CHILDREN ORAL HEALTH TOOTH DECAY 1

Amelia Gonzalez
Helen Brown
Health Promotion
16 March, 2017
Need Assessment

Children Oral Health Tooth Decay

BIG PICTURE

Good oral health is essential to achieve for overall health, wellbeing and quality of life.
The most common childhood disease in developing and industrialized countries is dental caries
(decay), causing toothache, infection, and tooth loss (Selwitz, Ismail, & Pitts, 2007). The worst
part is childrens cavities are not seen as a concern for oral health (Carlson, V. and Veschucio,
2014). Numerous children nationwide go untreated each year due to limit access to and
availability of dental services, lack of awareness for care, and financial hardship (Division of
Oral Health, 2017). Childrens primary teeth are an essential tool for chewing, learning correct
pronunciation, and play a vital role in the proper alignment and spacing of permanent teeth.
Primary teeth are susceptible to caries because they are less densely mineralized. Therefore, it is
important to practice good oral hygiene for children early during their first years of life to
establish a proper oral hygiene routine and prevention of cavities for primary teeth and
developing strong, healthy permanent teeth (Importance of Childhood Oral Hygiene & the Role
of Parents, 2017). Healthy People 2020 objectives for children (birth-5 years of age) is to
reduce the proportion of children with dental caries and with untreated dental decay in their
primary teeth.

QUALITY OF LIFE AND SOCIAL ASSESSMENT

Demographic Data Canyon Idaho U.S.A

County
Population 198,921 1,616,547 316,515,02
1
High school graduation 72% 80.6% 75.5%
Bachelors degree 17.74% 25.86% 29.77%
Persons below poverty 26.07% 19.19% 21.73%
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(children)
Uninsured Children 8.73% 8.52% 6.28%
Access to Dentist 42.41% 64.2% 65.6%
Dental Care Utilization 34.4% 31.4% 30.2%

The quality of life in the Canyon County area has a population of 198,921 people living
in the area (587.37 square mile). The current population plays a role in oral health to determine
where social services are needed. High school graduation rate within the area report at 72% of
students graduating which is less than the Healthy People 2020 target of 82.4%. Bachelors
degree rate report at 17.74% compared to the U.S at 29.77%. The amount of the population
educated is relevant because the lack of education affects access to care and ability to engage in
healthy behavior. Education is one of the strongest interventions to promote overall health,
wellbeing, and quality of life (Community Commons, 2017).
Oral Health is an essential component for quality of life but due to the cost of service it
may be impossible for those who are uninsured, living in poverty, or have limited access to
dental services. The percentage of children living in poverty in Canyon County is 26.07% which
is below the Federal Poverty Level. The percentage of children uninsured is 8.73% compared to
U.S at 6.28%. The percentage of dentist access in the area is 42.41% compared to the U.S at
65.6%. Lastly, the percentage of adults who have not visited the dentist is 34.4%, slightly higher
compared to the U.S at 30.2%. The reported data is relevant because the rate of financial
hardship and uninsured are at risk for health care access causing a primary barrier to regular
dental visits and care for oral health (Community Commons, 2017).

EPIDEMIOLOGICAL ASSESSMENT

# Canyon County,
Trend Idaho United States
ID
1 Poor Dental 12% 13.3% 15.7%
Health
2 Poor General 17.4% 14.7% 15.7&
Health
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The risk for poor dental and general health is slightly better in Idaho at an average at 14%
than compared to national at 15.7%. The epidemiological data indicates there has been
improvement made in oral health but there is still a need to increase access to oral healthcare and
reduce the financial burden associate with oral health conditions such as tooth decay (Carlson, V.
and Veschucio, 2014).
In Idaho, poor dental health exists among the Hispanic population at a rise of 46%
comparing to non-Hispanic at 31%. Children between two to eight years of age who experience
dental caries were at 37% and 23% had dental caries in their primary teeth (Carlson, V. and
Veschucio, 2014). The number of poor health exist due to disparities such as lack of health
insurance coverage, education, and income especially for those who are underprivileged. Lack of
insurance is a primary barrier to access of dental care services. The amount of education
indicates current knowledge on oral health which is limited to those who struggle financially.
These disparities indicate barriers to achieve good oral and general health for families with
children (Division of Oral Health, 2017).

