Women’s Health Nurse Practitioner Program

CURRICULUM INTEGRATION OF INTERPROFESSIONAL ORAL HEALTH CORE COMPETENCIES:

•  Introduction to Reproductive Healthcare of Women

• Ambulatory Care of Women

•  Integrated Care of Women

• Resources

© Oral Health Nursing Education and Practice (OHNEP)

The OHNEP Interprofessional Oral Health

Faculty Toolkit

S            

INTRODUCTION

The Oral Health Nursing Education and Practice (OHNEP) program has developed an Interprofessional Oral Health Faculty Tool Kit to provide you with user friendly curriculum templates and teaching-learning resources to use when integrating oral health and its links to overall health in your Women’s Health Nurse Practitioner program. Oral health and its relation to overall health has been identified as an important population health issue. Healthy People 2020 (2011), the IOM Reports, Advancing Oral Health in America (2011) and Building Workforce Capacity in Oral Health (2011), as well as the IPEC Competencies (2011), challenged HRSA to develop interprofessional oral health core competencies for primary care providers. Publication of the report, Integrating Oral Health in Primary Care Practice (2014), reflects those interprofessional oral health competencies that can be used by Women’s Health Nurse Practitioners for faculty development, curriculum integration and establishment of “best practices” in clinical settings. The HRSA interprofessional oral health core competencies, the IPEC competencies and the NONPF core competencies provide the framework for the curriculum templates and resources. Exciting teaching-learning strategies that take students from Exposure to Immersion to Competence can begin in the classroom, link to simulated or live clinical experiences and involve community-based service learning, advocacy and policy initiatives as venues you can readily use to integrate oral health into your existing primary care curriculum. The Women’s Health Nurse Practitioner program curriculum template illustrates how oral health can be integrated into health promotion, health assessment and clinical management courses. The Smiles for Life interprofessional oral health curriculum provides a robust web-based resource for you to use that articulates with the oral health curriculum template for each course. A good place to begin oral health integration is by transitioning the HEENT component of the history and physical exam to the HEENOT approach. In that way, you and your students will NOT forget about including oral health in patients encounters. Research continues to reveal an integral relationship between oral and systemic health. Diabetes, sexually transmitted infections, and eating disorders are but a few of the health problems that have oral manifestations that can be treated or referred to our dental colleagues. It is important for Women’s Health Nurse Practitioners on the frontline of primary care to have the oral health competencies necessary to recognize both normal and abnormal oral conditions and provide patients with education, prevention, diagnosis, treatment and referral as

needed. We encourage you and your students to explore the resources in the templates as you “weave” oral health and its links to overall health into your Women’s Health Nurse Practitioner program. If you need additional technical assistance, please feel free to contact us at OHNEP@nyu.edu

WHNP Curriculum Integration of Interprofessional Oral Health Competencies in Introduction to Reproductive Healthcare of Women

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2) IMMERSION 3) COMPETENCE

CONSTRUCTS

1) EXPOSURE: INTRODUCTION INTRODUCTION TO REPRODUCTIVE HEALTHCARE OF WOMEN

IPEC Competencies:

Values and Ethics, Roles and Responsibilities Interprofessional Communication, Teams & Teamwork

HRSA Oral Health

Competencies: Oral Health Risk Assessment, Oral Health Evaluation, Oral Health Preventive Intervention, Communication and Education

NONPF Competencies:

Integrates gender-specific

evidence into practice;

Recognizes disease

manifestations unique to

women; Provides infertility

and sexually transmitted

disease services to sexual

partners of female patients

KNOWLEDGE: ORAL CARE IN GYN, WELL-WOMAN, & PRECONCEPTION VISITS Goal: Describe oral exam of the adolescent and adult woman

• Complete Smiles for Life Modules 1,3, 7

• Complete Quizzes for SFL modules 1,3, 7(Appendix 2, 3, 4)

• Submit SFL certificates of completion

KNOWLEDGE: RISK FACTORS FOR ORAL DISEASES IN WOMEN Goal: Describe oral disease risk factors for adolescent and adult women

• Read:• Women’s oral health: why sex

and gender matter (Niessen etal. 2013)

