergencies Policies dealing with dental emergencies arising in or during extra curricular activities. EMERGENCY CARE AND FIRST AID

23. P rocess of providing learning experiences It should cover the aspects of Personal hygiene Environmental health and Family life. SCHOOL HEALTH EDUCATION:

24. - Useful in analyzing & evaluating school health programs provide a useful link between the home, the school and the community. CURATIVE SERVICES: R egular dental check ups and prompt treatment wherever possible and referral for special problems. MAINTENANCE OF SCHOOL HEALTH RECORDS:

25. Advantages Comprehensive dental care Access during formative years School clinics are less threatening than private offices 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 and time can be saved Utilizing dental auxiliaries

26. 1) Improving school-community relations: First step - formation of an advisory committee. T ask of these committees is To appraise & publicize dental needs of school children To address concern - promotion of oral health. To make people realize the importance of dental health

27. 2) Conducting dental inspections: Extent of dental diseases > 95% or more Basis for school dental health instruction. Positive findings - provides greater motivation towards dental health. B uilds a positive attitude Motivation to seek adequate professional care Fact-finding experience Baseline & cumulative data - are made available Provides information - to plan a sound dental health program.

28. 3 ) Conducting dental health education: AGE ORAL HEALTH TOPICS MATERIALS & VISUAL AIDS 0-3 yrs Information to parents about oral health, teething, tooth brushing, breast feeding, dummies/bottles, nutrition, caries, medicine, dental trauma Picture books, posters, slides, video, models, food 3-5yrs Teach keeping the mouth clean, brushing the teeth and rinsing Leaflets, models, drawing & coloring sheets, puppet show, role-playing, songs 6yrs Teeth, oral hygiene, nutrition/food pyramid, shape & function of different teeth Picture books, slides, video, puppet shows, models, fishing games, food, jigsaw puzzles, drawing/exercise sheets 7-9 yrs Importance of good dental health to physical health – Dentitions, caries process, body/oral consciousness, hygiene, trauma Slides, videos, fishing games, food, leaflets on nutrition, models

29. AGE ORAL HEALTH TOPICS MATERIALS & VISUAL AIDS 10-12 yrs Body, nutrition, hidden sugar & types of sweets, caries process, dental plaque, bacteria, caries registration, self–examination, importance of preventive measures Slides, videos, overhead projections, picture books, role-playing, cultivation of bacteria, worksheets, recipes, models 13-15 yrs Health & well-being, oral health in general, structure of tooth & supporting tissues, initial caries, oral hygiene, proximal caries, healthy lifestyles, tobacco & nutrition, sweet drinks, hidden sugar Overhead projections, slides, videos, leaflets, x-rays, newspaper articles, worksheets, music, music, dental floss, nutrition, computer programs, statistics 16-17 yrs Gingivitis/periodontitis, change to adult dental health care. Oral cancer & preventive measures Slides, videos, leaflets, newspaper articles, quality-of-life game, computer program Modified from stella . YL.Kwan et.Al . Health-promoting schools; an opportunity for oral health promotion: bulletin of the WHO (2005).

30. 4 ) Performing specific programs A) Tooth brushing programs: 6-8 children - group. A cup, a napkin, and a kit containing a disclosing tablet, a toothbrush, and a tube of fluoride dentifrice. The mastery of the 45° angulations and the short vibratory strokes - dentoform model. Emphasis on definite brushing sequence

31. Chewing & swishing the disclosing tablet - 30 seconds. Guided brushing During the entire process appropriate corrections and reinforcement of brushing technique should be emphasized .

32. The study assessed supervised tooth brushing and plaque disclosing agents among 7–8-year-old pupils in Dar es Salaam. Both methods improved oral hygiene and brushing skills, with plaque disclosing agents giving the best gum health and supervised brushing enhancing technique. The trial proved that school-based supervised brushing effectively improves children’s oral health .

33. B ) Classroom-based fluoride programs: Fluoride 'mouth - rinse' program: 20% to 40% reduction in dental caries. Kit - fluoride rinse dispenser, cups, napkins and plastic disposal bags. Non-sweetened and non-flavored Grades 1 to 12 but not below. Five ml of the rinse - for 1 minute

34. Fluoride tablet program: One tablet = one student Chews and swishes the tablet - a minute and then swallows. D aily tablet >>>> weekly rinse.

35. C) school water fluoridation programs: Amount of fluoride – school water = 4.5 times community water Systemic effects on developing teeth + topical effects on erupted teeth. D ental caries prevalence – ↓ 40% Children do not receive benefits until they begin school.

