Welcome to the 6th editition of the BPHC Office of Oral Health newsletter!
This newsletter, while updating you on our whereabouts and outreach efforts, centers on maternal and child oral health. We are specifically focusing on oral health's potential contribution to low birth-weight/pre-term births, as well as the use of xylitol to prevent transmission of decay-causing bacteria from caregiver to child. Scroll forward to view the Office of Oral Health's updates, links to recent maternal and child oral health research articles and resources, as well as upcoming oral health events and trainings!
Happy 1-Year Anniversary to the Boston Oral Health Improvement Coaltion (BOHIC)!
Members of the BOHIC met on May 16, 2011, to discuss future steps in moving forward with the Boston Oral Health Improvement Plan and to celebrate the Coalition's one-year anniversary! The very first Coalition meeting was held in February 2010, and members held monthly meetings for five months to be able to create a finalized Improvement Plan by September 2010. The Coalition has come a long way since its inception and we would like to thank all of its members for being incredible assets to the team! To view a copy of the May 16th BOHIC PowerPoint presentation, please click here. To view the May 16th and future meeting presentations and documents, simply search for the BOHIC group on Wiggio and gain access using the password: Coalition.
Help Us Name The New Addition to the Oral Health Team!
We are looking for a catchy name for our new kangaroo friend that will accompany the Oral Health Team during future outreach and events with children. Recent suggestions include: Kangaroo Dundee and Hoppy the Kangaroo! Submit ideas throughout July by visiting our Facebook page where we will also announce the winning name!
Holgate Housing Development Elderly Dental Screening
Fenway Community Health Center Department of Dentistry team members Michelle A. Dempsey, DMD, (left) and Melissa Fernald, RDH, (right).
On May 12, 2011, the MDPH Office of Oral Health, Fenway Community Health Center, Boston Housing Authority, and BPHC Office of Oral Health hosted a free senior dental screening at the Holgate Housing Development in Roxbury, MA. The screening was very successful, with 15 patients total. Residents also received oral hygiene instructions, and many made follow up appointments at Fenway Community Health Center. Great job everyone!
Boston Latin Academy Health Fair
Youth at the Girls' Health Fair.
We want to thank the Boston Latin Academy girls for welcoming us at their Girls' Health Fair on May 20, 2011. The Office of Oral Health spoke to the teens specifically on the dangers of oral piercings and tobacco, and the benefits of maintaining good oral health at an early age.
Presentation to BPHC Healthy Baby Healthy Child Employees
Dr. Doyle Williams, Chief Dental Officer, Delta Dental of Massachusetts
The Office of Oral Health collaborated with the Massachusetts Public Employees (MPE) Fund and Delta Dental of Massachusetts on May 26, 2011, when Delta Dental of MA's Chief Dental Officer Dr. Doyle Williams presented to BPHC Healthy Baby Healthy Child employees on the importance of maintaining good dental care, especially for pregnant women and new mothers. Dr. Williams spoke specifically on the transmission of decay-causing bacteria from caregiver to child, the dental benefits of adequate xylitol use, the effectiveness of water fluoridation and dental sealants, as well as how oral health impacts overall health. Dr. Williams and Susan Fournier, Executive Director of the MPE Fund, have provided three excellent presentations for Commission employees! Thank you again!
12th Annual Family Health Fair Fun Day
Oral health team distributing oral health hygiene and educational materials. The Boston Healthy Start Initiative (BHSI), in collaboration with the Friendly Father Initiative (FFI), hosted the 12th Annual Family Health Fair Fun Day on June 15, 2011, at Harambee Park in Dorchester, MA. The BPHC Office of Oral Health and various other organizations set up information booths, and if the families visited all of the organizations, they were eligible to win raffle prizes. The BPHC Office of Oral Health gave out free toothbrushes, toothpaste, floss, and flyers, while the Boston University Henry M. Goldman School of Dental Medicine graciously provided free dental screenings and oral health education. The fair included a barbeque, music, games, face painting, a magician, and pony rides! A heartfelt thank you to Kathy Lituri, Nancy Smith, and Xandra Negron for their hard work to make this day a success!