• Dietary behaviors and oral-

systemic health in women (Kimet al., 2013)

KNOWLEDGE: COMMON WOMEN’S ORAL HEALTH ISSUES

Goal: Describe oral manifestations of common health problems in women

• Domestic Violence: Enhancing DentalProfessionals’ Response to Domestic Violence(Shanel-Hogan et al., 2005)

• GERD: Oral manifestations ofgastroesophageal reflux disease (Ranjitkar etal., 2012)

• Sexually Transmitted Infections: Oralmanifestations of sexually transmittedinfections (DePaola, 2013)

SKILL/BEHAVIOR

Goal: Include oral health in history

and risk assessment (HEENOT) in simulation lab

• Review American DentalAssociation Caries RiskAssessment tool, Age > 6(Appendix 1)

SKILL/BEHAVIOR

Goal: Include oral health in physical

exam (HEENOT) in simulation lab

• Review common adult oralabnormalities (Appendix 5)

• Develop a strategy to promote

smoking cessation (Reviewresources athttp://women.smokefree.gov/)

SKILL/BEHAVIOR

Goal: Demonstrate understanding of health

literacy and strategies to improve oral health behaviors

• Following health literacy principles, create a patient brochure demonstratinghow practicing good oral hygiene isessential to maintaining good overallhealth

SKILL/BEHAVIOR

Goal: Demonstrate competency in oral health history, risk assessment and HEENOT in gynecological, well-woman, and preconception visits in clinical setting

• Read

Putting the Mouth Back in the Head: HEENT to

HEENOT (Haber et al, 2015)

• Document HEENOT findings in electronic healthrecord

• Develop a community dental resource network andhave a list of accessible dental providers, includingthose who accept Medicaid, to offer to your patients

SKILL/BEHAVIOR Goal: Demonstrate competency in oral health history and

risk assessment in gynecological, well woman, and

preconception visits in clinical setting

• Document oral health history and risk factorsfindings in electronic health record

• Read: Letters to the Editor: Letters on Preconception

Counseling and Care (Silk, 2014)

COLLABORATIVE CASE PRESENTATION Goal: Identify a collaborative care plan for female patient with an eating disorder and dental erosion

• WHNP and dental hygiene student will read Eatingdisorder-induced dental complications: a case report(De Moor, 2004) and collaborate on casepresentation, including plan for patient education, prevention, anticipatory guidance, referral andfollow-up care

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© Oral Health Nursing Education and Practice (OHNEP)

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION

APPENDIX 1 Introduction to Reproductive Healthcare of Women

American Dental Association Caries Risk Assessment tool , Age > 6

(ADA,  2011)  

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION

APPENDIX 2 Introduction to Reproductive Healthcare of Women

Smiles for Life Module 1 Quiz:The Relationship of Oral to Systemic Health

1. What is the most common

chronic disease of childhood?

A.  Asthma

B. Seasonal allergies

C. Dental caries

D. Cefuroxime

2. What is a consequence of

untreated dental caries?

A. Osteonecrosis of alveolar

bone

B. Gingival hyperplasia

C. Oral mucositis

D. Tooth fractures

3.Which condition is associated with

periodontal disease?

A.  Asthma

B. Preterm labor

C. Sinusitis

D. Hypothyroidism

4. Which of the following medications is

linked to gingival hyperplasia?

A.  Phenytoin

B. Amoxicillin

C. Digoxin

D. Coumadin

5. What can a primary care clinician

do to promote oral health?

A.  Collaborate with dental and

other health professionals

B. Apply dental sealants

C. Prescribe oral fluoride

supplements to every patient

D. Apply fluoride varnish to the

teeth of all adults

6. Which of these classes of medications

is NOT generally associated with

decreased salivary flow?

A.  Antihistamines

B. Antibiotics

C. Corticosteroids

D. Anticholinergics

E. Diuretics

7. A patient undergoing chemotherapy

for cancer is at risk for which of these

oral complications due to the effects of

chemotherapy?

A. Osteonecrosis of alveolar bone

B. Gingival hyperplasia

C. Oral mucositis

D. Tooth fractures

8. Which of the following infections

is NOT potentially caused by direct

extension from a dental source?