HEALTH BEHAVIOR DATA

Trend Idaho
Dental Care Utilization 61.1 65.7%

The behavior risk associated with oral health indicated by behavior risk factor
surveillance data indicated the crude prevalence percentage for those who visited the dentist or
dental clinic within the past year. Idaho prevalence rate reported between 61.1-65.7%. Dental
care utilization is critical to engage in to prevent behaviors that are likely to develop in the
future, such as bad dental hygiene. Dentist visits should also be utilized to insure caries dont go
untreated and cause consequences for familys quality of life (BRFSS Prevalence & Trends Data:
Explore by Topic | DPH | CDC, 2017).
Childrens primary teeth should be well cared for and preserve since they play a vital role
in the proper alignment and spacing for the development of permanent teeth (Importance of
Childhood Oral Hygiene & the Role of Parents, 2017). Negative factors that increase the
chance of developing dental caries are poor oral hygiene and diet (Carlson, V. and Veschucio,
2014). Therefore, it is important to establish an oral care routine as soon as birth to set a
CHILDREN ORAL HEALTH TOOTH DECAY 4

foundation for developing healthy and strong permanent teeth. In addition to good oral hygiene,
childs diet also plays a key role in keeping teeth clean. The frequency of sugar consumption
should be limited to and avoided as much as possible especially in the morning and night.
(olak, Dlgergil, Dalli, & Hamidi, 2013).

ENVIRONMENTAL DATA

Changeable environmental factors that are important to address are access to dentist, oral
health education, coverage for uninsured children and water fluoridation. Early primary
prevention for dental caries is possible for children if there is access to dental clinics and dentist.
Canyon County rate access to dentist at a low 47 % compared to the U.S. at 65%. Access to
dentist may be difficult for low-income, uninsured children causing a hardship financially and
quality of life. The rate of uninsured children in Canyon County is 8.73%, slightly higher
compared to than the U.S at 6.28% (Community Commons, 2017). Thus, it is important to
address coverage for oral health and access to dentist who accept varies type of insurance
coverage to insure dentist visit are affordable based on families income (Needs, 2012).
Addition to improving oral heath for children age 0-5 is to educate families on oral health. An
effective oral health education may influence the care for oral hygiene through educating parents.
Thus bringing a shift on parents current beliefs and attitude to change behavior for caring for
their childs teeth starting as soon as their birthday(Needs, 2012). Lastly, for prevention of caries
is to use products with fluoridation. Fluoride products have shown to reduce caries between 30%
and 70% compared with no fluoride therapy (J Dent Res. 2004).
Current knowledge on oral health through surveys may be helpful to address what needs
to be educated through parents to promote oral hygiene and prevent tooth decay in children. The
amount of fluoridation in the public water supply in canyon county may be needed to learn about
the environment. Such as what households have adequate supply of water fluoridation. This
information can be obtained by interviewing Idahos Department of Environmental Quality to
assess the quality of public drinking water.

IDENTIFYING THE PROGRAM PURPOSE

CHILDREN ORAL HEALTH TOOTH DECAY 5

Predisposing Factors
Dental caries is related to ones lifestyle and behavior factors that include poor oral
hygiene, poor dietary habits, and inappropriate methods of feeding infant. Poor oral hygiene is
associated with lack of knowledge on when tooth decay can occur early at childhood. Poor
dietary habits include sugary drink, medication, and consumption of refined carbohydrate
(Selwitz et al., 2007). Inappropriate methods of feeding for infants include going to bed with a
bottle of juice, milk, or formula in their mouth. The sugar content in these liquids feed the
bacteria in the enamel causing tooth decay. Thus, providing breastfeeding the perfect nutrition
for infants (olak et al., 2013).
There has been a decline in the prevalence of dental caries in children in the western
countries, although early childhood caries remains a problem in pre-school children in both
developed and developing countries (Selwitz et al., 2007). Making it important for the need of
data in problem countries to address the issue on which interventions are not working and are
affective. I suggest using observation and survey tools for families to address the issue on
children oral health.

