Expanding oral health preventative services for young children: a successful interprofessional model.

Progressive solutions are needed to solve the oral health chronic disease problem in the U.S. The importance of oral health coupled with urgent community oral health needs, shortage of primary providers, and emphasis on interprofessional collaboration make the timing ripe for allied health training and practice in oral health preventative services. A successful model is described that addressed the unmet oral health care needs of low-income and at-risk children. The model is a guide for integrating an oral health screen, fluoride varnish, anticipatory guidance, and dental referrals into allied health practice. An alternative oral health provider approach was used to address the low rate of early caries detection, preventative oral care, and access for underserved children. A comprehensive system for the administrative and clinical components of the project, including implementation plan, clinical protocols, prescriptive authority, a dental home referral system, clinical training and competency testing, was developed. The interprofessional project increased oral health services capacity and practice acceptance of oral health screening and fluoride varnishing among dietitians. Oral health care services provide allied health practitioners with unique opportunities to impact the poor access and unmet needs of at risk children and adults and to improve overall health.

A novel, minimally invasive approach to managing mild epithelial dysplasia.

Conventional oral cancer screening examinations can be enhanced by direct tissue fluorescence visualization. Early dysplastic lesions detected during screening examinations often are monitored for progression or changes in appearance. Aggressive surgical intervention usually is contraindicated for mild epithelial dysplasia. As epithelial dysplasia progresses from mild to severe, the likelihood of it developing into carcinoma increases. Minimally invasive tissue management procedures should be considered as a possible method of early intervention to reduce the occurrence of oral cancer. This case report describes a novel approach to managing mild epithelial dysplasia when therapy is indicated (due to a high risk for oral cancer) but aggressive surgical management is contraindicated (due to a potential loss of function and increased morbidity).

Self-esteem: a hidden concern in oral health.

Little is known about the impact of oral health on self-esteem. The purpose of this descriptive study was to identify the frequency of low self-esteem in vulnerable persons who received oral health care at an academic nursing center. Participants (N = 86) completed the Index of Self-Esteem (Hudson, 1982b), answered open-ended questions concerning oral health care practices, and participated in an oral health examination. We found that 53% demonstrated low self-esteem, 67% (n = 58) had minor dental problems, and 33% (n = 28) had major dental problems. Oral health problems were ranked in importance along with cancer, diabetes, high blood pressure, and asthma. Oral hygiene included no tooth brushing, infrequent tooth brushing, flossing, chewing gum, and using mouth wash. This study emphasizes the roles of the community health nurse in assessing oral health (particularly among a vulnerable population), advocating for policy change, and providing education.