A. Otitis media

B. Sinusitis

C. Brain abscess

D. Facial cellulitis

9. What is the suggested common

pathway linking chronic periodontitis

and conditions such as diabetes,

coronary artery disease and adverse

pregnancy outcomes?

A. Direct bacterial extension

B. Poor nutrition

C. Circulating antibodies

D.  Inflammation

10. Which of the following is NOT a

mechanism for inter-relationships

between oral and systemic disease?

A.  Behavioral

B.  Iatrogenic

C. Neurologic

D.  Inflamatory

(Clark  et  al.,  2010)  

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION Smiles for Life Module 3 Quiz: Adult Oral Health

1. Which dental procedure does NOT require

prophylaxis for individuals at high risk

of bacterial endocarditis?

A. Dental extractions

B. Periodontal procedures

C. Post-operative suture removal

D. Prophylactic cleaning of teeth if

bleeding is anticipated

E. Re-implantation of avulsed teeth

2. Periodontal disease can be clinically

distinguished from gingivitis in which of

the following ways?

A.  Inflammation of the gums

B. White discoloration of the permanent

teeth

C. Enlarged pockets at the gum base

D. Gingival hypertrophy

3. Which of the following is NOT a

common site for oral cancers?

A. Tongue

B. Floor of mouth

C. Hard palate

D. Lower lip

4. Which of the following is most likely to

lead to poorer oral health in the elderly?

A.  Alzheimer’s dementia

B. Coronary artery disease

C. Hypothyroidism

D. All of the above

5. Risk factors for adult caries may include all

the following except:

A.  Low socioeconomic status

B. Existing tooth restoration

C. Decreased salivary flow

D. A vegetarian diet

E. Physical disabilities

6. Which of the following patients requires

bacterial endocarditis antibiotic prophylaxis?

A.  A 26 year old woman with mitral valve

prolapse undergoing routine teeth cleaning

with no anticipated bleeding.

B. A 64 year old man with a prosthetic mitral

valve who is undergoing a tooth extraction.

C. A 16 year old boy with a ventricular septal

defect completely repaired in infancy who

requires extraction of an impacted wisdom

tooth.

D. A 32 year old man who had bacterial

endocarditis 5 years ago who

isundergoing orthodontic appliance

adjustment.

7. Which of the following is not a normal

age-related tooth change?

A.  Gingival recession

B. Root caries

C. Yellowing of teeth

D. Wearing away of teeth with exposed

dentin

8. Which of the following statements,

concerning xerostomia or dry mouth, is

not true?

A.  Xerostomia is caused by a decrease in

the production of saliva

B. Xerostomia can cause a burning sensation,

change in taste, and difficulty swallowing

C. Medications can contribute to xerostomia

D. Xerostomia can increase the development of

caries

E.  Xerostomia is rarely a problem for patients

wearing complete dentures

9. Which of the following has been

implicated in the development of recurrent

aphthous ulcers?

A.  Trauma

B. Vitamin C deficiency

C. Sickle Cell Anemia

D. Herpes simplex virus infection

10. Which of the following factors is

NOT involved in the development of

“Meth Mouth”:

A.  Poor oral hygiene

B.  Increased carbohydrate

consumption

C. Nighttime mouth breathing

D. Teeth grinding

E. Xerostomia

(Clark  et  al.,  2010)  

APPENDIX 3 Introduction to Reproductive Healthcare of Women

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION Smiles for Life Module 7 Quiz: The Oral Examination

1. What constitutes a tooth’s outer layer?

A.  Enamel

B. Dentin

C. Pulp

2. What is a full complement of adult teeth?

A.  26

B. 28

C. 30

D. 32

3. A caregiver asks you how many teeth

her 3 year old child should have. What

would you respond?

A.  20

B. 22

C. 24

D. 28

4. At what age do teeth typically

begin to erupt in children?

A.  3-9 months

B. 9-15 months

C. 15-21 months

D. 21-27 months

5. Oral cancer is most common in which area

of the mouth?