36. D) N utrition as a part of school preventive dentistry programs : School lunch programs - one third of the daily intake Sugar discipline - counseling by the school dietician, Dental hygienist or teacher. ↓ The frequency of sugar intake

37. Mid day meal program of government of india 1 st introduced For disadvantaged children in Madras Municipal corporation , Tamil Nadu – 1925 Gujarat, keral a , Tamil Nadu, UT of pondicherry – 1984 1990-91 – 12 other states implemented Karnataka -1997, Akshara Dasoha Program (2002-03) – all the districts

38. Scheme Class 1-5 → 80% Attendance/Month – Food Grains 3kgs Per Child Government Aided Schools From 1-9-2004 The Program was extended to VI And VII Standards In Government / Government Aided Schools From 01 -10-2004. From 2008-09 1st April, 2008, The Programme Covers All Children Studying In Government, Local Body Revised name- PM Poshan Scheme (2021)  for a five-year period.

39. The objectives of the Midday Meal Scheme   To boost enrolment and improve attendance To reduce school drop outs. To improve child health by increasing nutrition level. To improve learning levels of children. Attracting children who are reluctant to go to schools

40. Sealant placement: First, second, 6th and 7th standards Sealant placement + follow-up application of fluoride + fluoride mouth rinse or fluoride tablet program

41. Science fairs: Education and motivating school children to improve their oral health Local and state dental associations

42. 5 ) Referral for dental care: In few schools dental care is provided at the school itself. In cases where only emergency treatment is provided - parent should be informed and made to understand that such emergency treatment is not a cure "Blanket" referral: All children - referral cards – dentist signs the cards upon completion of examination, treatment, or both. Return to school nurse, or classroom teacher

43. 6) Follow up: D ental hygienist - follow up examinations. Leave concessions from school for dental treatment are strongly recommended. Two reasons for such concessions: a) Child - more co-operative patient when medical/ dental services - early or middle part of the day. b) Dentists provide better services for children when they have time and do not have to crowd their child patients into after school hours.

44. SCHOOL DENTAL HEALTH PROGRAMMES “Learning About Your Oral Health” – Prevention Oriented School Programme “Tattle Tooth Program" - Texas Statewide Preventive Dentistry Program Askov Dental Demonstration North Carolina Statewide Preventive Dental Health Program School Health Additional Referral Programme (Sharp) Teenage Health Education Teaching Assistants Program (Theta Program) Colgate’s Bright Smiles, Bright Futures

45. 1. “ Learning about your oral health” ADA + ADA house of delegates - 1971 ‘Learning about your oral health’ is a comprehensive programe covering current dental concepts

46. The primary goal - develop the knowledge, skills and attitudes needed for prevention of dental diseases. Implementation of the program: Preschool (designed for children too young to read). LEVEL I ( Kindergarden - GRADE 3). LEVEL II (GRADES 4 - 6). LEVEL III (GRADES 7 - 9). LEVEL IV (GRADES 10 - 12 ).

47. Each teaching packet includes: A teacher's self-contained guide on "dental health facts" Glossary A curriculum guide Five lesson plans (preschool level) and seven or more lesson plans (other levels each) Four overhead transparencies Twelve spirit masters (for copying) Methods and activities for parental involvement

48. 2 . Tattle Tooth Programme – Texas Statewide Preventive Dentistry Program 1974-1976 Texas Dental Health Professional Organizations + Texas Department Of Health + Texas Education Agency 1975 – Pilot study 1976 – Field study 1989 – New programme to replace existing tattle tooth programme Tattle tooth II – (A new generation for grades K-6 ) - videotapes

49. Three video tapes were produced as part of the teacher training package. First video tape – lesson format & contents Second videotape – brushing & flossing for teacher training & educational unit Third videotape – additional background info .

50. Programme philosophy & goals Basic goal is to reduce dental disease & to develop positive dental habits to last a lifetime The programme embraces the six elements. Anticipatory set Setting the objective Input modeling Checking for understanding Guided practice Independent practice

51. Program implementation Texas department employs 16 Hygienists - teachers training & provide them copy curriculum Teacher – demonstrate brushing & flossing Field trip to a dental office – kindergarden children :

52. Program evaluation The students in grades 3, 5, 7, 9 and11 were given the Texas Assessment of Academic Skills (TAAS) by the Texas Education agency. A major field test conducted in 1975and 1976 studied 15,000 children in 18 educational service regions Dental Health Knowledge levels – increased Plaque levels – decreased – 15% -2,142 children 80% - teacher – helpful & effective In 1989 – tattle tooth II curriculum was conducted 94 %- teacher – helpful & effective

53. The evaluation of the tattle tooth programme in 1977 and 1978 had three major goal; 1). to conduct a gross dental screening 2). to conduct an experimental study 3). To conduct an evaluation of the services

54. 3. Askov dental demonstration ASKOV is a small farming community located in Northeastern Section Of MINNESOTA Aim : To determine the value of total or community dental care over 10 years periods ASKOV community request to the health department of MINNESOTA to conduct a survey on ASKOV School Observation:- They observed high incidence of dental caries among ASKOV school children.

