THE SCOPE OF ORAL HEALTH PRACTICE AND NEEDS OF CHILD HEALTH CARE MEDICAL PROVIDERS IN FLORIDA Michelle Valdes, Hilma Benja...
Disclosures <ul><li>Rani Gereige and the co-authors of the abstract have documented that they have no relevant financial r...
Background <ul><li>Dental caries are the most common infectious disease in the U.S. (CDC) </li></ul><ul><li>The AAP adopte...
Objectives <ul><li>Provide an indepth look at the pediatric oral health scope of practice of primary care providers (PCP) ...
Design/Methods <ul><li>Web-based survey was sent to the AAP Florida Chapter listserv and resident section </li></ul><ul><l...
Results
Results
Results
Results
Results 38% 62% 64% 12% 11% 7% 6% 2% 63% 35% 40% 60% 71% 29% (79%) <ul><li>Gender </li></ul><ul><ul><li>Male </li></ul></u...
Results Fig 4.
Results Fig 5.
Results Fig 6.
Results Fig 7.
Results Fig 8.
Results Fig 9.
Results Fig 10.
Results Fig 11.
Limitations and Challenges <ul><li>Limitations inherent to the study design </li></ul><ul><ul><li>Survey: Reporter bias </...
Future Directions <ul><li>Use the pilot data to design a larger scale study </li></ul><ul><li>Chart audits rather than rep...
Conclusions <ul><li>Overall, most PCPs and residents, despite inadequate oral health training, include OHRA as part of hea...
References <ul><li>Florida Health Insurance Study,  Insurance Coverage Updates, Fact Sheet No. 2, August 2005. </li></ul><...
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  • Sixty five percent of respondents were PCPs and 35% were residents (Fig 1)
  • Twenty percent are in academic (Fig 2)
  • 47% have been in practice &gt; 15 years (Fig 3)
  • Among all respondents, only 25% had an oral health curriculum in residency, 89% in the form of didactics (Table 1)
  • PCPs routinely ask about brushing habits (57%), Fluoride exposure (53%), and the availability of a dental home (77%) (Fig 4)
  • over 55% of respondents do not routinely assess mother/caregivers oral health in any way (history and/or physical examination) (Fig 5)
  • Over 85% of respondents reported routine dental inspection of all groups of children 0-3 as part of the PE particularly those with visible cavities (Fig 6)
  • Over 58% of respondents look for and document early and late signs of dental caries (Fig 7)
  • Only around 6% perform Fluoride varnish application if needed (Fig 8)
  • Around 86% of respondents feel that oral health assessment is part of their responsibility yet less than 40% feel adequately trained to perform such assessment (Fig 9)
  • Respondents expressed interest in learning more about oral health (Fig 10)
  • Respondents feel they need more training particularly in the form of hands-on workshop (64%) (Fig 11)
  • THE SCOPE OF ORAL HEALTH PRACTICE AND NEEDS OF CHILD HEALTH ...

    1. 1. 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
    2. 2. Disclosures <ul><li>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 </li></ul>
    3. 3. Background <ul><li>Dental caries are the most common infectious disease in the U.S. (CDC) </li></ul><ul><li>The AAP adopted Oral Health as one of its focus areas for 2006-2007 </li></ul><ul><li>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 </li></ul><ul><li>There is a great deal of variability in the oral health training and scope of practice of child health care professionals </li></ul><ul><li>No study has previously described how much Oral Health care child providers routinely perform (particularly in the State of Florida) . </li></ul>
    4. 4. Objectives <ul><li>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 </li></ul><ul><li>Assess current practice barriers and training issues </li></ul>
    5. 5. Design/Methods <ul><li>Web-based survey was sent to the AAP Florida Chapter listserv and resident section </li></ul><ul><li>The survey link was placed in the Florida Academy of Family Physicians (FAFP) electronic newsletter </li></ul><ul><li>Over the span of three months, four reminder e-mails we sent </li></ul><ul><li>The survey collected demographic data, oral health training data and practice patterns </li></ul>
    6. 6. Results
    7. 7. Results
    8. 8. Results
    9. 9. Results
    10. 10. Results 38% 62% 64% 12% 11% 7% 6% 2% 63% 35% 40% 60% 71% 29% (79%) <ul><li>Gender </li></ul><ul><ul><li>Male </li></ul></ul><ul><ul><li>Female </li></ul></ul><ul><li>Ethnicity </li></ul><ul><ul><li>Caucasian </li></ul></ul><ul><ul><li>Hispanic </li></ul></ul><ul><ul><li>African-American </li></ul></ul><ul><ul><li>Asian/Pacific Islander </li></ul></ul><ul><ul><li>Other </li></ul></ul><ul><li>Geographic setting of Practice/ Residency </li></ul><ul><ul><li>Rural </li></ul></ul><ul><ul><li>Urban </li></ul></ul><ul><ul><li>Suburban </li></ul></ul><ul><li>Training institution has an affiliated dental school </li></ul><ul><ul><li>Yes </li></ul></ul><ul><ul><li>No </li></ul></ul><ul><li>Oral Health curriculum in residency </li></ul><ul><ul><li>No </li></ul></ul><ul><ul><li>Yes </li></ul></ul><ul><ul><ul><li>Didactics </li></ul></ul></ul>% Characteristics of Respondents
    11. 11. Results Fig 4.
    12. 12. Results Fig 5.
    13. 13. Results Fig 6.
    14. 14. Results Fig 7.
    15. 15. Results Fig 8.
    16. 16. Results Fig 9.
    17. 17. Results Fig 10.
    18. 18. Results Fig 11.
    19. 19. Limitations and Challenges <ul><li>Limitations inherent to the study design </li></ul><ul><ul><li>Survey: Reporter bias </li></ul></ul><ul><li>Small sample size did not allow stratification by specialty, year of practice, or training exposure </li></ul><ul><li>Residents sample limited by the number of residents in the State of Florida </li></ul>
    20. 20. Future Directions <ul><li>Use the pilot data to design a larger scale study </li></ul><ul><li>Chart audits rather than reporting as a measure of practice pattern </li></ul><ul><li>More efforts to include Family Medicine residents </li></ul><ul><li>Will be used by Florida DOH </li></ul>
    21. 21. Conclusions <ul><li>Overall, most PCPs and residents, despite inadequate oral health training, include OHRA as part of health maintenance visits </li></ul><ul><li>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 </li></ul>
    22. 22. References <ul><li>Florida Health Insurance Study, Insurance Coverage Updates, Fact Sheet No. 2, August 2005. </li></ul><ul><li>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. </li></ul><ul><li>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. </li></ul><ul><li>Oral Health Resources, </li></ul><ul><ul><li>http:// www.cdc.gov/oralhealth/topics/child.htm </li></ul></ul><ul><li>Florida Department of Health, floridacharts.com, Access to Dental Care by Low Income Persons </li></ul><ul><li>Florida Department of Health, floridacharts.com, Percent of Access to Dental Care at 200% below the Federal Poverty Level by county </li></ul><ul><li>Oral Disease: A Crisis Amount Children of Poverty, National Maternal and Child Oral Health Resource Center, May 1998. </li></ul>
    23. 23. Thank You!!!

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