A.  Hard palate

B. Surface of tongue

C.  Inside of cheek

D. Posterolateral tongue

6. When performing the “knee-to-knee” oral

exam on a young child, in what position

should the child start?

A.  Facing the examiner

B. Standing up

C. Sitting on the exam table

D. Facing the caregiver

7. Which of the following is NOT needed by a

primary care clinician to conduct a thorough

oral exam?

A.  An exam light to illuminate key

features in the mouth

B. Tongue depressors to lift the lip

and retract the cheek

C. A mouth mirror to view lingual surfaces of

teeth

D. Dental explorer

E. Gauze pads to grasp the tongue

8. When examining a 9 month old child’s

mouth, what is a reason for an early

referral to a dentist?

A.  The child has only 4 incisors

B. Developmental tooth defects are present

C. No molars have erupted

D. No canine teeth have erupted

E. Counting less than 20 teeth

9. You are performing an oral exam on your

21 year old patient who has been using

smokeless tobacco for 4 years. What part of

this patient’s oral cavity is especially

important for you to examine?

A. The sun-exposed areas of the patient’s cheeks

B. The inner aspect of the patient’s lips and cheeks

C. Any discoloration or pitting of the patient’s teeth

D. Any plaque build-up along the patient’s gum line

E.  The patient’s posterior pharynx

10. A complete oral examination includes

each of the following EXCEPT:

A.  Temporomandibular joint (TMJ) exam

B. Cervical node exam

C. Palpation of the floor of the mouth

D. Sinus exam

E.  Exam of the skin around the mouth

(Clark  et  al.,  2010)  

APPENDIX 4 Introduction to Reproductive Healthcare of Women

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION Smiles for Life Modules 1, 3, & 7 Answer Key

(Clark  et  al.,  2010)  

APPENDIX 2-4 Introduction to Reproductive Healthcare of Women

Module 1:

1.  C

2.  A

3.  B

4.  A

5.  A

6.  B

7.  C

8.  A

9.  D

10.  C

Module 3:

1.  C

2.  C

3.  C

4.  A

5.  D

6.  B

7.  B

8.  E

9.  A

10.  C

Module 7:

1.  A

2.  D

3.  A

4.  B

5.  D

6.  D

7.  D

8.  B

9.  B

10.  D

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION

APPENDIX 5 Introduction to Reproductive Healthcare of Women

Adult Oral Health Checklist

Please check as you identify each item:

Strep throat (A)

Periodontal disease (B)

Black hairy tongue (C)

Herpetic lesion (D)

Gingival recession (E)

Canker sore (F)

Angular cheilitis (G)

Tori madibularis (H)

Images from:

CDC public health images library

Gujral, D. M., Bhattacharyya, S., Hargreaves, P., & Middleton, G. W. (2008). Periodontal disease in a patient receiving Bevacizumab: a case report. Journal of medical case reports, 2(1), 47.

Jain, A., & Kabi, D. (2013). Severe periodontitis associated with chronic kidney disease. Journal of Indian Society of Periodontology, 17(1), 128.

Jeong, J. S., Lee, J. Y., Kim, M. K., & Yoon, T. Y. (2011). Black hairy tongue associated with erlotinib treatment in a patient with advanced lung cancer. Annals of dermatology, 23(4), 526-528.

Kwon, K. H., Lee, D. G., Koo, S. H., Jo, M. S., Shin, H., & Seul, J. H. (2012). Usefulness of v-y advancement flap for defects after skin tumor excision. Archives of plastic surgery, 39(6), 619-625.

Lee, K. H., Lee, J. H., & Lee, H. J. (2013). Concurrence of Torus Mandibularis with Multiple Buccal Exostoses. Archives of plastic surgery, 40(4), 466-468.

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION

APPENDIX 5 Introduction to Reproductive Healthcare of Women

Adult Oral Health Checklist (Answer Key)

Please check as you identify each item:

Strep throat (A)

Periodontal disease (B)

Black hairy tongue (C)

Herpetic lesion (D)

Gingival recession (E)

Canker sore (F)

Angular cheilitis (G)

Tori madibularis (H)

Images from:

CDC public health images library

Gujral, D. M., Bhattacharyya, S., Hargreaves, P., & Middleton, G. W. (2008). Periodontal disease in a patient receiving Bevacizumab: a case report. Journal of medical case reports, 2(1), 47.

