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Communicating the Role of Oral Health on Pregnancy Outcomes in Rural Kentucky

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Collaborating Sights Center for Oral Health Research at ... of COD Dental Public Health Dental ... KY CARAT Diabetes and oral disease link Early ... – PowerPoint PPT presentation

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Title: Communicating the Role of Oral Health on Pregnancy Outcomes in Rural Kentucky


1
Communicating the Role of Oral Health on
Pregnancy Outcomes in Rural Kentucky
  • Sharlee Shirley Burch, RDH, MPH
  • Judy Skelton, RDH, PhD
  • MR Mullins, DMD, MPH

University of Kentucky College of Dentistry
2
The Value of Partnerships
  • Health Education through Extension Leadership
    University of Kentucky College of Agriculture
  • Kentucky Consortium for Applied Research and
    Treatment University of Kentucky College of
    Dentistry

3
Health Education Through Extension Leadership
  • Addressing the health issues of Kentuckians
  • Bridging people, resources, ideas and actions
  • Outreach, education and research
  • Formal collaborations with long term partnerships

4
HEEL PROGRAM GOALS
  • Build community capacity to improve health
  • Educate consumers to make informed health choices
  • Educate and empower individuals and families to
    adopt healthy behaviors and lifestyles

5
University of Kentucky College of Dentistry
Division of Public Health Dentistry
  • Tackling the Epidemic of Oral Disease
  • Beyond the Dental Professional
  • A History of Collaboration

6
A track record for thriving partnerships
  • Cabinet for Health and Family Services
  • Tobacco Prevention Program
  • Ronald McDonald Charities
  • Fayette County Public Schools
  • Pikeville School of Osteopathic Medicine
  • College of Public Health
  • College of Medicine
  • Area Health Education Centers
  • Family Resource Centers
  • State and Local Health Departments

7
Agriculture and Dentistry Not so Strange
Bedfellows
  • Health Education Through Extension Leadership
    Project
  • Chronic Disease Education diabetes, heart
    disease, obesity, cancer
  • Oral health linkages
  • Economic Development

8
Oral Health Wellness and Disease Prevention
Program a HEEL Partnership
  • Collaborative projects
  • Public education
  • Public policy
  • Applied research
  • Service programming
  • Technical assistance
  • Instruction

9
The Outreach and Research Connection KY-CARAT
10
KY CARATKentucky Consortium for Applied Oral
Health Research and Treatment
11
Purposes
  • provide an infrastructure for educating dental,
    medical and health professionals
  • provide state-of-the-art clinical care and
    education to patients in communities
  • enable the development of outreach research
    capabilities in rural regions of the
    Commonwealth.

12
Purposes (cont.)
  • provide an economic impact by
  • decreasing expenditures for major/heroic oral
    health care of children and adults
  • focusing oral health dollars for regional
    implementation of preventive and early
    intervention strategies
  • providing an economic stimulus to the regional
    sites through creation of jobs
  • increasing oral health care access, thus
    broadening the participation and generating a new
    funding base that remains and/or flows into the
    regions.

13
Results and Benefitsof KY CARAT
  • Infrastructure development
  • Training
  • Research capacity
  • Healthier Kentuckians!!

14
Collaborating Sights
  • Center for Oral Health Research at the University
    of Kentucky in Lexington (Central Kentucky)
  • The Center for Rural Health in Hazard, KY
  • Mountain Comprehensive Health Corporation
    facility in Whitesburg, KY (Eastern Kentucky)
  • St. Clair Hospital in Morehead, KY (Northern
    Kentucky)
  • Trover Foundation in Madisonville, KY (Western
    Kentucky)

15
Areas of Focus
  • Preterm low birth weight babies
  • Early childhood caries
  • Diabetes and oral disease link

16
Background on Preterm Low Birth Weight Babies
  • The rate of preterm/low birth weight (PTLBW)
    infants in the U.S. has not significantly
    decreased during the last 3 decades
  • Spontaneous preterm births account for 10 of all
    live births in the US and is a predominant cause
    of perinatal morbidity and mortality
  • These rates tend to be highest in underserved
    rural populations

