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Dhyg 415 Adpi Paper Template
Dhyg 415 Adpi Paper Template
Dhyg 415 Adpi Paper Template
Community Dental Health Project: Assessment, Diagnosis, Planning, and Implementation Phases
Alicia Gardner
Kat Mundell
Lillias Ojala
11/29/17
COMMUNITY DENTAL HEALTH PROJECT: L’ARCHE
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Assessment
Our target population was people with developmental disabilities. This population has
little access to oral health resources. We chose to do this project because one way to increase
their resources is to teach their caregivers about oral health. A group member had worked as a
caregiver for people with disabilities and was taught very little about oral health or how to
properly take care of her client’s teeth. We contacted her old supervisor from L’Arche Tahoma
Hope and she agreed to let us do a presentation during one of their weekly meetings.
Community profile
According to a review of studies from the Washington State Institute for Public Policy,
the population of people with disabilities is diverse (Lee & Miller, 2009). In other words, a
description that fits one individual may not fit another. Therefore, it is difficult to pinpoint a
community profile on this diverse community. According to this same study, in 1971, the state of
Washington decided children with disabilities have a right to a free education, meaning all
people with disabilities went through school. Also around this time, funding started going
towards more local, residential homes, versus state institutions. People with developmental and
intellectual disabilities now live more in residential homes instead of institutions. This
(DDD) and the Department of Social and Health Services (DSHS). About 79,000 people with
intellectual disabilities live in Washington State. After age 21, they can receive money from
DDD through employment and day programs. They can also receive money through Medicaid.
According to Stephanie Lee and Marna Miller, out of the people that receive developmental
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disabilities services in Washington State, 62% are non-Hispanic white, and 36% are a minority.
81% non-Hispanic whites that receive services live in residential communities similar to the
Needs Assessment
Our contact for L’Arche Tahoma Hope was Teresa Hershberger. She mentioned the core
members, or residents, sometimes do not let the caregivers brush their teeth for more than 30
seconds. The caregivers go through 75 hours of training to become Home Care Aids, but the only
training on oral health they receive is how to brush dentures. There is a need for the caregivers to
be educated on proper oral hygiene of their clients in order to increase the knowledge and health
of this community.
L’Arche Tahoma Hope is in Tacoma, WA. This city has fluoridated water. This specific
community mostly goes to public dental clinics, such as DECOD at the University of
Washington. This community has a very low income due to their disabilities and inability to
work. As a result, they receive money from state programs that support them and their needs.
This population does not get a specific stipend for hygiene products, specifically, oral hygiene
Literature Review
People with developmental disabilities are prone to dental decay and have a higher
chance of periodontal disease. Caregivers as a whole are severely under trained in oral health.
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This population is also at a greater risk for oral pathology since it can be difficult to detect. All
these topics made us concerned for this population and want to help in educating caregivers.
One article demonstrated a definite link between periodontal infection and cardiovascular
disease. It showed that inflammatory factors from periodontitis and poor oral hygiene may be the
cause of cardiac and cerebrovascular problems, including myocardial infarction and pulmonary
disease. The disabled population would be at a greater risk of these health problems because
they tend to have worse oral hygiene (Arigbede, A., Babatope, B., etc., 2012).
Dental caries is a widespread disease, and the presence of specific bacteria in the oral
environment leads to the development of caries. Dental plaque is a contributing factor in the
development of dental caries. Good oral hygiene leads to a reduction in caries, which is why we
would like to teach oral hygiene to the caregivers. Being educated on the decay process and how
to give proper oral hygiene care should significantly improve the outcome of dental disease
One of the articles we looked at before completing our presentation compares disparities
between adults with different types of disabilities. This article by Minihan, P.M., Morgan, J.P.,
Park, A, ect. also compares people with and without disabilities. According to this article, people
with disabilities were 1.4 times less inclined to see a dentist in a year compared with a person
without a disability. People with intellectual disabilities (IDD) are more inclined to see a dentist
when compared to someone without a disability. On the other hand, the article also states people
with intellectual disabilities are more likely to have oral health troubles. The article concluded
“caregivers play an important role in providing at-home oral care, and they must be included in
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efforts to improve oral health outcomes for people with DDs [developmental disabilities].”
disabilities face. “People with disabilities experience worse health and poorer access to health
care compared to people without disability.” (Havercamp, Sm.M. and Scott, H.M.). People with
disabilities may need assistance in their daily dental routine. Little is known about how trained in
oral hygiene the caregivers are. Caregivers reported brushing their clients teeth less than twice a
day. When asked about flossing, the caregivers reported that flossing was most likely not
completed. Some of the reasons caregivers did not complete a dental hygiene routine were their
clients behavior and physical obstacles. The article concluded that there are challenges,
especially in flossing that prevent people with disabilities getting satisfactory dental hygiene.
