the scope of oral health practice and needs of child health
TRANSCRIPT
THE SCOPE OF ORAL HEALTH PRACTICE
AND NEEDS OF CHILD HEALTH CARE
MEDICAL PROVIDERS IN FLORIDA
Michelle Valdes, Hilma Benjamin, M.D., Maja Marinkovic, M.D., and Rani S Gereige, M.D., MPH. Department of Pediatrics, University of South Florida, Tampa, Florida, United States.
Partially supported by a resident’s planning CATCH Grant from the American Academy of Pediatrics
APA School and Community Health SIG
Disclosures
Rani Gereige and the co-authors of the abstract have documented that they have no relevant financial relationships to disclose or conflict of interests to resolve
Background Dental caries are the most common infectious disease in
the U.S. (CDC) The AAP adopted Oral Health as one of its focus areas for
2006-2007 The AAP goal is to train child health professionals to
incorporate oral health risk assessment (OHRA) as part of well visits especially for children 0-3y
There is a great deal of variability in the oral health training and scope of practice of child health care professionals
No study has previously described how much Oral Health care child providers routinely perform (particularly in the State of Florida) .
Objectives Provide an indepth look at the pediatric
oral health scope of practice of primary care providers (PCP) (Pediatrics, Med-Peds and Family Practice) and residents in the State of Florida
Assess current practice barriers and training issues
Design/Methods Web-based survey was sent to the AAP Florida
Chapter listserv and resident section The survey link was placed in the Florida
Academy of Family Physicians (FAFP) electronic newsletter
Over the span of three months, four reminder e-mails we sent
The survey collected demographic data, oral health training data and practice patterns
Results
Fig 1. Field of Practice of Survey Respondents (n=92)
14%1%
35%
50%
Pediatrics Family Medicine
Med-Peds Resident
Results
Fig 2. Work Setting of Practicing Physicians Respondents
13%
48%
17%
11%
8% 3%
Solo Group
Academic Pub Hlth/Comm Hlth Cntr
Hospital-Based Other
Results
Fig 3. Years of Practice of Practicing Physicians Respondents
20%
23%
13%
44%
< 5 years 5-9 years 10-15 years > 15 years
Results
Characteristics of Respondents %
GenderMaleFemale
EthnicityCaucasianHispanicAfrican-AmericanAsian/Pacific IslanderOther
Geographic setting of Practice/ ResidencyRuralUrbanSuburban
Training institution has an affiliated dental schoolYesNo
Oral Health curriculum in residencyNoYes
Didactics
38%62%
64%12%11%7%6%
2%63%35%
40%60%
71%29%
(79%)
Results
Fig 4.
Results
Fig 5.
Results
Fig 6.
Results
Fig 7.
Results
Fig 8.
Results
Fig 9.
Results
Fig 10.
Results
Fig 11.
Results
Limitations and Challenges Limitations inherent to the study design
Survey: Reporter bias Small sample size did not allow
stratification by specialty, year of practice, or training exposure
Residents sample limited by the number of residents in the State of Florida
Future Directions Use the pilot data to design a larger scale
study Chart audits rather than reporting as a
measure of practice pattern More efforts to include Family Medicine
residents Will be used by Florida DOH
Conclusions Overall, most PCPs and residents, despite
inadequate oral health training, include OHRA as part of health maintenance visits
The oral health scope of practice could be improved with more needed training, Fluoride varnish application, and increased awareness of the role parent/caregiver oral health plays among others
References Florida Health Insurance Study, Insurance Coverage Updates, Fact
Sheet No. 2, August 2005. U.S. Department of Health and Human Services. A National Call to Action
to Promote Oral Health. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention and the National Institutes of Public Health, National Institute of Dental and Craniofacial Research. NIH Publication No. 03-0503, May 2003.
U.S. Department of Health and Human Services, A National Call to Action to Promote Oral Health, Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Center for Disease Control and Craniofacial Research. NIH Publication NO, 03-5303, May 2003.
Oral Health Resources, http://www.cdc.gov/oralhealth/topics/child.htm
Florida Department of Health, floridacharts.com, Access to Dental Care by Low Income Persons
Florida Department of Health, floridacharts.com, Percent of Access to Dental Care at 200% below the Federal Poverty Level by county
Oral Disease: A Crisis Amount Children of Poverty, National Maternal and Child Oral Health Resource Center, May 1998.
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