Jain, A., & Kabi, D. (2013). Severe periodontitis associated with chronic kidney disease. Journal of Indian Society of Periodontology, 17(1), 128.

Jeong, J. S., Lee, J. Y., Kim, M. K., & Yoon, T. Y. (2011). Black hairy tongue associated with erlotinib treatment in a patient with advanced lung cancer. Annals of dermatology, 23(4), 526-528.

Kwon, K. H., Lee, D. G., Koo, S. H., Jo, M. S., Shin, H., & Seul, J. H. (2012). Usefulness of v-y advancement flap for defects after skin tumor excision. Archives of plastic surgery, 39(6), 619-625.

Lee, K. H., Lee, J. H., & Lee, H. J. (2013). Concurrence of Torus Mandibularis with Multiple Buccal Exostoses. Archives of plastic surgery, 40(4), 466-468.

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2) IMMERSION 3) COMPETENCY

CONSTRUCTS

1) EXPOSURE

S U MMAT TI VE

A S S E S SME N T

E NT R Y

L E VE L

A S S E S SME N T

AMBULATORY CARE OF WOMEN

IPEC Competencies:

Values and Ethics, Roles and Responsibilities Interprofessional Communication, Teams & Teamwork

HRSA Oral Health

Competencies:

Oral Health Risk Assessment, Oral Health Evaluation, Oral Health Preventive Intervention, Communication and Education, IP Collaboration

NONPF Competencies:

Advocates for healthcare

policies and research that

support accessible,

equitable, safe and effective

healthcare for women;

Manages disease

manifestations unique to

women

KNOWLEDGE: PRENATAL ORAL HEALTH CARE Goal: Describe oral exam of the pregnant woman

• Complete Smiles for Life Module 5

• Complete Quizzes for SFL module 5(Appendix 1)

• Submit SFL certificate of completion

KNOWLEDGE: ORAL HEALTH IN PREGNANCY MYTHS

Goal: Identify common myths about oral health during pregnancy

• Read: Oral health care during pregnancy: national consensus statement Oral Health Care During Pregnancy Expert Workgroup, 2012)

• Committee opinion no. 569: oral health care duringpregnancy and through the lifespan (ACOG, 2013)

KNOWLEDGE: COMMON DISCOMFORTS OF PREGNANCY Goal: Describe common oral problems in pregnancy and how they can influence oral-systemic health outcomes for mother and baby

• Read: Oral Health During Pregnancy (Silk et

al., 2008)

• Review SFL Prenatal Pocket Card (See Appendix 2)

• Complete APTR Oral Health Learning Module Part 2: Oral Health For Pregnant Women and Their NewbornsRead Pharmacological Considerations forPregnant Women (Appendix 3)

SKILL/BEHAVIOR

Goal: Demonstrate ability to dispel a

common myth about oral health during pregnancy

• Conduct a literature review and write

an evidence-based argument to dispel

one of the common myths about oral

health during pregnancy

SKILL/BEHAVIOR

Goal: Include oral health history, risk

assessment and HEENOT in prenatal care in simulation lab

• Discuss SFL Oral Health in Pregnancy Case Study 1 (Appendix 4)

• Discuss safe antibiotic choices for

pregnant women

• Discuss risk factors for periodontal

disease in pregnancy

SKILL/BEHAVIOR

Goal: Demonstrate understanding of health

literacy and strategies to improve oral health

behaviors

• Review Two Healthy Smiles Brochure

(Appendix 5) and comment on discussion board

• Review Tips for Good Oral Health During Pregnancy (Appendix 6)

• Following heath literacy principles, preparea FAQ sheet about dental care duringpregnancy for pregnant women

COLLABORATIVE CASE PRESENTATION

Goal: Identify a collaborative care plan for pregnant patient with periodontal disease

• WHNP and dental student to collaborate on casepresentation, including comprehensive antepartumplan of care for the mother and baby, for a pregnantwoman with periodontal disease

• Read: Evaluation of periodontal pathogens in amniotic

fluid and the role of periodontal disease in pre-termbirth and low birth weight (Ercan et al., 2013)

• Refer at risk, first-time pregnant women to the localNFP program

SKILL/BEHAVIOR

Goal: Demonstrate ability to analyze contemporary

issues, policies, and health care system(s) factors that influence oral-systemic health outcomes for mother and baby

• Identify a policy that would help pregnant women inyour catchment area overcome barriers to accessingoral health care. Prepare a brief evidence-basedspeech to present this policy to your localrepresentative.

