Community

Assessment
Needs Project
By
Alina.P, Dinh.T, Jade.S, Justina.C, Victor.A
DHY 391 Community Dental Health I
March 12, 2024
 • Children attending Roxhill Elementary School in the
Seattle Public Schools
– 282 students enrolled
– 36 students in the 3rd grade, ages 8-9
Population – 52.9% of students regularly attend
• Located in a large city area
• Ranked in the bottom 50% of elementary schools in
Washington State for overall test scores
Population
 • Currently American
Indian/Alaskan Native, Native
Hawaiian/Pacific Islander, and
Hispanic students have the
highest proportion of dental
Proposal: caries
• The DOH states that children
The Need with tooth decay are more at
risk for chronic
absenteeism, low academic
success, and lifelong dental
struggles.
Dental Caries
among 3rd
graders
across the
State
 3rd graders
caries based
on
Race/Ethnicity
 Proposal: Solution

• Early Caries Risk Assessment:

o To determine the child's
specific requirements
o Provide basic preventive interventions
such as family oral health education and
fluoride varnish treatments during routine
health visits.
• Education:
o Inform students & parents about the
importance of quality oral health care
o Provide students with age-appropriate
patient education and oral hygiene
instructions
o Engage student learning by demonstration
of brushing and flossing with a teach back
technique
o Discuss with students & families how the
foods we consume affect our oral health.
 Needs Assessment
Strengths Weakness
- Odessa Brown rotation: experience treating & - Lack of access to care or dental establishment
educating young children & adolescents
- providing PE/OHI to every patient guides us to - Lack of insurance or other resources for
keep lessons short but engaging especially for aid/advice
children of ages 8-9 (third graders) - Lack of parental encourage to keep up with oral
- Engaging lessons encourages healthier habits & hygiene
oral health

Opportunities Threats
- Free preventative health lessons covered by Seattle - Children dental fears
Central College dental hygiene professional seniors
- Lack of attention from children throughout lessons
- Teach-Back method used to promote high success - parents with personal beliefs against
in recreating lessons(flossing/brushing) at home
fluoride/sealants
- Questions right after lessons to challenge & increase
retention of information
 • Children
• Parents
• Caregivers
• Teachers
Stakeholders
• Staff
• Dental providers
• Community health centers
 Mission
Statement

• Roxhill Elementary, a full

service community school,
fosters a climate of
compassion, academic
excellence, problem solving,
creativity, and cultural
awareness where the school,
families, and the community
are working together for the
social, emotional, physical,
and intellectual development
of each child.
 Vision

To educate children and staff in 3rd grade classes on

the importance of quality oral health care.

Provide oral hygiene instructions and demonstrate

proper techniques in brushing and flossing.

Introduce some nutritional facts that impact oral

health
 Instructional Goals
Our presentation goals will be:

Get the kids thinking about the importance of their teeth

Educate the kids about why homecare and professional care is

important – plaque, biofilm

Go over proper brushing technique – Bass technique

Go over flossing techniques – technique

Talk about nutritional importance

Surveys
 Analyze/Assessment
Dental Experience:
• In 2015, 3rd graders had the highest percentage
of caries experience compared to
kindergarteners and 2nd graders.
• Compared to 2005, the % of caries experience
among 3rd graders in WA had been lower by 7%
in 2015-2016.
– However, 53% of caries experience among 3rd
graders in Washington State didn’t meet the
Healthy People 2020 goal of 49%.
– According to Washington State Smile Survey
2015-2016, the oral health disparities could be
caused due to the large gaps existing by income,
race and ethnicity, and language spoken at
home.
 Analyze/Assessment
Disparity by income in 2015-2016 study:
• Comparison of low-income households versus
higher-income households among 3rd graders
in Washington State.
o Caries experience: low income 68% versus
41% higher income children.
o Rampant decay: low income 25% versus
11% higher income children.
o Treatment needed: low income 15%
versus 9% higher income children.
 Disparity by Race/Ethnicity in 2015-2016
Analyze/Assessment study:
• Compared with white and other rates of 2nd
and 3rd grades combined:
o Caries experience: HNOPI 75% versus 45
% Caucasian children.
o Rampant decay: AI/AN 37 % versus 15%
Caucasian children.
o Untreated decay: NHOPI 26% versus 10%
Caucasian children.
 Analyze/Assessment
Disparity by Primary Language Spoken at home in
2015-2016 study:
• Compared with children who speak English
among 3rd graders in Washington.
• Children speak other language at home had
higher rate than children whose primary
language was English in term of:
o Decay experience: 67% versus 49%
English.
o Untreated decay: 17% versus 11%
English.
o Rampant Decay: 21% versus 10%
English.
o Treatment needed: 16% versus 10%
English.
 Analyze/Assessment
• According to Washington Smile
Survey, 2015-2016 in 3rd graders found
that:
o American Indian/Alaska Native
(AIAN), Hispanic, and Native
Hawaiian/other Pacific Islander
(NHOPI) had the highest rate of
decay experience.
o Children received National School
Lunch Program (NSLP) had higher
rate of caries experience compared
to children whose are not eligible
for NSLP.
o Children speak Spanish or other
language at home resulted with
higher rate of caries experience
compared to children whose
primary speak English at home.
 Program Design

Let’s talk about teeth

Why do we clean our teeth?