In another article the authors aim to identify factors which influence the oral status of
patients with mental disabilities by assessing the type and degree of their mental disability, the
mood, motivation, and behavior of the patients and/ or their caregivers, side effects of
medications, lifestyle factors that could influence their oral health status, and the training level of
caretakers. Their goal is to make aware the reason for the increased need for routine oral
hygiene care due to the high levels of periodontal disease and dental caries often seen in mentally
The authors of this article thoroughly explained the information they wanted to convey.
They provided complete and accurate definitions of what mental disabilities are with resources to
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back up the information they provided. This article is useful for my project because my goal is to
make the caregivers I will be presenting to aware of the oral diseases that can occur in mentally
disabled people, and this article helps to back up the information I want to give to the caregivers.
In the last article we looked at, the authors’ goal is to determine whether dental caries and
periodontal disease is more prevalent in patients with cerebral palsy as compared to patients
without cerebral palsy and who are otherwise healthy. The authors conducted research on
participants aged 2-18 with varying levels and types of cerebral palsy, taking into consideration
al., 2014).
The authors of this article had a clear idea of the information they hoped to discover
when conducting their research. They made aware the parts of their research that were not useful
and the parts they had to exclude for various reasons. The findings of the research were clearly
explained and easy to understand. This article is useful in my project because it establishes that
people with mental and physical disorders (cerebral palsy in this case) are more prone to dental
caries and periodontal disease, which is what I would like to convey to the caregivers I will be
presenting to.
Based on our research, we became concerned with people with developmental disabilities
because they are an underserved population. They have an increased rate of caries and
periodontal disease. In order to reach this community, we decided to increase the oral health
knowledge of caregivers.
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Diagnosis
The most important need is that the caregivers of this population are lacking proper
training in oral hygiene so they may be practicing poor oral homecare on their clients. A
secondary need is that this population needs assistance in oral healthcare. Some need reminders
to take care of their teeth, others may need their teeth brushed and flossed for them. Most of this
population needs help in going to the store to purchase oral hygiene products. Programs already
Our target population is the residents at L’Arche Tahoma Hope. The residents are
developmentally disabled adults that live in a residential setting. We selected this group because
one of our group members used to work at this community facility and was aware of the need of
increased oral hygiene education. The size of the target population is approximately 20 people.
To access this target population, we presented to the caregivers at L’Arche Tahoma Hope in
Planning
To plan for our community health project, Kat emailed a community coordinator in April
that she previously worked with, and asked if they would be interested in being the host of our
project. They emailed back and stated they would be interested. The community coordinator
requested we provide a test for the caregivers we would be presenting to so they could receive
continuing education credits toward their license. The next phase of our planning involved the
kind of presentation we wanted to do. We decided on a visual and oral presentation with some
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initial quiz with information from our PowerPoint. The community coordinator decided she
wanted a PowerPoint presentation to turn into the state to get the presentation approved for
continuing education credits. One of our group members contacted her employer, a dentist, and
asked if he would be willing to donate oral hygiene products and let us borrow dentoforms. We
also emailed the Oral B/Crest representative that we had previously talked to at the Pacific
Northwest Dental Conference to ask if he would still be willing to donate hygiene products as
well. We started to develop our goals of the presentation. We brainstormed on what activities
and demonstrations we would do. Our group finalized the presentation by finishing the
PowerPoint and practicing our presentation. We edited our pre and post-test so that it coincided
with the material from our PowerPoint. Our group members each gathered materials for the
presentation which included dentoforms, goodie bags, and snacks a few days prior to the
presentation.
Our goal for this presentation was to educate the caregivers at L’Arche Tahoma Hope
about oral health. We had three objectives. The first objective was to increase the knowledge
about oral hygiene of the caregivers at L’Arche Tahoma Hope.The second objective was to
increase the knowledge of the caregivers at L’Arche Tahoma Hope about oral pathologies. Our
third and final objective was to increase the knowledge of the caregivers at L’Arche Tahoma
Timeline
April 12, 2017- We emailed Teresa Hershburger, one of the community coordinators at L’Arche
Tahoma Hope, asking whether the community would be interested in a presentation about oral
health.
May 15th, 2017- Emailed Mark Hedgeberg, Oral B representative, about donating homecare aids
Spring 2017- During Community Dental Health classes, we formed the goal and objectives of
our presentation.
July 25, 2017- We created an agenda and wrote a pre-and post test and emailed it to our contact.
Aug 10, 2017- Messaged Lillias’ previous employer to ask to borrow dentoforms and if he was
Aug 24, 2017- Finalized power point presentation, interactive activities, and edited the pre-post
test.
Spring 2018- Present about our experience to staff and first years.