Final BPHC Office of Oral Health Child Care Trainings
Sr. Program Manager, Sandra Vasquez, educating the crowd in proper oral health care and wellness in the child care setting.
The Office of Oral Health held the last two oral health training sessions for Boston's home-based child care providers on June 21 & 22, 2011. A recent MA regulation requires that child care providers must brush the teeth of the children who are in their care for four or more hours or have consumed a meal while in their care. The presentations were designed to reinforce the importance of oral health in young children and display helpful tips for providers to incorporate and comply with the recent regulation. Over two days, the Office of Oral Health trained 148 providers, reaching over 900 kids and their parents. A total of 4,203 toothbrushes, 100 toothbrush holders, and thousands of toothpaste and educational materials were distributed! A special thank you to BPHC Operations and the staff at the East Boston Harborside Community Center for their valuable assistance.
Oral Health Non-Dental Provider/
Community Based Practice
Patricia Whitworth, RN, B.S.
Director of Client Services
Healthy Baby Healthy Child program in partnership with the Henry M. Goldman School of Dental Medicine embarked on a home based initiative in July of 2008 to expand oral health preventive services using non-dental health care providers. The initiative specifically targeted pregnant women, infants up to 1 year of age and their siblings. The partnership provided an opportunity for Public Health nurses working with a disproportionately underserved / high risk population, to expand by incorporating oral health assessment and Early Childhood Caries (ECC) risk factors reduction counseling into their on-going health promotion activities.
Eighteen Public Health Nurses were trained to assess women's understanding of oral health, to provide oral health counseling and conduct oral screenings on their infants at the ages of 3, 6, 9 and 12 months. The initiative also addressed the concerns of Boston's health disparities - rates of preterm birth, low birth weight and chronic conditions linked to poor oral health contributors. The nurses were prepared to deliver culturally competent oral health screenings, comprehensive preventive education and linkages to a dental home.
Nurses championed the goal of changing maternal knowledge, attitudes and health behaviors (e.g., nutrition, infant feeding practice, oral health hygiene and mother to child oral bacterial transmission) that affect these women and their children. The nurses' interventions included, supporting all families in identifying and building relationships with a dental home, scheduling an infant's initial dental visit at the age of 1 year and building family awareness and practice of seeing an oral health provider at a minimum of bi-annually.
Overall, this initiative had a positive impact on changing the clients' health habits, inclusive of building healthy behaviors, reduction of pregnancy risk factors, improvement in oral health practices of the clients' and their families, increased knowledge on the impact of early childhood health education on a child's quality of life and early identification of a dental home.
The Benefits of Xylitol
Jehan AlHumaid, BDS, DScD
Boston University Henry M. Goldman School of
Xylitol is a naturally occurring sugar substitute found in fibers of many fruits and vegetables. During the 1970's it was introduced in the dental literature and was found to reduce dental decay dramatically. Studies have shown that Xylitol helps teeth resist decay by reducing the cavity-causing bacteria thus blocking acid production and formation of plaque. In addition, Xylitol helps reverse initial decay when used in combination to other caries preventive measures. For expectant mothers, Xylitol has been found to significantly reduce the transmission of cavity-causing bacteria from mother to child. Moreover, for children of all ages and children with special needs, Xylitol is highly accepted and can reduce cavities up to 80% without the need for diet modification. For adults, Xylitol use has significantly reduced root caries and gingival disease. Some available Xylitol products include chewing gums, mints, toothpaste and candies. For maximum benefit, Xylitol should be listed as the first ingredient. Xylitol should also be taken or chewed 3-5 times/day (5-10 grams/day) for 5-10 minutes after meals. The timing of intervention for school children is critical, for long-term preventive effect, Xylitol use should start at least one year before permanent tooth eruption at 6 years of age. Finally, Xylitol should be considered as a dental caries preventive strategy. Practitioners should also consider Xylitol dose and frequency when prescribing Xylitol to their patients.