17
Preterm Low Birth Weight Babies
  • Cost to the government between 1.4 and 2.6
    billion annually in Medicaid and Aid to Families
    with Dependent Children
  • It is estimated that an additional 6.4 to 12
    billion dollars cost to society as a result of
    both short term and long term care
  • In Kentucky gt5,000 PTLBW occur annually with an
    estimated acute care cost of nearly 40,000/birth

18
Oral Health and PTLBW
  • periodontal (gum) disease has been implicated as
    a contributing factor to an increased incidence
    of PTLBW
  • periodontal infection
  • periodontal pathogens
  • low-level, chronic bacteremia release
    of chemical mediators
  • cross placenta
  • initiate labor

19
Oral Health and PTLBW
  • Periodontal disease is preventable and treatable
  • Cost to maintain periodontal health is minimal
    when compared to the costs attributed to negative
    birthing outcomes
  • The potential reduction of cost to society,
    impact on family structure, and prevention of
    disease related to preterm birth validate the
    need to clarify the association between
    periodontal disease and preterm birth

20
Oral Health Wellness and Disease Prevention
Program HEEL Contribution to KY CARAT
  • Oral health resources for each community on
    pregnancy and oral wellness
  • Training of Extension Agents on oral health and
    pregnancy outcomes for spreading knowledge to
    at-risk moms in rural communities
  • Community based outreach and education on oral
    health and pregnancy

21
The Model for Outreach and Service Centering
Pregnancy Reaching Rural Women - Project site
Trover ClinicWomens Center Madisonville,
Kentucky
22
Centering Pregnancy
  • routine, individually-based prenatal care is
    abolished
  • replaced by a system that provides complete
    prenatal care to groups composed of 8-10 women of
    similar gestational age
  • incorporates the three components of prenatal
    care risk assessment, education, and support
    in a unified format

23
Centering Pregnancy
  • encourages the women to take responsibility for
    their own health
  • at each visit, standard prenatal risk assessment
    is followed by an educational session using a
    discussion format
  • free exchange among the group members is
    encouraged

24
Centering Pregnancy
  • an atmosphere of mutual support is developed
  • more efficient and cost effective
  • additional peer-support occurring within these
    maternal networks

25
Centering Pregnancy with Smiles
  • Adaptation of the Centering Pregnancy model
  • Designed to create an integrated oral/medical
    health education and an intervention model

26
Centering Pregnancy with Smiles
  • Integrated educational units
  • Treatment to control oral infections
  • Self-assessment of oral diseases

27
Centering Pregnancy with Smiles
  • Oral diseases
  • Plaque control and disease prevention
  • Relationship of nutrition oral health
  • Oral anatomy and eruption patterns
  • Maintaining babys oral health

28
Formative Research The Process of Centering
Pregnancy in Madisonville Kentucky
29
In the Beginning
  • 2 days, possibly two groups
  • Slow, ramp up process
  • Hiring a Registered Dental Hygienist
  • Equipment and material needs
  • Scheduling and Billing
  • Will this model work???

30
Currently
  • Groups every day!
  • Several groups a day!
  • RDH works full time with educating groups and
    serving pregnant moms!
  • Dental chair and equipment housed in the Center!
  • Scheduling and Billing in process!
  • Is this model working???

31
Project Completion Goal Early 2007
  • Centering Pregnancy with Smiles continues on
    large scale basis
  • Continued tweaking of project
  • Data Gathering
  • Continued Community Education and Outreach

32
Early Findings
  • Rural Women in Kentucky will accept group
    prenatal care
  • Rural Women in Kentucky will accept dental
    treatment during pregnancy
  • Rural Women in Kentucky are engaging with each
    other and providers and learning more about their
    bodies and their babies

33
Questions/Comments?Thank you!
34
Communicating the Role of Oral Health on
Pregnancy Outcomes in Rural Kentucky
  • Sharlee Shirley Burch, RDH, MPH
  • Judy Skelton, RDH, PhD
  • MR Mullins, DMD, MPH

University of Kentucky College of Dentistry
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