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San Francisco dental hygiene society community service projects.

San Francisco, Calif., is a highly diverse city both culturally and economically, where caries remains a chronic childhood disease. ADHA's Diversity Committee member Michael J. Long, RDH, works with the San Francisco Dental Hygiene Society (SFDHS) to focus community service efforts in under-served areas and educate parents and non-dental health care providers.

"Many of our community outreach projects overlap," Long said. "Our focus goes beyond the children's diverse oral health needs and recognizes a diverse city's oral health needs." Below is an overview of those projects.

Children's Oral Health Partnership of San Francisco

This program was initiated in 2009 to provide caries screening, fluoride varnish treatment and family education to the underserved Latino community in the San Francisco's Mission District. Located in the pediatric department of Mission Neighborhood Health Center (MNHC), the program also aims to educate the non-dental professional team at MNHC and to work with primary care physicians to establish dental homes in local practices for children served. Depending on a child's oral health needs, he or she may be reappointed for additional in-house screening and treatment to alternate with appointments at the dental home, ensuring frequent monitoring and needed services. Documentation is included in the patient's health record, and a multilingual AmeriCorps recorder from the San Francisco Community Clinic Consortium (SFCCC) follows up with all families as many as four times after the initial screening to facilitate ongoing care.

SFDHS and members of the pediatric dental department at Native American Health Center provide clinical support, while coordination and materials are provided by the San Francisco Department of Public Health's Child Health and Disability Prevention (CHDP) program, through funding provided by American Academy of Pediatrics' CATCH Grant. Margaret Fisher, RDHAP, BS, has made extraordinary efforts in support of the program in her role of public health department dental hygienist as well as SFDHS public dental health chair. The AmeriCorps recorders provide interpretation services during treatment. Patient materials are available in Spanish as well as English and Chinese. The program recently received an ADHA Institute for Oral Health/Wm. Wrigley, Jr. Company Foundation Grant to support its outreach efforts for another year.

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Targeted Community Outreach Efforts

Research by Lisa Chung, DDS, MPH, and the San Francisco Department of Public Health in 2006 identified high prevalence of caries and greatest need for treatment in specific geographic areas of San Francisco; among them the Latino community in the Mission/Excelsior Districts, the African-American population in Bayview-Hunters Point and the Asian population in Chinatown.

The Institute of Medicine advocates the inclusion of collaborative and multidisciplinary teams working across the health care system, recognizes that oral health care is essential to comprehensive health care, and states that oral health promotion and disease prevention are essential to any strategies aimed at improving access to care. Using these principles as a basis, SFDHS developed programming to address oral health disparities in the underserved areas of San Francisco by working alongside--and working to educate--non-dental professionals.

Give Kids A Smile/PSA

SFDHS has participated in Give Kids A Smile Day during National Children's Dental Health Month for four years now, joining forces with the San Francisco Department of Public Health and CHDP to promote the idea of an early dental home in Bayview-Hunters Point and at San Francisco General Hospital's Women, Infants and Children site. Children receive screening for dental needs and fluoride varnish, parents receive oral health education, and the child is referred to a dental home where he or she will receive examination and prophylaxis. Someone from the program follows up with each child to verify their ongoing relationship with the dental home. At the hospital site, nursing students receive training in the provision of oral health screenings and fluoride varnish application. SFDHS produced a video public service announcement to promote Give Kids A Smile events incorporating footage from a previous event. The voiceover for the PSA was provided in Chinese, English and Spanish and distributed to area television stations.

"One of the older children in 2011, a 10-year old girl, was brought [to Give Kids A Smile Day] by her grandma," said Michael Long, RDH. "She had been up all night with a toothache. This little girl had a scarf wrapped around her mouth and neck. She looked and felt ill. When she was examined, we found that she had an abscessed tooth that had progressed to cellulitus. We were able to have a San Francisco State University nursing student walk her over to the ER at San Francisco General Hospital to get IV antibiotics. CDHP staff also assisted the family in getting a follow up dental appointment to extract the tooth and begin restoration of her other teeth. Together, we were able to prevent something dangerous from progressing to deadly. Ideally, we want to prevent this kind of dental emergency from ever happening, by educating parents about protocols for prevention and getting every child established in a dental home no later than by age one."

Wu Yee

Wu Yee Children's Services is a Head Start location in Chinatown. SFDHS works with area health education programs to provide the children served there with free dental screenings, education and fluoride varnish. Wu Yee follows up to ensure continued evaluation and care.