How do we clean our teeth?

How can food impact our mouths?

Wrap Up!
 Lesson 1: Let’s Talk About Teeth!
Goal/understanding: Why teeth are important
Specific instructional – Students will be able to recognize all the daily tasks we use
Objectives: our teeth for:
o Talking
o Eating
o Smiling
– Primary à Permanent teeth

Instructor Activities: • Ask class why teeth are important and what we use them for
• What foods do we eat that require teeth?
• Say their own name, teacher’s name with no teeth
• Say thirty-three thirsty thieves
Time frame: 5 minutes
Student Activity: • Think about and become aware of how much we use and
need our teeth
Time frame: Discussion
Resources, Materials & • Image of skull with primary and permanent teeth
Technology • Speech activity
• Picture of toothless smiling
 Lesson 2: Why Do You Clean Your Teeth?

Goal/understanding: • Establish base understanding of plaque/biofilm

build up
• Cavities

Specific instructional • What plaque is, how it collects

Objectives: • Why it is important to remove plaque everyday

Instructor Activities: • Informative video on plaque

Time Frame: 5 minutes

Student Activity:
Time frame: 5 minutes
Resources, Materials & https://www.youtube.com/watch?v=tUL96Bt6ZBE
Technology Start at 1:00minute, stop at 3:24 or 4:10 (?)
 Lesson 3: How Do You Clean Your Teeth?

Goal/understanding: – Proper toothbrush technique

– Importance of flossing (c-shape?)

Specific instructional • How often? When? How long? Pattern

Objectives: • Bass technique (?)
• Importance of flossing
• Key pointers – when, pattern, how

Instructor Activities: • Demonstrate bass technique on typodont

Time Frame: 5 minutes

Student Activity: • Demonstrate/practice brushing with tooth model

Time frame: 5 minutes

Resources, Materials & • Colgate typodont

Technology • Image from plaque video
• Floss video à show how far under gum line you
should be going (Start at 1:04 for max, 2:46 for
mand)
 Lesson 4: How can food impact our mouths?

Goal/understanding: What foods cause cavities

–

Specific instructional Students have an understanding of what

–

Objectives: foods cause cavities and why.

Instructor Activities: Go over which foods tend to cause cavities
Time Frame: 5 minutes
Student Activity: Game
Time frame: 5 minutes
Resources, Materials Cut outs of the different foods for students
& Technology to categorize into cavity causing and not
 Wrap Up!

Goal/understanding: Summarize the information that was covered

Specific instructional Quick review

Objectives:
Instructor Activities: Go through the goodie bags and ask children
questions about each item
Time Frame: 2 minutes

Student Activity: Join discussion about goodie bag

Time frame: all together

Resources, Materials Goodie bags (toothbrush, toothpaste,

& Technology floss/floss picks, timer, checklist, etc.)
Take home baggie
Handout Pamphlet — English
 Handout Pamphlet — Spanish

Plan/Develop
 Socioeconomic
status

Developed eating
Parents/Caregivers
patterns

Nutrition

Peers Knowledge

Marketing
 Dental Caries Process By Diet

Bacteria in plaque
metabolize
Organic acids
fermentable Drop in pH Dental caries
produced
carbohydrates
(sucrose)
Foods that Cause
Cavities

Sucrose is one of the highly cariogenic

substrate for oral biofilm

Examples:
Sticky foods like candy
Bread
Cake
Crackers
Sugary breakfast cereals
Soda/pop
Fruit juices
Fruit roll ups
Flavored milk
Fruit canned in syrup
Foods that Don’t Cause Cavities
These foods do not cause a reduction in pH
below 5.5, which the drop in pH is what begins
the cavity process.

Plain milk Carrots

Cheese Nuts
Cottage cheese Vegetables
Yogurt Eggs
Celery Meat
Carrots Apples
Critical Stages of Dental Caries
Development
Prenatal stage

Birth to the first

year of age

First and second

year of age
Two to five
years of age and
beyond
 The Early Stage Impact

• All these stages are critical in the

prevention of early childhood caries into
their elementary school years
• Food choices during these stages can
increase the child’s caries risk during the
developmental stages and create poor
eating habits
• As mentioned in previous slides, 3rd
graders had the highest percentage of
caries experience compared to
kindergarteners and 2nd graders.
• It is essential to have support from
parents/caregivers to provide optimal
oral health to reduce the rate of
incidence for 3rd graders
Dental Affects of Poor
Nutrition

• High caries risk and periodontal

disease
• Delayed tooth eruption
• Salivary gland dysfunction
• Protein/vitamin deficiencies
• Enamel hypoplasia
• Hypo-mineralization
• Absence of lamina dura
• Abnormal alveolar bone
 HEALTH BELIEF MODEL: Early Childhood Caries in School Aged Children