SKILL/BEHAVIOR

Goal: Demonstrate competency in oral health history,

risk assessment and HEENOT in prenatal visit in clinical setting

• ReviewPutting the Mouth Back in the Head: HEENT to

HEENOT (Haber et al, 2015)

• Document HEENOT findings in electronic health record

• Develop a community dental resource network and

have a list of accessible dental providers, includingthose who accept Medicaid, to offer to your pregnantpatients

WHNP Curriculum Integration of Interprofessional Oral Health Competencies in Ambulatory Care of Women

© Oral Health Nursing Education and Practice (OHNEP)

•

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION Smiles for Life Module 5 Quiz: Oral Health in Pregnancy

1. Which of the following is a FALSE statement?

A. Gingivitis is very common in pregnancy B. Periodontitis is associated with preterm birth

C. Treatment of periodontitis in pregnancy

decreases the risk of preterm birth D. Deep root scaling to improve periodontitis

is safe during pregnancy

2. Which of the following is a TRUE statement:

A. Mothers with caries pass their genetic

predisposition for caries on to their babies B. Mother with caries pass caries-causing

bacteria to their babies in utero C. Mother with caries pass caries-causing bacteria

to their infants early in life via saliva transmission

D. All of the above

3. A pregnancy granuloma:A. Has malignant potential and should be biopsied

B. Should be excised during pregnancy even if

asymptomatic to avoid complications

C. Can be observed D. Is not likely to recur if excised

4. A pregnant patient asks you for guidanceabout having dental treatment during her

pregnancy. What would you say?A. Dental treatment should only be done

during the second and third trimester B. Dental treatment should only be done

during the third trimester because organogenesis is complete

C. Dental treatment should only be done during the second trimester for comfort and safety

reasons D. Dental treatment can be done

during any trimester

5. What guidance should you give a pregnantpatient about having dental x-rays during her

pregnancy? A. Dental x-rays should be avoided during

pregnancy B. Dental x-ray should be limited to only one

film per pregnancy C. Dental x-rays should be taken as

necessary to reach a full diagnosis D. Dental x-rays are rarely needed during

pregnancy

6. What oral health guidance should you give a pregnant patient?

A. Brush twice daily with fluoridated toothpaste B. Use chlorhexidene mouthwash three times per

day C. Avoid sugary drinks and snacks between meals

D. Take fluoride dietary supplements

E. A and C only

7. All of the following conditions can causeworsening gingivitis EXCEPT:

A. Onset of puberty

B. Monthly menses

C. Menopause

D. Use of oral contraceptives

E. Pregnancy

8. If a pregnant woman has an oral abscessin the first trimester, what should she do

regarding its treatment?

A.  Take antibiotics and pain medication only and

wait until her second trimester to see the dentist

B. Avoid x-rays for further diagnosis

C. Have the tooth treated or extracted under local anesthesia immediately

D. Delay definitive treatment until

after delivering her baby

9. Amalgam restorations placed during pregnancy can lead to which negative

outcome in the fetus?

A.  Birth defects

B. Neurologic sequelae

C. Spontaneous abortions

D. None of the above

10. What could pregnant women do after

vomiting to reduce the risk of enamel erosion?

