Open Mouth, Open Mind: Expanding the Role of Primary Care Nurse Practitioners

Increasing the Awareness of Pediatric Nurses about the Protection and Continuity of the Oral and Dental Health of Children

Objectives: To provide pediatric nurses with knowledge and skills on oral and dental health and to increase their awareness. Material and Methods: In the first phase of the study, pre-tests were given to pediatric nurses in Trabzon and Rize central and district hospitals. A Whatsapp group was created with the nurses who completed the tests, and the training video prepared by the researcher was shared. In the second phase of the study, the same questions were applied again as the post-test. Jamovi (Version 1.0.4) software was used for statistical analysis. P < 0.05 was accepted as statistically significant in all analyses. Results: Of the 91 nurses who completed both the pre-test and the post-test, 83 (91.2%) were female and 8 (8.8%) were male. In all sections in the test category consisting of six different sections (Tooth Decay, Risk Factors in Dental Caries, Prevention of Dental Caries, Oral and Dental Injuries, Children with Special Care Needs, What to Do - How to do?), the success rate was significantly higher in the post-test ( p < 0.001). Conclusion: Research emphasizes that neonatal nurses, pediatric nurses and health professionals working in community health centers should be activated and empowered in order to prevent oral and dental health problems of children, and awareness should be increased with scientifically valid educational guidelines. The results of the present study support these views and emphasize the importance of education by showing significant improvement with the training provided to nurses who had insufficient knowledge and awareness about the subject. Amaç: Pediatri hemşirelerine ağız ve diş sağlığı konusundaki bilgi ve beceriyi kazandırmak ve onların farkındalıklarını artırmaktır. Gereç ve Yöntemler: Araştırmanın birinci aşamasında, Trabzon ve Rize merkez ve ilçe hastanelerindeki pediatri servis hemşirelerine ön test soruları verildi. Testi cevaplayan hemşirelerle oluşturulan Whatsapp grubunda, tarafımca hazırlanan eğitim videosu paylaşıldı. İkinci aşamada; ön test sorularının aynısı, son test olarak tekrar uygulandı. İstatistiksel analiz için Jamovi (Sürüm 1.0.4) yazılımı kullanıldı. İstatistiksel anlamlılık için olasılık seviyesi p = 0,05 olarak belirlendi. Bulgular: Hem ön test hem de son testi cevaplayan 91 hemşirenin 83’ ü (91.2%) kadın, 8’i (8.8%) erkekti. Altı farklı bölümden oluşan test kategorisindeki tüm bölümlerde ( Diş Çürüğü, Diş Çürüklerinde Risk Faktörleri, Diş Çürüğünün Önlenmesi, Ağız ve Diş Yaralanmaları, Özel Bakım İhtiyacı Olan Çocuklar, Ne Yapmalı - Nasıl Yapılır?) eğitim sonrası yapılan son testteki başarı oranı anlamlı ölçüde artmıştı (p

Interprofessional peer-led learning in oral health training

Research on peer-led interprofessional learning in oral-health training for pediatric nurse practitioner (PNP) students is sparse. Therefore, we conducted a mixed-methods pilot study to assess the feasibility and impact of a student-led interprofessional training program centered on pediatric oral-health with PNP and dental students. Eleven PNP students rotated through the dental clinic to receive an oral-health education from 12 second-year dental students. These students learned how to treat avulsed teeth, apply fluoride varnishes, detect caries, and to do lap-to-lap baby dental exams. A reflection and a self-report survey-measure were used to elucidate what the students gained from the experience, their satisfaction with the training, how it may be improved, and how they see future collaboration of PNPs and dentists. PNP students felt dental students were well equipped to teach them, felt confident in their ability to conduct an oral evaluation/apply fluoride varnishes, and felt the experience to be valuable to their future practices. Dental students learned the scope of practice of PNPs and ideated ways the two professions overlap and complement each other. While some may find it challenging to envision dentistry regularly collaborating with other healthcare providers, clinical interprofessional education can be one way to break down these barriers.