Enabling Factors
The enabling factors that contribute to making dental visits possible for preventing tooth
decay are the availability of dental clinics that accept a variety of insurances or places available
to educate underprivileged families on children oral health. What contributes to tooth decay is
limited access to dentist offices, lack of education, poor dietary habits, and financial hardship.
What needs to be changed is the starting age for when children need to attend to oral hygiene and
dentist visit. Feeding infants sugary drinks including formula in bottles while going to bed need
to be abandoned so bacteria doesnt form and cause tooth decay.

Reinforcing Factors
CHILDREN ORAL HEALTH TOOTH DECAY 6

The reinforcing factors that would improve children oral hygiene is making dental visits
affordable for underprivileged families based on their income. Also, by providing education skill
class for dental hygiene in prenatal clinics, pre-schools, and daycares.

VALIDATING NEEDS AND CONCLUSION

The goal for childrens oral health is to prevent or delay child for acquiring bacteria that
cause tooth decay. Parents are role models for their children therefore, they have a key role in
promoting and establishing a proper oral hygiene routine to prevent tooth decay and help their
child develop healthy teeth. Changing feeding methods and age start of oral hygiene care is the
most important predisposition factors to prevent tooth decay and healthy development of
childrens permanent teeth. Access to dentist is the most important enabling factor so the dentist
can assess childs teeth for tooth decay and treat condition before becoming worse. Lastly,
making dental visit affordable will not only insure child is receiving oral care but wont leave
family in financial hardship due to dental services.

ASSESSMENT TEAM
The Department of Health and Welfare may be helpful by including educational courses
into their supplemental nutrition program for women, infants, and children (WIC). Barriers that
need to be consider for their involvement is their attitude towards children oral health. I believe
influence from dentists need to address the issue of tooth decay to promote oral health included
in general overall health for children zero to five years of age.

Reference
CHILDREN ORAL HEALTH TOOTH DECAY 7

BRFSS Prevalence & Trends Data: Explore by Topic | DPH | CDC. (n.d.). Retrieved March 28,
2017, from https://nccd.cdc.gov/BRFSSPrevalence/rdPage.aspx?
rdReport=DPH_BRFSS.ExploreByTopic&islClass=CLASS13&islTopic=Topic16&islYear=
2015&go=GO
Carlson, V. and Veschucio, C. (2014). The Burden of Oral Disease in Idaho.
olak, H., Dlgergil, . T., Dalli, M., & Hamidi, M. M. (2013). Early childhood caries update: A
review of causes, diagnoses, and treatments. Journal of Natural Science, Biology, and
Medicine, 4(1), 2938. https://doi.org/10.4103/0976-9668.107257
Community Commons. (n.d.). Retrieved March 28, 2017, from
http://legacyassessment.communitycommons.org/CHNA/report?
page=2&id=772&reporttype=libraryCHNA
Home | Division of Oral Health | CDC. (2017, March 21). Retrieved March 28, 2017, from
https://www.cdc.gov/oralhealth/index.html
Importance of Childhood Oral Hygiene & the Role of Parents. (n.d.). Retrieved March 28, 2017,
from http://www.colgateprofessional.com/patient-education/articles/childhood-oral-
hygiene-and-the-role-of-parents
Needs, A. (2012). k ai s e r commission, (202).
Selwitz, R. H., Ismail, A. I., & Pitts, N. B. (2007). Dental caries. The Lancet, 369(9555), 5159.
https://doi.org/http://dx.doi.org/10.1016/S0140-6736(07)60031-2
WIC. (n.d.). Retrieved March 28, 2017, from
http://healthandwelfare.idaho.gov/FoodCashAssistance/WIC/tabid/3339/Default.aspx