HIV+ Focus and Education at Tenderloin Health Center

SFDHS members volunteer on an ongoing basis at the Tenderloin Health Center, which received a federal "special projects of national significance" grant to increase access to oral health care for uninsured and underinsured people living with HIV and AIDS. The Tenderloin District is home to over 2,000 residents who are unstably housed, live with HIV/AIDS and have multiple diagnosed addictions. Reported barriers to care in this population are affordability of care, reluctance of providers to treat HIV-positive patients, inability to find care, not valuing or desiring oral health care, and fear of pain.

At the Tenderloin Health Center, poor oral health damages participants' self esteem. Among the comments from those receiving care were

"It's embarrassing to date someone with no teeth or [no] dentures."

"It definitely affects getting a job, especially if you have to work with customers."

"Because you can't chew, you have to watch what you eat, and you also have digestion problems."

"If you have meth mouth or crack mouth, people know and judge you. I judge, myself, because I know."

Project Homeless Connect

Project Homeless Connect[TM] (PHC) was created as a single location where non-profit medical and social service providers can collaborate to serve the homeless of San Francisco with comprehensive, holistic services. SFDHS volunteers with the San Francisco Department of Public Health and the University of the Pacific Arthur A. Dugoni School of Dentistry to provide oral screening and services including prophylaxis.

Foster Parent Oral Health Education

SFDHS works quarterly with new foster families at a San Francisco Department of Public Health program called Options for Recovery. Many of the fostered children are from homes where parents are affected by drug use. This program targets the foster parents of 0- to 5-year olds, educating them about the importance of preventing dental disease and protecting the oral health of their kids for a lifetime. SFDHS has also involved dental hygiene students from Carrington College California-San Jose Campus in this project.

SFSU School of Nursing Revised Education Curriculum

After three years incorporating didactic and practicum education in Early Childhood Caries to San Francisco State University (SFSU) School of Nursing, SFDHS and the San Francisco Department of Public Health were approached by Larry Vitale, professor at SFSU, for assistance in developing an oral health curriculum within a revised nursing curriculum.

The project is ongoing. According to SFDHS's Long, "With a shift from acute care to community-based learning, the program should represent a scaffolding approach, beginning with the basic concept of healthy patients and building from there. SFDHS is thrilled to be a part of this new educational program that we believe will bring improved oral health to many, many more."

Pre-Dental Society at San Francisco State University

This club for undergraduate dental students at SFSU was developed to provide its members opportunities through community outreach, shadowing programs and dental education. SFDHS includes the society regularly in its outreach programs to underscore for them the importance of dental hygienists to dentistry now and in the future.

San Francisco Children's Dental Health Committee

For over 25 years, SFDHS has served on this committee, which also includes the San Francisco Department of Public Health and many area health care associations and educational programs. Its charge is to coordinate children's oral health events throughout the city, sharing information and resources as needed. Currently, the committee is working closely with the San Francisco Dental Society, the University of California-San Francisco and University of the Pacific pediatric dental departments, the San Francisco Unified School District, and the San Francisco Department of Public Health to establish dental homes within general dental practices by children's first birthdays by drafting a letter to all San Francisco general dentists.

California Dental Hygienists' Association "Adopt a Skilled Nursing Facility"

The California Dental Hygienists' Association (CDHA) received the Wm. Wrigiey Jr. Company Foundation Community Service Grant for its components to "adopt" an in-service skilled nursing facility. CDHA provided materials to each component, including a DVD/CD and a CD. SFDHS has made several contacts at different facilities in San Francisco, but to date has not successfully teamed with a skilled nursing facility.

"The current rehabilitation and health care center we are talking to has over 200 nursing staff, 90 percent of whom are certified medical assistants," Long said. "The facility has both long-term residents and short-term care stays of two to three months. SFDHS is working hard to implement CDHA's Public Health Project."

This special feature was compiled by ADHA staff from comprehensive notes contributed by Michael 3. Long, RDH, a member of ADHA's Diversity Committee and the San Francisco Dental Hygiene Society.

* For More Information

"Oral Health Status of San Francisco Public School Kindergarteners 2000-2005" by Lisa Chung and others

www.sanfranciscodhs.org/Chungl.pdf

"Improving Access to Oral Health Care for Vulnerable and Underserved Populations"

www.iom.edu/Reports/2011/Irnprovtng-Access-to-Oral-Health-Care-for-Vulnerable-and-Underserved-Populations/Report-Brief, aspx

Wu Yee

www.wuyee.org/about/history/

http://sfheadstart.org/

Tenderloin Health

http://www.tlhealth.org/

Project Homeless Connect

www.projecthomelessconnect.com/

CDHA 2011-2012 Public Health Project: Adopt a Skilled Nursing Facility

www.dentalstudents.com/ePOS/form=item.html&item= 244&store=211
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Title Annotation:special feature
Publication:Access
Geographic Code:1U9CA
Date:Apr 1, 2012
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