55. IN 1949 TO 1957 This community conduct mainly two programs: Corrective program Preventive programs.

56. Corrective programmes This programme demonstrated about Cleaning teeth Filling teeth Extraction Replacement of missing teeth.

57. Preventive programme It demonstrated about NaF solution application Ammoniated tooth powder with proper brushing technique after meal. Dietary and personal habits. Significance of lactobacillus in dental caries development. Application of x-ray in dentistry (bitewing). Topical fluoride treatment.

58. Results: After 1 year: 39.6% decrease in lactobacillus count. 24.7% decrease in carious tooth surface. Slight increase in number of youngster with perfect teeth. After 10 years: 28% ↓ in DC in deciduous teeth (3 to 5 years) 34% ↓ DC (6 to 12 years) 14% ↓ DC (13 to 17 years) Increase in filled tooth ratio and good health .

59. 4. North Carolina Statewide Preventive Dental Health Programme 1970- North Carolina Dental Society 1973 – Frank E. Law – Initiated 10 Yr Program to reduce dental disease These programme include producing 19 videotapes for class teachers Philosophy & goal Primary prevention & education – most effective Y oung children – greater positive impact – attitude & behaviour pattern of the individuals to improve their oral health habits through dietary changes, tooth brushing and flossing.

60. Objectives for the attainment of the goal are: Appropriate use of fluoride Health education in schools and communities Availability of public health dental staff in all counties.

61. Programme implementation : In the year 1990, services delivered through the program included The fluoridation of water supplies of 130 rural schools, Weekly fluoride mouth rinse for more than 416,000 students in 1,051 schools. Screening and referral for more than 3,39,000 children. Dental health education was presented to 361,000 children and 42,000 adults. More than 33,000 dental sealants were applied. Teachers are believe to be the key in the educational program.

62. Program evaluation Survey – 10 yrs – community water F – 53% dmft score 8 yrs – school water F – 34% d m ft score use of sealants- 86% reduction of dental caries rate after 4 years – permanent teeth

63. 5. SCHOOL HEALTH ADDITIONAL REFERRAL PROGRAMME (SHARP)  Instituted in PHILADELPHIA Purpose: to motivate parents into initiating action for correction of defects in their children through effective utilization of community resources. Carried out by the district nurses with the cooperation of all school personnel. In New Zealand, government dental nurses render the care upto the age 13 years and have their own clinics on the school premises.

64. 6. Teenage Health Education Teaching Assistants Program (Theta Program) Developed by the National Foundation for the prevention of oral disease for the Department of Health and Welfare, Division of Dental Health in San Francisco . Philosophy: Dental personnel train high school children to teach preventive dentistry to elementary school children.

65. Goals To give knowledge & skills to young children. Allows high school children to develop understanding of young children. Introduces them to career opportunities. In 1974, the THETA program in Ukiah, California trained high school students and teachers through the SAVE system to teach elementary children about oral hygiene, including plaque control, brushing, flossing, and healthy eating. Results –improvement in oral health knowledge skills – Brushing and flossing by 72% and 38% “ THETA: Teenage Health Education Teaching Assistants” by Robert L. Weiss and Evelyn M. Lee (1974) :

66. 7. Head Start Preschool Dental Health Programme - United States Preschool years - critical period Preschool children can be reached through Department of Health Baby clinics, necessary schools, day-care centres , and kindergarten classes.

67. Head Start - In 1965, Head Start, A National Preschool Programme , was initiated in the United States under the Economic Opportunity Act of 1964 Mainly focuses on assisting children from low income families b. Smiling for Life - The nutritional survey (1995) of British preschool children showed that the consumption of non-milk extrinsic sugars (NMES) was significantly higher at 19 % of total energy, than the 10 % recommended level.

68. St. David’s Dental Program - A Mobile School-Based Dental Program For Children 1998 as a collaboration between the City of Austin and St. David’s Community Health Foundation (SDCHF) free delivers dental screenings, sealants, treatment, and education to children in Central Texas through fully equipped mobile vans and portable dental facilities that travel to schools. Program – Screening, Parental Consent, Treatment.

