It has been well documented that a mother's oral health status is directly related to the oral health of her children, especially during the perinatal period. This association is complex, with maternal oral health status as well as maternal knowledge, attitudes and health behaviors all affecting the child's oral health. Early childhood caries (ECC), an infectious, chronic disease most commonly transmitted from mother to child, is a prime example of the maternal-child link. The earlier a child is infected with Mutans Streptococcus (MS), the bacteria primarily associated with dental caries, the greater the child's risk of developing dental caries. Mothers who have poorer oral health, especially the presence of untreated dental decay, are more likely to have higher rates of MS, more likely to infect their child and more likely to infect their child at an earlier age. Home visiting programs were specifically developed to reach underserved; at risk children and annually over 1 million children are estimated to receive health care in their homes. The home visiting model offers an ideal venue to incorporate oral health promotion activities aimed at reducing ECC prevalence since 1) these programs already target children at highest risk for dental disease, 2) health promotion is one of their primary aims, 3) health professionals provide preventive services and 4) home-based health care providers have less time constraints than clinic based providers. Building on the tenets of the chronic care model, this exploratory study is designed to assess the feasibility of public health nurses incorporating oral health promotion activities into an ongoing pre and post natal home visiting program.
The specific aims i nclude: 1) to determine if an oral health promotion model, with a focus on patient-centered counseling and ECC prevention, can be effectively delivered by nurses as part of an ongoing perinatal home visiting program; 2) to determine nurses' ability to accurately assess oral health status, in a home setting, and 3) to determine patient acceptance of oral health promotion being delivered by nurses. The long term goal of this study is to use these results to design and test a multifaceted intervention to prevent ECC that incorporates both patient centered counseling and fluoride varnish applications in a home visiting setting. Using this delivery strategy to address the oral health needs of high risk women and children, when replicated in other settings, could potentially have far reaching impact in eliminating oral disease and oral health disparities. ? ? ?
