Download the scope of oral health practice and needs of child health care

THE SCOPE OF ORAL
HEALTH PRACTICE AND
NEEDS OF CHILD
HEALTH CARE MEDICAL
PROVIDERS IN FLORIDA
APA School and Community Health SIG
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
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

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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
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Design/Methods
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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
Results
Fig 1. Field of Practice of Survey
Respondents (n=92)
35%
50%
1%
14%
Pediatrics
Med-Peds
Family Medicine
Resident
Results
Fig 2. Work Setting of Practicing Physicians
Respondents
8%
3%
13%
11%
17%
48%
Solo
Academic
Hospital-Based
Group
Pub Hlth/Comm Hlth Cntr
Other
Results
Fig 3. Years of Practice of Practicing Physicians
Respondents
20%
44%
23%
13%
< 5 years
5-9 years
10-15 years
> 15 years
Results
Characteristics of Respondents
Gender
Male
Female
Ethnicity
Caucasian
Hispanic
African-American
Asian/Pacific Islander
Other
Geographic setting of Practice/ Residency
Rural
Urban
Suburban
Training institution has an affiliated dental school
Yes
No
Oral Health curriculum in residency
No
Yes
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.
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
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References
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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.
Thank You!!!