Children's Oral Health and Barriers to Seeking Care: Perspectives of Caregivers Seeking Pediatric Hospital Dental Treatment

Objectives:

To investigate the demographics of children (and their caregivers) requiring hospital-based tertiary dental care, oral health services use and perceptions of and barriers to oral healthcare in Nova Scotia.

Method:

A questionnaire was administered to caregivers (N = 62) on behalf of their child (N = 62).

Results:

Nearly half (45.8%, N = 27) of the caregivers experienced difficulty seeking oral healthcare for both themselves and their children. Less than a quarter (23.2%, N = 13) of the caregivers sought care for their child by the recommended age of one (mean age of first visit = 2.69 years). Alternate delivery in a school, community or primary healthcare setting was preferred by 53.3% (n = 32) of the caregivers for children's oral healthcare. Low-income families (53.8%, n = 28), rural areas (47.4%, n = 27) and Indigenous children (9.7%, n = 6) were over-represented in the study's sample.

Conclusion:

Socio-economically disadvantaged populations are more vulnerable to oral diseases. Oral health of priority populations in Nova Scotia appears to be inadequately addressed.

Implementation science: Changing practice in oral health

Caries remain the most common preventable chronic childhood disease. One state oral health program including fluoride varnish showed a decrease in presence of decay and improvement in overall oral health; however, early childhood caries did not improve. Implementation of an oral health preventive program during well-child medical visits may address this gap.

Implementing Pediatric Fluoride Varnish Application in a Rural Primary Care Medical Office: A Feasibility Study

INTRODUCTION

The objective of this study was to determine if the application of fluoride varnish (FV) to children 5 years and under was acceptable and practical for health care providers in a rural primary care office.

METHODS

We employed a quasi-experimental study design comprised of providers who received education and training in FV application. Pre- and post-study surveys regarding barriers and facilitators were administered. Data was collected on the number of FV applications, time spent on procedure, perceived barriers, and overall cost.

RESULTS

The total direct variable cost of providing FV was $4.35 per procedure, resulting in an $11.85 profit. FV application increased 9.57%. Potential barriers were lack of proper supplies, lack of adequate support staff, and lack of additional financial compensation for providers.

DISCUSSION

FV application is a service that can be delivered in a rural practice with existing resources, but the initiative needs support from practice management.

Interprofessional Oral Health Education Improves Knowledge, Confidence, and Practice for Pediatric Healthcare Providers

Dental caries is the most prevalent chronic childhood disease in the United States. Dental caries affects the health of 60-90% of school-aged children worldwide. The prevalence of untreated early childhood dental caries is 19% for children 2-5 years of age in the U.S. Some factors that contribute to the progression of dental caries include socioeconomic status, access to dental care, and lack of anticipatory guidance. The prevalence of dental caries remains highest for children from specific ethnic or racial groups, especially those living in underserved areas where there may be limited access to a dentist. Although researchers have acknowledged the various links between oral health and overall systemic health, oral health care is not usually a component of pediatric primary health care. To address this public health crisis and oral health disparity in children, new collaborative efforts among health professionals is critical for dental disease prevention and optimal oral health. This evaluation study focused on a 10-week interprofessional practice and education (IPE) course on children's oral health involving dental, osteopathic medical, and nurse practitioner students at the University of California, San Francisco. This study's objective was to evaluate changes in knowledge, confidence, attitude, and clinical practice in children's oral health of the students completed the course. Thirty-one students participated in the IPE and completed demographic questionnaires and four questionnaires before and after the IPE course: (1) course content knowledge, (2) confidence, (3) attitudes, and (4) clinical practice. Results showed a statistically significant improvement in the overall knowledge of children's oral health topics, confidence in their ability to provide oral health services, and clinical practice. There was no statistically significant difference in attitude, but there was an upward trend toward positivity. To conclude, this IPE evaluation showed that offering an interprofessional course on children's oral health to graduate students in dentistry, nursing, and osteopathic medicine can improve their knowledge, confidence, and practice toward children's oral health and expand their professional goals to include caring for underserved, minority children.