Periodontal Disease and its Association with PTB/LBW
Among a small sample population in Brazil, findings suggest that treatment of periodontal disease during the second trimester of gestation would decrease the risk of PTB/LBW, although the small sample size is a major limitation of the study. Click here for the article.
Through careful analysis of large randomized trials, it has been determined that treatment of periodontal disease during pregnancy does not seem to offer any clear benefit to the reduction of PTB/LBW. It is still possible that treatment and control of periodontal disease before pregnancy may contribute to improvement in prenatal outcomes. Click here for the article.
The results of a meta-analysis to assess the overall consensus among randomized control trials do not show a reduction of PTB/LBW in women treated for periodontal disease during pregnancy, yet it is possible that the timing of treatment during pregnancy may play a role in health outcomes. Click here for the article.
Treatment of periodontal disease in pregnant women is safe but does not significantly affect PTB/LBW. It is possible that periodontal care was delivered too late in pregnancy to affect rates of birth outcomes. Click here for the article.
Chewing gum with xylitol or sorbitol/maltitol can reduce dental plaque and acid production in the saliva of schoolchildren. Xylitol-containing gum may also interfere with the composition of Streptococcus mutans, a bacterium commonly found in the human oral cavity and is largely attributed to dental decay. Click here for the article.
Maternal use of xylitol chewing gum can prevent dental caries in their children by prohibiting the transmission of Streptococcus mutans from mother to child. Click here for the article.
Children who chewed gum had a significantly lower progression of tooth decay than children who did not chew gum. Click here for the article.
The chewing of xylitol, sorbitol, and even sugar gum has been suggested to reduce caries rates, with gum containing xylitol being most effective. Click here for the article.
Mothers who chewed gum with xylitol had a lower rate of mother to child Streptococcus mutans transmission. Click here for the article.
For those Interested in Further Data:
Health of Boston 2010's
1) Maternal and Child Health (pg 209)
2) Low Birthweight Data (pg 217)
3) Infant Mortality (pg 227)
March of Dimes Prematurity Awareness & Low Birth Weight
The National Healthy Mothers Healthy Baby Coalition
The Healthy Baby/Healthy Child Program (HBHC) is a community-based program designed to promote infant survival, positive birth outcomes, oral health, and family unity.
According to The Family Nurturing Center of Massachusetts,
Nurturing programs are validated, internationally recognized curricula that promote nurturing relationships among all family members while building community connections to support positive parenting.
The Dorchester House Multi-Service Center Mom's Group offers a free support group for new and expecting moms in a nurturing community. Participants have the chance to connect with other moms and receive breastfeeding support and health and parenting education.
Parent to Parent individual and group sessions allow parents to share stories and advice with others, helping their children and family to thrive.
Welcome Baby provides new parents with information on the community services available to assist them with parenting. Participants receive a one-time home visit and a package of some basic baby clothes and supplies.
Boston Healthy Start Initiative (BHSI) is a federally funded program whose goal is to eliminate disparities in perinatal health by ensuring that Black pregnant women receive quality health care by funding case management, health education, interconceptional care, and maternal depression services.
Upcoming Events and Trainings
ADA Evidence-Based Dentistry Champions Conference
July 28, 2011
ADA Institute for Diversity in Leadership
September 9, 2011
ADA Annual Session 2011
October 10, 2011
Las Vegas, NV
APHA 2011 Annual Meeting and Exposition
October 29- November 2, 2011
3rd Tufts Summer Institute on Web Strategies for Health Communication
July 17-22, 2011
The World Congress 9th Annual Health Care Quality Congress
August 1, 2011
Oral Health Training for Community Health Workers in MA
September 13, 2011
Oral Health Training for Community Health Workers in MA
October 4, 2011
2011 Connected Health Symposium: Driving Quality Up and Costs Down: New Technologies for an Era of Accountability.
October 20, 2011