69. Colgate Bright Smiles, Bright Futures -1976 Program is a global oral health initiative that teaches children oral health habits including proper hygiene, diet, and physical activity. It brings together dental professionals, parents, and educators to highlight oral health as part of a child’s overall Physical and Emotional development Primary school children receive guidance from the Indian Dental Association using audio-visual aids and printed materials, along with free dental care packs Program has covered 162+ million children-2017, 2018-19 alone – 11.5 million Colgate Bright Smile, Bright Future. Available from: https://www. colgatepalmolive.co.in/core-values/community-responsibility/brightsmiles-bright-futures

70. Pit and Fissure Sealant Pilot Project - National Oral Health Program (NOHP), AIIMS, New Delhi Under the central component of NOHP , the current pit and fissure sealant project have been launched , for which training of representatives from 12 dental colleges was done on May 1, 2017 with a target to seal 53,750 permanent molars in children 6-14 years of age to prevent dental caries.

71. INCREMENTAL DENTAL CARE Defined as periodic care so spaced that increments of dental disease are treated at the earliest time consistent 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.

72. ADVANTAGES: Prevent pulpal involvement & loss of teeth PDL diseases identified at early age Preventive programs on periodic basis Bills for dental services are equalized and regularly spaced. In economic terms, the programme is supposed to avoid high expenditure for initial dental care. (economical) Habit of periodic return

73. DISADVANTAGES: Time consuming Financial resources may be exhausted Attention to deciduous teeth. Psychology and changing patterns of modern family life. Increasing likelihood of interruption in children’s dental health programmes . Inertia toward the seeking of private dental care.

74. COMPREHENSIVE DENTAL CARE Definition: It is the meeting of accumulated dental needs at the time a population group is taken into programme and the detection and correction of new increments of dental disease on a periodic basis

75. This approach is broken into four stages: Stage 1 (Pain relief and/ or immediate problem solving) Stage 2 (Treatment planning) Stage 3 (Treatment phase) Stage 4 (Treatment review and maintenance/Prevention program)

76. Stage 1 (pain relief and/ or immediate problem solving): CDC aims to alleviate or lessen immediate pain/problem ASAP Treatment offered may be provisional, for example: A temporary or sedative dressing Smoothening of sharp fractured tooth Antibiotics to reduce swelling Definitive treatment may not be appropriate

77. Stage 2 (treatment planning): A complete examination Dental radiographs (x-rays) Other special tests or records. A separate appointment is often organized to discuss any problems and review possible treatment options. For more complex treatment plans, a written report and provisional treatment plan is provided. Patient’s input and feedback Early dental education to prevent ongoing problem is also provided.

78. Stage 3 (Treatment phase): Appointments are scheduled depending on the treatment needs. Time frame discussed to achieve the desired result The length of the appointment is tailored to best suit an optimal treatment outcome as well as comfort.

79. Stage 4 (Treatment review and maintenance/Prevention program): Regular appointments are scheduled to review what has been achieved. These are customized to pt’s needs Dental prevention program will be discussed to stop or slow future dental problem.

80. CONCLUSION . Poor oral health can have a detrimental effect on children’s quality of life as well as the oral-health quality of life and in turn affect their performance at school and their success in later life Implementation of community-based preventive oral health programs focused on a healthy diet and adequate oral hygiene practices should be promoted in school curricula, be part of comprehensive school health programs

81. REFERENCES Soben peter. Textbook of community & preventive dentistry, 5 th edt . Marya c m. A textbook of public health dentistry. New delhi : JP medical ltd; 2011. S s hiremath - textbook of  preventive & community dentistry- 2 nd edition. Text book of community dentistry – satish chandra Schools as opportunity for oral health promotion: existing status in india puneet chahar , meena jain , ankur sharma , nisha yadav , parul mutneja , vishal jain ; indian J child health; vol 5 | issue 8 | august 2018 SCHOOL DENTAL HEALTH PROGRAMMES- A REVIEW; sangeetha K.M , nitish shrivastava , nivedan K.S, dhanya R.S, brilvin pinto, shobha R; journal of advanced medical and dental sciences research |vol. 5|issue 1| january 2017 Vinej S. School dental health programs - A way to meet the unmet oral health needs. Adv dent & oral health. 2017; 6(2): 555685. Doi: 10.19080/adoh.2017.06.555685

82. Priyadarshi S, tangade P, singh V, jain A, khan S N, yadav J. School health programmes: A review article. TMU J dent 2021;8(3)6-8. Kwan syl , petersen pe, pine cm, borutta a. Health-promoting schools: an opportunity for oral health promotion. Bull world health organ. 2005;83(9):677–685.