Coordinated by: Bonnie Bruerd, Drph and Kathy Phipps, Drph april 2007

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Design a program plan
The program plan should be customized to the community and encourage ongoing development of strategies and education materials tailored to the population. It should also include an evaluation plan that can be used to monitor the success of the program. You will probably want to collect information at the beginning of your program and then every year or two, so you can see if you are making a difference. (See “Community-Based Program Planning”)

ECC Survey Form

Name of examiner___________________________ Date ___________

Location of screening _____________________________________
Total Treatment

Name Age # decayed needed

Note: For “Total # decayed”, write the number of primary teeth that are decayed, restored, or extracted due to decay.

Risk Assessment for Infants and Toddlers

Low Risk

No active carious lesions at exam

Good oral hygiene habits

Shallow, coalesced grooves

No white spot lesions

Doesn't sleep with a bottle

Oral hygiene instruction

Fluoride toothpaste &

Assess for systemic supplements

6-12 month recall

High Risk

Any cavitated or white spot lesions
High S. mutans level

Bottle fed beyond 12-14 months

Diet high in refined sugars

Family caries history

Inadequate exposure to fluoride

Inadequate saliva flow

Oral hygiene instruction

Fluoride toothpaste

Assess for systemic supplements
Sealants (behavior permitting)

Fluoride varnish treatments

Restore any carious lesions*

Dietary counseling.

Discourage bottle use at bedtime.

3-6 month recall

*Consider using atraumatic restorative technique (ART) to restore primary teeth.

Increasing Access for Infants and Toddlers: What Works?
Keep in mind that 2 years old is too late!

  • Through your clinical data system or immunization program, obtain a list of all one year olds and send them a birthday card along with a ticket for a dental screening, toothbrushes, toothpaste, tippee cups, and other goodies.

  • Work with well-baby and immunization programs to encourage referrals to the dental clinic for a screening. Some clinics are applying fluoride varnish treatments on-site at these programs while others have trained the medical staff to apply fluoride varnish.

  • Work with WIC to establish a referral system for one-year-old children.

  • Work at making your dental clinic family-friendly with as few barriers as possible to make it easy for families with young children to visit your clinic.

  • Use media sources such as radio, local TV stations, and newspapers or newsletters to promote brief dental appointments for one-year-old children.

  • Set up blocks of time each week or month when you can see infants on a walk-in basis. You might coordinate this time block with an immunization clinic or another event that draws families of young children into the clinic.

Community-Based Program Planning: POARE Model

The following model can assist you in program planning, evaluation, and grant writing. On the next page, you will find a form that will get you started on your very own oral health promotion program plan. Good Luck!

Problem: Decide which oral health problems are of the greatest concern in your community. You can do this by assessing your screening results. You will also want to take into account the major health problems in your community. For instance, if diabetes is a major health problem in you community, then you might want to focus on limiting pop and other sweetened beverages. Also take into consideration the health problems that parents are most concerned with.

Objectives: Write one or more objectives that address what you can realistically achieve. Try to make each objective measurable. Ask yourself, how will I know if we achieved this objective?

Activities: What actions or activities will you implement to reach your objectives? This could include educating parents, making an appointment to talk to the dentist, purchasing educational materials, etc.

Resources: How much money and other resources will you need to achieve your plan? Items might include personnel, outside services, materials, funding and approvals. Start out by thinking big. You can make reductions later if you have to. The people who get their budget increased have positive attitudes about money. You have to think big and play to win. Don’t be afraid of money and don’t be afraid to use it.

Evaluation: Put simply, how will you know if you have met your objectives? Keep your evaluation plan simple and if possible, measurable.

Health Planning Worksheet

Health Problem


Activities Who When


Evaluation and Follow-up

Additional Resources

Northwest Portland Area Indian Health Board website:

This website will give you information about the Dental Support Center and provides links to other good dental websites.

IHS Division of Oral Health website:

The IHS website has an Oral Health Promotion/Disease Prevention page that includes the HP/DP program objectives, trainings, communications, information on

prevention programs, and education materials that you can download and print.
To download AI/AN education materials:

You will also find links in the Resource Guide to many other good websites.

IHS Head Start Program website:

National Head Start Oral Health Resource Center

Oral Health in America: A Report of the Surgeon General published by the

Department of Health and Human Services in 2000 is the first-ever Surgeon General's Report on Oral Health.


  1. The 1999 Oral Health Survey of American Indian and Alaska Native Dental Patients: Findings, Regional Differences and National Comparisons. DHHS, IHS Division of Oral Health.

  2. Chen MS, Andersen RM, Barmes DE, Leclercq MH, Lyttle CS. Comparing oral health care systems: A second international collaborative study. Geneva: World Health Organization; 1997.

  3. Berkowitz RM. Acquisition and transmission of mutans streptococci. J Calif. Dent. Assoc. 2003; 31:106-9.

  4. Featherstone JD. Caries balance: the basis for caries management by risk assessment. Oral Health Prev Dent. 2004; 2:259-64.

  5. Recommendations for using fluoride to prevent and control dental caries in the United States. Centers for Disease Control and Prevention MMWR. 2001; 50(RR-14):1-42

  6. Beltran ED, Burt BA. The pre-and post-eruptive effects of fluoride in the caries decline. J Public Health Dent 1988;48:233-40.