A.  Swish with baking soda and water

B. Vigorously brush her teeth

C.  Immediately take a dose of a proton pump

inhibitor

D. Immediately take 3-4 antacid tablets

(Clark  et  al.,  2010)  

APPENDIX 1 Ambulatory Care of Women

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION Smiles for Life Module 5 Quiz Answer Key

(Clark  et  al.,  2010)  

APPENDIX 1 Ambulatory Care of Women

Module 5:

1. C

2. C

3. C

4. D

5. C

6. E

7. C

8. C

9. D

10. A

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION

Ambulatory Care of Women APPENDIX 2

(Silk,  Douglass,  &  Douglass,  2012)  

Smiles for Life Prenatal Oral Health Pocket Card, Side 1

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION

Ambulatory Care of Women APPENDIX 2

(Silk,  Douglass,  &  Douglass,  2012)  

Smiles for Life Prenatal Oral Health Pocket Card, Side 2

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION

Ambulatory Care of Women APPENDIX 3

Oral Health Care During Pregnancy: A National Consensus Statement

(Oral  Health  Care  During  Pregnancy  Expert  Workgroup,  2012)  

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION

Ambulatory Care of Women APPENDIX 4

(Clark  et  al.,  2010)  

Smiles for Life Module 5 Case 1, Part 1

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION

Ambulatory Care of Women APPENDIX 4

(Clark  et  al.,  2010)  

Smiles for Life Module 5 Case 1, Part 2

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION

Ambulatory Care of Women APPENDIX 4

(Clark  et  al.,  2010)  

Smiles for Life Module 5 Case 1, Part 3

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION

Ambulatory Care of Women APPENDIX 5

(Holt,  Clark,  &  Barzel,  2009)  

Two Healthy Smiles Brochure, Side 1

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION

APPENDIX 5 Ambulatory Care of Women

(Holt,  Clark,  &  Barzel,  2009)  

Two Healthy Smiles Brochure, Side 2

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION

Ambulatory Care of Women APPENDIX 6

(Oral  Health  Care  During  Pregnancy  Expert  Workgroup,  2012)  

Tips for Good Oral Health During Pregnancy Handout, Side 1

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION

Ambulatory Care of Women APPENDIX 6

(Oral  Health  Care  During  Pregnancy  Expert  Workgroup,  2012)  

Tips for Good Oral Health During Pregnancy Handout, Side 2

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2) IMMERSION 3) COMPETENCY

CONSTRUCTS

1) EXPOSURE

S U MMATI VE

A S S E S S ME N T

E NT R Y

L E VE L

A S S E S S ME N T

INTEGRATED CARE OF WOMEN IPEC Competencies:

Values and Ethics, Roles and Responsibilities Interprofessional Communication, Teams & Teamwork

HRSA Oral Health

Competencies: Oral Health Risk Assessment, Oral Health Evaluation, Oral Health Preventive Intervention, Communication and Education, IP Collaboration

NONPF Competencies:

Integrates research, theory and evidence-based practice knowledge to develop clinical approaches that address women’s responses to physical and mental health and illness across lifespan; Provides counseling, management and/or referral based on identified healthcare risk

KNOWLEDGE: INFANT ORAL HEALTH EDUCATION FOR NEW MOTHERS

Goal: Describe importance of oral health for mother and baby

• Watch Teeth for Two Online Educational

Presentation (Password: nyu2014)

• Guidelines on Infant Oral Health Care(AAPD, 2014)

• American Academy of PediatricsPolicy Statement on Breastfeeding (2012)

• Focus On Sub-specialties Frenotomy for breastfed

tongue-tied infants: a fresh look at an old procedure

(Mayer, 2012)

KNOWLEDGE: ORAL HEALTH CARE DURING MENOPAUSE

Goal: Understand oral health issues

during menopause

Read:

• Crosstalk between

hormones and oral healthin the mid-life of women(Grover et al, 2014)

• Menopause and oral health(Suri & Suri., 2014)

KNOWLEDGE: OLDER ADULT PRIMARY CARE Goal: Recognize oral health needs of older adults

Read:

• Reducing care-resistant behaviors during oralhygiene in persons with dementia (Jablonski etal, 2011)

• Ensuring Oral Health for Older Individuals with

Intellectual and Development Disabilities

(Waldman & Perlman, 2012)

SKILL/BEHAVIOR

Goal: Identify strategies for educating new mothers

about infant oral health care

• Read: Nursing strategies to reduce the incidenceof early childhood caries in culturally diverse

populations (Hallas et al., 2011)