Lesson Plan
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Tahoma Hope in Tacoma, WA. The room we presented in was a living room with a small
projector set up. There were thirteen people who participated in the presentation. By the end, a
couple more people had joined the group. The resources we needed for the presentation were a
laptop, a projector, goodie bag supplies (toothpaste, toothbrushes, floss), dentoforms (big and
regular sized), masks, and gloves. The method that we used to teach our group was a visual and
oral presentation using a Powerpoint. During the Powerpoint presentation we demonstrated how
to brush teeth properly on dentoforms. We passed around three dentoforms and toothbrushes so
everyone could practice. We also demonstrated how to floss using the C shape method by
bringing up a couple of volunteers to stand side by side (acting as teeth) and using a rope (acting
as the floss) and floss in between the two “teeth”. Anyone who wanted to try flossing was
Budget
The proposed budget for our project: our goal was under $51.50
Estimated 1.50 0 0 0 5 20 25
Budget (donated)
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Summary
everyday life. They go through a short training course to learn the basics of how to care for
people with disabilities, but they do not receive much education in oral health. The only oral
health information they are taught is how to clean a denture properly. In order to better care for
their patients, it is important that the caregivers know the basics of periodontal disease, how to
properly brush and floss, and the connection between oral health and systemic health. The next
Implementation
Our first objective was to increase the knowledge about oral hygiene of the caregivers at
L’Arche Tahoma Hope. Our second objective was to increase the knowledge of the caregivers at
L’Arche Tahoma Hope about oral pathologies. Our third and final objective was to increase the
knowledge of the caregivers at L’Arche Tahoma Hope about the relationship of overall health
and oral health.We planned to present our project on September 6th, 2017 at 10:00 AM at
L’Arche Tahoma Hope in Tacoma, WA. We presented to about thirteen people. The method that
we used to teach our group was to visually and orally present with a Powerpoint. During the
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around three dentoforms and toothbrushes so everyone could practice. We also demonstrated
how to floss using the C shape method by bringing up a couple of volunteers to stand side by
side (acting as teeth) and using a rope (acting as the floss) and floss in between the two “teeth”.
See lesson plan (Appendix A). We plan to evaluate the outcome of our community project by
comparing a pretest and posttest that we gave to the caregivers to complete before and after our
Summary
increasing their knowledge of oral hygiene and why it is important. We plan to evaluate the
success of our presentation by comparing the pre and post test the caregivers completed. The
References
Arigbede, A., Babatope, B., & Bamidele, M. (2012). Periodontitis and systemic diseases: A
doi:http://dx.doi.org/10.4103/0972-124X.106878
Cardoso, A. M. R., Gomes, L. N., Silva, C. R. D., de S. C. Soares, R., de Abreu, M. H. N. G.,
Brazilian children and adolescents with cerebral palsy. Int J Environ Res Public Health.
Havercamp, S., Scott, M.A. (2014). National Health surveillance of adults with
disabilities, adults with intellectual and developmental disabilities, and adults with no
2014.11.002
Lee, Stephanie and Miller, Marna. (2009). Children and adults with developmental disabilities:
Minihan PM, Morgan JP, Park A, et al. (2014). At-home oral care for adults with
Peterson, S. N., Snesrud, E., Liu, J., Ong, A. C., Kilian, M., Schork, N. J., & Bretz, W. (2013).
The dental plaque microbiome in health and disease. PLoS One, 8(3).
doi:http://dx.doi.org/10.1371/journal.pone. 0058487
Solanki, J., Khentan, J., Gupta, S., Tomar, D., Singh, M. (2015). Oral rehabilitation and
from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4347189/
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Appendix A
Lesson Plan
i. Tongue
-Tongue scrapers
- Bacteria on tongue
ii. Palate
iii. Tips to reduce missed areas
-Tip head back
Iv. inside of lower front teeth
-hold toothbrush vertically
V. cheek side of upper molars
-have patient close halfway to increase elasticity of cheeks
i. Give distraction
- Toy or something to hold
- For Core Members that brush independently, assistant can say reminders
like, “Make sure to get _____ really well!”
3) Brush Technology
i. Get into sulcus (between gums and teeth) using brushing techniques
ii. Brush lower teeth at night, upper teeth in the morning
iii. Focus on back side of teeth toward the tongue, and lower front teeth
iv. To clean brush: Put in very warm water for 30-60 mins
-Replace toothbrushes after 3 months or if the bristles are splayed out
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1. Medications
i. Most common symptom is xerostomia (dry mouth)
● Xerostomia increases caries risk
● Suggest saliva substitute
● Rinse with water after taking medication
2) How disease of the mouth can affect the rest of the body, and vice versa
i. Periodontal disease may lead to systemic disease through
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Appendix B
Pre-test
5) If a patient has dry mouth, can their oral health be affected as a result?
a. Yes
b. No
6) Which two are the most common areas to find signs of oral cancer? (Choose 2 answers)
a. Inner lip
b. Tongue
c. Inner cheeks
d. Roof of mouth
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Appendix C
Post-test
5) If a patient has dry mouth, can their oral health be affected as a result?
a. Yes
b. No
6) Which two are the most common areas to find signs of oral cancer? (Choose 2 answers)
a. Inner lip
b. Tongue
c. Inner cheeks
d. Roof of mouth
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