A suite of oral health tools developed by UH is helping keiki in Hawaii and beyond

A health care provider meeting with a parent and child during a well-child visit discusses oral health.

Oral health is an integral part of overall health and societal impact research shows that too many people in Hawaii do not have access to the necessary oral health care. Report from Hawaii A state health department published in 2022 found that HawaiiLow-income preschoolers have the highest prevalence of tooth decay in the nation. The effects of poor oral health affect the entire body, and many oral health conditions are preventable and can reduce costly emergency room visits.

University of Hawaii in Mānoa School of Nursing Associate Professor Nancy Atmospera-Walch (NAUSON) developed an oral health toolkit to teach nurses, physicians, and health care students how to effectively integrate oral health into their practice. This project is a collaboration between Hawaii State Department of Health (HIDDOH) Department of Family Health Services and NAUSON.

Deborah Matheus headshot
Deborah Mathew

“Integrating oral health into pediatric primary care practice is an essential and cost-effective way to reduce poor oral health outcomes and improve the overall health and quality of life of our Islanders,” said Deborah Mathewproject manager and NAUSONProfessor of School Health. “As a practitioner APRN (nurse practitioner), I see children in the clinic all the time who have poor oral hygiene. We have a great opportunity to proactively care for their teeth as part of their well child visit. This will prepare these children for good dental hygiene when they grow up.”

Matheus, who is also Hawaii Keiki, Healthy & Ready to Learn’s senior practice director and dental sealants program director, said young children are seen by primary care providers (pediatricians and nurse practitioners) more often than dentists, with an average of 12 recommended well-child pediatric visits in the first three years and annually between ages three to 21.

“Every primary care visit is an opportunity to assess oral health status, provide oral health education, connect families to a dental office and, when appropriate, apply fluoride varnish,” she said.

Toolkit development and training

The project funded by HIDDOH was titled Oral Health into Primary Care Practice: Oral Health Essential Services in a Well Child Visit and consisted of creating an educational video and promotional toolkit and distributing content to a national audience.

The toolkit includes: 1) a video and handout on the steps for applying fluoride varnish; 2) visual examples of early childhood caries (cavities); 3) medical card template; and 4) an information sheet for families with fluoride varnish.

The video uses local actors with content tailored for a Hawaii audience. Content feedback was requested HIDDOHcommunity partners, Hawaii Members of the Oral Health Coalition, the leadership of Harvard University’s Center for Integrating Primary Care and Oral Health, Huh teachers, dentist, doctors and nurses. See the video here.

In May 2022, Matheus provided training on oral health assessment and fluoride varnish application to a Doctor of Nursing Practice (DNP) students in NAUSON. Mateus has shared the toolkit with others Hawaii nursing/medical programs with requests to schedule workshops beginning in the fall semester of 2022. She is working with these programs to integrate oral health into their curriculum.

National distribution

The video and toolkit were distributed to the American Academy of Pediatrics Hawaii head, Hawaii Association for Primary Care, National Association of Pediatric Nurse Practitioners Hawaii head, Hawaii American Nurses Association, Hawaii Oral Health Coalition and Hawaii Dental service.

The toolkit also reached the continent US and was distributed by the Academy of Pediatrics Section on Oral Health, the Harvard University Center for Integrating Primary Care and Oral Health, the Network for Progress and Equity in Oral Health, and Oral Health Nursing Education and Practice.

Matheus has been invited to present the keynote address at the National Maternal and Child Oral Health Resource Center’s Oral Health Learning Cafe Webinar in November 2022.

For more information about the project or to request the video and toolkit, contact Mattheus at [email protected]

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