  7. Hamilton IR. Biochemical effects of fluoride on oral bacteria. J Dent Res 1990;69:660-67.

  8. Bowden GHW. Effects of fluoride on the microbial ecology of dental plaque. J Dent Res 1990;69:653-59.

  9. Burt BA an CDC. Fluoridation of drinking water to prevent dental caries. MMWR Morb Mortal Wkly Rep 1999;48:933-940.

  10. U.S. Department of Health and Human Services. Review of fluoride benefits and risks: report of the Ad Hoc Subcommittee on Fluoride. Washington: U.S. Department of Health and Human Services, Public Health Service; 1991.

  11. Ismail AI. Fluoride supplements: current effectiveness, side effects and recommendations. Community Dent Oral Epidemiol 1994 Jun;22(3):164-72.

  12. World Health Organization. Fluorides and oral health. Geneva: The World Health Organization; 1994.

  13. Adair SM. The role of fluoride mouthrinses in the control of dental caries: a brief review. Pediatr Dent 1998 Mar-Apr;20(2):101-114.

  14. Ripa LW. A critique of topical fluoride methods in an era of decreased caries and increased fluorosis prevalence. J Public Health Dent 1991 Winter;51(1):23-41.

  15. Stamm JW, Bohannan HM, Graves RC, Disney JA. The efficiency of caries prevention with weekly fluoride mouthrinses. J Dent Educ 1984 Nov;48(11):617-26.

  16. Sterritt G, Frew RA, Rozier RG, Brunelle JA. Evaluation of a school-based fluoride mouthrinsing and clinic-based sealant program on a non-fluoridated island. Community Dent Oral Epidemiol 1990 Dec;18(6):288-293.

  17. Eklund SA. Dentistry, Dental Practice, and the Community. 4th ed. WB Saunders Co. 1992.

  18. Ripa LW. Sealants revisited: an update of effectiveness of pit and fissure sealants. Caries Res 1993; 27:77-82.

  19. Mertz-Fairhurst AJ, et al. Ultraconservative and cariostatic sealed restoration: results at year 10. JADA 1998;129:55-66.

  20. Wagoner WF, Siegel M. Pit and fissure sealant application: updating the technique. JADA 1996;127:351-61.

  21. Birkhed D. Behavioral aspects of dietary habits and dental caries. Caries Res 1990;24:27-35.

  22. Edmondson IMS. Food composition and food cariogenicity factors affecting the cariogenic potential of foods. Caries Res 1990;24:60-71.

  23. Consensus: Oral health effects of products that increase salivary flow rate. J Am Dent Assoc 1988;116-757.

  24. Walsh MM, Heckman B. et al.: Effect of a rubber cup polish after scaling. "Dental Hygiene" 1985; 59(11):494-498.

  25. Waring MB, Horn ML, et al.: Plaque reaccumulation following engine polishing or tooth brushing—a 90-day clinical trial. "Dental Hygiene" 1988;62:282-285.

  26. Tinanoff N, Wei SHY, Parkins FM: Effect of a pumice prophylaxis on fLuoride uptake in tooth enamel. "Journal of the American Dental Association" 1974;88:384-389.

  27. Biller IR, et al. Enamel loss during a prophylaxis polish in vitro. J Int. Assoc. Dent. Child., 11:7-12, June 1980.

  28. Clarke P and Seabrook I. Effectiveness of self prophylaxis and rubber cup prophylaxis for improving pedodontic home care. Cand. Dent. AJ 41:511-4 September 1975.

  29. Holve S. Fluoride varnish applied at well child care visits can reduce early childhood caries. IHS Primary Care Provider. October 2006.

  30. Ramos-Gomex FJ et al. Implementing an infant oral care program. J Calif. Dent. Assoc. 2002; 30:752-6.

  31. Donly, KJ. Fluoride varnishes. J Calif. Dent. Assoc. 2003; 31:217-19.

  32. Weintraub JA. Fluoride varnish for caries prevention: comparisons with other preventive agents and recommendations for a community-based protocol. Special Care in Dentistry. 2003; 23(5):180-6.

  33. Anderson M. Chlorhexidine and xylitol gum in caries prevention. Special Care in Dentistry. 2003; 23:173-6.

  34. Autio JT and Courts FJ. Acceptance of the xylitol chewing gum regimen by preschool children and teachers in a Head Start program: a pilot study. Pediatr Dent. 2001; 23:71-74.

  35. Hayes C. The effect of non-cariogenic sweeteners on the prevention of dental caries: A review of the literature. J Dent Educ. 2001; 65(10):1106-9.

  36. Lynch H. and Milgrom P. Xylitol and dental caries: an overview for clinicians. J Calif. Dent. Assoc. 2003; 31:203-9.

  37. Kanellis MJ. Caries risk assessment and prevention: strategies for Head Start, Early Head Start and WIC. J Public Health Dent. 2000: 60(3):210-17, discussion 218-20.

  38. Kanellis M, et al. S mutans suppression in preschool children using 1% chlorhexidine gel. Abstract at

  39. Scheer M and Phipps K. Compliance with chlorhexidine and xylitol among high risk mothers. Abstract, J Public Health Dent. 2003; 63(Suppl 1):38.

  40. Soderling E, Isokangas P, Pienihakkinen K, et al. Influence of maternal xylitol consumption on mother-child transmission of mutans streptococci: 6-year follow-up. Caries Res. 2001; 35(3):173-77.

  41. Anderson MH. A review of the efficacy of chlorhexidine on dental caries and the caries infection. J Calif. Dent. Assoc. 2003; 31:211-14.

  42. Xiong X, et al. Periodontal disease and adverse pregnancy outcomes: a systematic review. BJOG: International J of Obstetrics and Gynecology. 2005; 113:135-43.

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