Concept Intervention Goal

Perceived Susceptibility Provide oral health and caries risk assessment to child Help that individual/caregiver of
individual become aware of caries risk
Discuss caries risk and relation to diet/nutrition and need for behavioral change

Perceived Severity Complete/record biofilm index, DMFT (Decayed, Provide knowledge of the childhood
Missing, and Filled Teeth) index, and analyze nutrition caries and the risks/consequences
intake

Perceived Benefits Motivate/encourage caries prevention — fluoride Discuss benefits of these preventative
varnish, sealant programs, and dental exams treatments to lower caries risk

Perceived Barriers Discuss intervention through restorative treatment and Discuss resources available to the
identify any financial barriers community such as low-cost or no-cost
dental caries prevention programs

Cue to Action Set up comprehensive/recall exams for dental Provide take home handouts —
screenings, encourage cleanings, implement plan information about homecare &
through take home handouts in English (also available nutritional recommendations, sample
in Spanish) dental bags, provide resources
Self-Efficacy Demonstrate/educate patients with proper homecare Provide guidance in caries prevention and
techniques tips for nutritional goals
 • Dental hygiene students will go over what foods are cariogenic and
anti-cariogenic
– Will use simple terms for elementary students to understand
such as “cavities”, “healthy”, “not healthy”
• After the quick lesson, kids will be given the opportunity to play a
matching game

Matching – There will be two columns:

• Foods that cause cavities
• Foods that do not cause cavities

Game – Students will be given a pack of laminated foods

– There will be 5 minutes for the elementary students to place
the foods in the appropriate column
– Afterwards, dental hygiene students will go over the results
– The elementary students will be given a take home pamphlet
that goes over these same foods to help them retain the
information learned from the matching game

Plan/Develop
Matching Game
Implement

• After speaking to the school, we found that a

large population of the students spoke Spanish.
In preparation we made sure to have the
pamphlets available in English and Spanish.
• We also made sure that a group member that
spoke Spanish was present in the class with the
Spanish speaking students. The students were
able to speak comfortably and fully express
themselves.
• When the videos included in the presentations
were playing, the teacher suggested that we
turned on the Spanish subtitles.
 Presentation

• Our presentations took place at two different elementary

schools:

• Dearborn Elementary — Dinh, Jade & Victor

– Pendergast (3rd grade students)
– Johnston’s (3rd grade students)
– Towel’s (2nd and 3rd grade students)

• Roxhill Elementary — Alina & Justina

– Mr. Mac (3rd grade students)
– Ms. Tuner (3rd grade students)
Dearborn
Elementary
Roxhill Elementary
3rd grade students
 Evaluation
• Throughout the presentation, we would
stop and ask the class questions –
summarizing what we had explained
• The students showed comprehension
through active participation with the aid
of prizes throughout the presentation
• At the end of the presentation we played
a sorting game related to nutrition
– Foods that cause cavities vs Foods that do not
cause cavities
 References
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Llena/publication/273777946_Association_between_the_number_of_early_carious_lesions_and_diet_in_children_with_a_high_prevalence_of_caries/links/55ccea0d08aeb
ebb8f577b0e/Association-between-the-number-of-early-carious-lesions-and-diet-in-children-with-a-high-prevalence-of-caries.pdf?origin=publication_detail

Diet and nutrition to prevent dental problems - statpearls - NCBI bookshelf. (n.d.). https://www.ncbi.nlm.nih.gov/books/NBK534248/

Schools, S. P. (2023, December 1). About: mission statement. Roxhill Elementary School.
https://roxhilles.seattleschools.org/about/#:~:text=for%20our%20students-,Our%20Mission,intellectual%20development%20of%20each%20child.

Wilkins, E. M. (2005). Clinical practice of the dental hygienist. Lippincott Williams & Wilkins.

U.S. News & World Report. (2021-2022). Overview of Roxhill Elementary School. Roxhill Elementary
School. https://www.usnews.com/education/k12/washington/roxhill-elementary-school-
222645#:~:text=The%20student%20population%20is%20made,enrolls%2052%25%20economically%20disadvantaged%20students.%20%E2%80%8B%20%E
2%80%8B

Washington Office of Superintendent of Public Instruction. (2022-2023). Roxhill Elementary Elementary School, Seattle School District No. 1. Report Card
Data. https://washingtonstatereportcard.ospi.k12.wa.us/ReportCard/ViewSchoolOrDistrict/101120

Department of Health. (2018). Washington State Health Assessment. https://doh.wa.gov/sites/default/files/legacy/Documents/1000//SHA-OralHealth.pdf

Guinn, S. (2017). Data and Statistical Reports Smile Survey 2015-2016. doh.wa.gov.
https://doh.wa.gov/sites/default/files/legacy/Documents/Pubs/340-309-2016SmileSurvey.pdf