• Review Lift the Lip Pamphlet (Appendix 1)

• ReviewCavity Free Kids Family EngagementTools (WDSF, 2014)

• Watch A Healthy Mouth for Your Baby video(NIDCR, 2013)

SKILL/BEHAVIOR

Goal: Include oral health history, risk

assessment and HEENOT when caring for

women in menopause

• Following health literacy principles, develop

an oral health FAQ sheet of oral health-associated problems and solutions for

women in menopause

SKILL/BEHAVIOR Goal: Provide comprehensive health maintenance

services to older adults

Collaborate together on Discussion Board on: • Cardiovascular case study (Appendix 2)• Diabetes case study (Appendix 3)

SKILL/BEHAVIOR Goal: Develop a comprehensive, collaborative infant oral health education plan for postpartum mother

• WHNP and Pediatric Nurse Practitioner studentcollaborate to provide oral health education andanticipatory guidance for parent of newborn atpediatric clinic

SKILL/BEHAVIOR Goal: Identify a collaborative care plan for women with oral health problems related to menopause

• WHNP and dental students to collaborate on case

presentation including education, prevention, treatment and referral

WHNP Curriculum Integration of Interprofessional Oral Health Competencies in Integrated Care of Women

COLLABORATIVE CASE STUDY

Goal: Collaborate interprofessionally on geriatric case with cognitive decline and oral health needs

• ReadOpportunities for Nursing-DentalCollaboration: Addressing Oral Health NeedsAmong the Elderly (Coleman, 2005)

• WHNP and dental students to collaborate ondeveloping a management plans forolder adults with cognitive decline and oralhealth needs (case studies)

© Oral Health Nursing Education and Practice (OHNEP)

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION

Integrated Care of Women APPENDIX 1

(Herschel  S.  Horowitz  Center  for  Health  Literacy,  2013)    

Lift the Lip Brochure

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION

APPENDIX 2 Integrated Care of Women

Design an oral exam and treatment plan for a 61 year old woman with a

prosthetic mitral valve who will undergo deep cleaning of her gingival and

gingival pockets.

What are your treatment plans if this patient is allergic to PCN?

Cardiovascular Disease Case Study

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION

APPENDIX 3 Integrated Care of Women

A 65 year old Hispanic female Mrs. M. was referred by

the Dental clinic because of early evidence of

periodontal disease. The patient has family history of

Type 2 Diabetes (T2D) and history of caring for her

diabetic grandfather for many years. She described

herself as an expert in diabetes because of the years of

caring for her ailing diabetic grandfather. During the

health history, she complained of symptoms of

hyperglycemia: fatigue, thirst, and weight loss. On

physical exam, her blood pressure was 160/95, BMI of

31, random blood sugar of 332 mg/dl, and HgbA1c >

13%. She was diagnosed with T2D and obesity. She

was started on Metformin twice a day and was

counseled on diet and physical activity. The patient was

referred back to dentistry for continued periodontal

care in light of her new diagnosis of T2D.

What is the follow-up nursing primary care action

plan for Mrs. M.?

What are the 3 months follow-up outcomes?

     

• Oral Health History

• Physical Health Exam

• Oral-Systemic Risk Assessment

• Action Plan

• Preventive Interventions

• Interventions

• Collaboration

• Referrals

 

Diabetes Case Study

2) IMMERSION 3) COMPETENCE 1) EXPOSURE: INTRODUCTION

Smiles for Life:

A National Oral Health Curriculum

www.smilesforlifeoralhealth.org

Healthy People 2020: Oral Health

https://www.healthypeople.gov/2020/

topics-objectives/topic/oral-health

Association for Prevention Teaching and

Research (APTR) Oral Health Across the

Lifespan Learning Module

http://www.aptrweb.org/?PHLM_15

National Maternal and Child Oral Health

Resource Center (OHRC)

http://www.mchoralhealth.org/index.html

Interprofessional Education Collaborative

(IPEC)

https://ipecollaborative.org/

University of Toronto Centre for

Interprofessional Education

http://ipe.utoronto.ca/

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RESOURCES

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