Explorer 2013

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Ostrow school of dentistry of usc

Oral Healthcare: Filling In the Gaps w ords by is a a c s u n a nd c athe r ine tan Dr. Roseann Mulligan, the Associate Dean of Community Health Programs and Hospital Affairs here at the Ostrow School of Dentistry of USC, is an expert in dental public health. One of her most recent publications, The Impact of Oral Health on the Academic Performance of Disadvantaged Children published in the September 2012 American Journal of Public Health, is the first study to determine the impact of oral health on academic achievement. The study provides a link between oral health and social outcomes, such as school and workdays missed due to dental problems. It stemmed from an earlier study, the Oral Health Needs Assessment Plan (OHNAP), which aimed to describe the oral health of underprivileged children in Los Angeles County. OHNAP was funded by First 5 LA, The Annenberg Foundation, The California Endowment, and The California Wellness Foundation. Each of these organizations provided funding in hopes to incorporate the findings into their strategic plans for future programs aimed to improve oral health in local communities. OHNAP was conducted on a stratified sample of over 2,300 children and students, ages 2 to 5, 6 to 8, and 14 to 16 years, who were identified with being disadvantaged by participation in Women, Infants, and Children centers, Head Start preschools or attendance at elementary or high schools with at least 50% ethnic minorities and at least 62% receiving the reduced or free meals program. OHNAP confirmed the overwhelming need for oral health care in LA County by discovering the prevalence of untreated dental caries to be 73%, with a total of 81% needing dental care. The more recent sub-study is an influential piece in the role of oral health on the development of children. The study shows that oral

health does in fact impact academic performance. A study of this depth and magnitude was the first of its kind, which Dr. Mulligan acknowledged might be due to the difficulty of conducting and organizing its many components. Some of the challenges included obtaining approval from several Institutional Review Boards, meeting objectives of several funders, gaining permission from the Los Angeles Unified School District which is the 2nd largest in the US, and parents for participation in the study, performing dental examinations by USC dentists and collecting records for thousands of children from 59 different sites. The most notable finding from the elementary and high school-aged students, was that students with toothaches were 4 times more likely to have a low grade point average. Also, 11% of students with inaccessible dental care missed school compared with only 4% of those with access. Furthermore, for every 100 elementary and high school-aged students, 58 and 80 school hours were missed a year, respectively, due to dental problems. These problems also affect the student’s families. Parents of students with toothaches are 4 times more likely to miss work. The findings of these studies are indicative of the importance of addressing the epidemic of dental caries in Los Angeles County at the school, community, health system, and government levels. The Ostrow School of Dentistry aims to address these issues by providing dental education and care through many different community programs. One notable program is Mobile Dental Clinics where USC students, staff, and faculty volunteer their time to travel to communities all over Southern California to provide comprehensive care for those in need. According to Dr. Mulligan,

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“It’s all about caring for kids falling through the safety net.” By traveling to areas of high need, the objective is to decrease the access to care issues that disadvantaged children face. While continuing to care for school-aged children, it is also necessary to focus more attention on those even younger. In an upcoming project, Dr. Mulligan and Community Health Programs are planning to partner with First 5 to expand education and oral care programs for children ages 5 and under to help maintain proper oral health and prevent dental caries. By identifying issues in oral health through research, providing care through community programs, and encouraging prevention through education, the dental community can make an incredible impact on children. It is the role of the health care providers to act as leaders in eliminating disparities in oral health. We as dental professionals must strive to fill the gaps in care and education to meet the needs of disadvantaged children in our communities. References: 1. Seirawan, H., Faust, S., & Mulligan, R. (2012). The impact of oral health on the academic performance of disadvantaged children. American Journal of Public Health. 102(9): 1729-1734. 2. Mulligan, R., Seirawan, H., Faust, S., & Barzaga, C. (2011). Dental caries in underprivileged children in Los Angeles. Journal of Health Care for the Poor and Underserved. 22: 648-662. 3. Mulligan, R. & Seirawan, H. (2010). The oral health baseline needs assessment of underprivileged children. The Children’s Dental Health Project of Los Angeles County.


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