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Bright Futures in Practice: Oral Health. What Is Bright Futures?. Bright Futures is A vision A philosophy A set of expert guidelines A practical developmental approach to providing health supervision. Bright Futures Guidelines.

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What Is Bright Futures?

Bright Futures is

  • A vision

  • A philosophy

  • A set of expert guidelines

  • A practical developmental approach to providing health supervision

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Bright Futures Guidelines

The first edition of the Bright Futures guidelines was published in 1994.

A second edition was published in 2000.

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Bright Futures in Practice Series

  • Oral Health

  • Nutrition

  • Physical Activity (forthcoming)

  • Mental Health (forthcoming)

  • Children with Special Health Care Needs (forthcoming)

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Bright Futures in Practice: Oral Health Manual


  • Coordinate services between dental professionals and health professionals

  • Assess risk factors and protective factors

  • Measure oral health outcomes

  • Make oral health care accessible

  • Provide early intervention

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...Bright Futures in Practice:Oral Health Manual

  • Designed for healthprofessionals, this guideprovides:

    • An overview of preventive oral health supervision for children andadolescents from birthto age 21

    • Risk assessment

    • A model for appropriateoutcome measures.

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….Bright Futures in Practice:Oral Health Manual

  • Introduces the concepts ofindividualized, cost-effective risk assessment

  • Emphasizes the contributionand partnership of dentalprofessionals, other healthprofessionals, and families inoral health supervision.

  • Stresses the importanceof early oral healthintervention for children.

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Bright Futures Focus - One Question

  • What do children and families need to prevent disease and promote health?

    • Family is focus forhealth supervision.

    • Dental professionals alsohave a larger role in theirpreventive care partnership with families.

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Four Innovations in Oral Health Supervision

  • Contributions of Dental and Nondental Professionals in Oral Health Provision

  • Early Intervention

  • Risk Assessment

  • Oral HealthOutcomes

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How Bright Futures in Practice: Oral Health is Organized

  • Section I – Oral Health Supervision Guidelines

  • Section II – Risk Assessment

  • Section II – Measuring Outcomes

  • Section IV – Making Oral Health Supervision Accessible

  • Section V – Essentials ofOral Health

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Section I:Five Developmental Periods

  • Prenatal

  • Infancy

  • Early Childhood

  • Middle Childhood

  • Adolescence

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Section II: Risk Assessment

  • Dental Caries

  • Periodontal Disease

  • Malocclusion

  • Injury

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Section III: Measuring Outcomes

Must be:

  • Comprehensible

  • Attainable

  • Measurable

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Section IV: Making Oral Health Supervision Accessible

  • Financial Concerns

  • Cultural Differences

  • Special Health CareNeeds

  • Fear of Discomfort/Infections

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Section V:Essentials of Oral Health

  • To provide background on key points concerning oral conditions/diseases.

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To Use Effectively:

  • Tailor to the individual needs of the children and the community.

Dental OfficeWoodlawn Elementary SchoolCarroll County School Division, Va.

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...To Use Effectively:

  • Recognize the Culture

  • Competing HealthConcerns

  • Health Behavior

  • Social Conditions

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ResourcesDental Services

Dental services are provided in the multiple localities to pre-school and school age children who meet eligibility requirements.

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...ResourcesFluoride Mouthrinse Program

Children "Swish and Spit" for one minute once a week in a school fluoride mouthrinse program in Goochland, Virginia.

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...ResourcesHealth Education

A public health hygienist teaches children about their"first trip to the dentist."

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  • Brochures Developed by VDH:

    • Dental Sealant "Seal Away Tooth Decay"

    • Baby Bottle Tooth Decay "Baby's First Step to Healthy Teeth"

    • School Fluoride MouthrinseProgram "Swish Away Decay"

    • Why Floss?

    • Tips for Healthy Smiles: Prevention/Care/Education(Public Health Dentistry in VA)

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...ResourcesNational Maternal and Child Oral Health Resource Center


  • Publications

    • Fact Sheets

    • Resource Materials

    • Practice and Policy Guidelines

    • Conference Proceedings

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Oral Health in America

  • “Silent Epidemic”

Oral Health in America:A Report of the Surgeon GeneralMay 2000

David Satcher, M.D., Ph.D.Assistant Secretary for Health and Surgeon GeneralOffice of Public Health and Science

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Dental Caries (Tooth Decay)

  • The Single Most CommonChronic ChildhoodDisease

    • 5 Times More Common Than Asthma

    • 7 Time More Common Than Hay Fever

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Children and Oral Health

  • This preventable health problem begins early:

    • 17% of children aged 2-4 years have already had decay.

    • By the age of 8, approximately 52% of children have experienced decay

    • By the age of 17, dental decay affects 78% of children.

*Centers for Disease Control and Prevention

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...Children and Oral Health

  • Studies by VDH show that 45% of children ages 5 to 18 have dental decay.

  • Children on free or reduced lunch have higher disease rates.

  • Only 38% of children have their filling needs met.

*VDH Studies 1950-1998

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Oral Cancer

  • Each year, more than 30,000 new cases of cancer of the oral cavity and pharynx are diagnosed and over 8,000 deaths due to oral cancer occur.

  • Preventing high risk behaviors

    • Cigarette, cigar or pipe smoking

    • Use of smokeless tobacco

    • Excessive use of alcohol

*Centers for Disease Control and Prevention

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Virginia Oral Health Profile

  • Dental Visits

    • 71.9% of the population visited the dentist or dental clinic within the past year.

  • Teeth Cleaning

    • 73.1% of the population had their teeth cleaned by a dentist or dental hygienist within the past year.

  • Complete Tooth Loss

    • 28.5% of the population 65+ have lost all of their teeth.

  • Fluoridation Status

    • 72.1% of the population on public water systems is receiving fluoridated water.

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Dental Disease Trends

  • In 1993

  • Children 5 to 17:

    • 632,000 school days were lost.

  • Adults > 18:

    • 3.6 million Work Days were lost.

  • *National Center for Health Statistics

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...Dental Disease Trends

  • The rate of progression of diseases has slowed.

  • The substantial risk for new dental decay may extend beyond early adolescence.

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...Dental Disease TrendsNew Studies

New studies indicate that periodontal disease may be linked with:

  • Cardiovascular Disease

  • Diabetes

  • Premature Births

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Dentist to Population Ratio:

  • 1 general dentist to 2,536 people.

  • 43 out of 136 cities and counties were identifiedas having less than dentist per 5,000 people.

*Item 311-Report of Availability of Dental Services in Virginia

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Gaps in Access to Care

  • Children with or without dental insurance and non provider

  • Special Populations

    • Elderly/Nursing Home

    • Head Start

    • Disabled

    • Adult Indigent

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Bright Futures: Oral Health

No matter how many brushes or paints that we use…each canvas will be different.