Oral Healthcare Initiative

Dental disease is the number one health problem for children in California. Children with dental decay experience pain, tooth loss, sleep deprivation, learning difficulties, nutrition problems, developmental problems, and medical infections. Children with the most advanced oral disease are found mostly among San Diego County's most vulnerable groups: the low-income, ethnically-diverse, homeless and migrant populations, and children with disabilities.

In April 2005, the Community Clinics Health Network (CCHN) was awarded funding from the First 5 Commission of San Diego to implement the Oral Healthcare Initiative (OHI).

The purpose of the Oral Healthcare Initiative is to increase the number of children from infancy to age 5 in San Diego County who are free from oral health disease. By targeting patients in this age group, as well as pregnant women, CCHN and partner agencies are addressing the growing concern of dental disease among young children. The goals of the initiative are to: 1) Increase oral health screening of children from infancy to age 5 coupled with parent education; 2) Increase the number of children from infancy to age 5 and pregnant women who receive dental exams; 3) Increase the number of children from infancy to age 5 and pregnant women with identified oral health issues who receive appropriate treatment services and/or follow-up; 4) Provide oral health care coordination services such as referral, case management and follow-up to children from infancy to age 5 and pregnant women; 5) Increase the number of parents and other caregivers who are knowledgeable about how to promote children's oral health; and 6) Increase the number of providers who are knowledgeable about how to promote children's oral health.

The need to provide oral healthcare to young children is critical. Twenty-five percent of poor and minority children have not seen a dentist before entering kindergarten. Less than 20 percent of Medicaid eligible children receive a single annual visit.  Children with the most advanced oral disease are found mostly among this county's most vulnerable groups: the poor, American Indians and other minorities, homeless and migrant populations, children with disabilities, and children with HIV.  Poor children have twice as much dental caries than their affluent counterparts.  An infant is 32 times more likely to have dental caries if they are of low socioeconomic status, have mothers with a low education level, and consume sugary foods. Dental caries is highly correlated with low income, limited education, and social disadvantage, much like asthma, learning difficulties and social problems.  Dental disease could be an indicator of other pediatric conditions related to inadequate diet and hygiene, and to family living conditions that do not support healthy lifestyles. Chronic dental disease results in diminished growth for toddlers and compromised nutrition, and can take a personal and social toll by wearing down a child's stamina and ambition. 

Fifteen non-profit community health centers operating at over 60 sites participate in this project.  Twelve of the clinics provide prevention, education, care coordination, and treatment services: Comprehensive Health Center, Family Health Centers, Fallbrook Family Health Center, Indian Health Council, La Maestra Community Health Centers, Neighborhood Healthcare, North County Health Services, Operation Samahan, San Diego American Indian Health Center, San Ysidro Health Center, Southern Indian Health Council, and Vista Community Clinic.  Three clinics provide prevention and education services only: Imperial Beach Health Center, Mountain Health and Community Services, and San Diego Family Care.  Rady Children's Hospital of San Diego, and its Anderson Center for Dental Care, provide screenings and education to children with special needs, and tertiary and advanced specialty pediatric dental services. The County of San Diego's Share the Care Dental Health Initiative offers education to childcare providers and community-based organizations. The County Office of Education (COE) SMILES Dental Disease Prevention Program provides education and oral health screenings to pre-school age children. Rady Children's Hospital and other OHI partners are educating general dentists on pediatric dental care, and prenatal care providers and primary care providers are trained about routinely incorporating oral health screenings into patient care.

For more information on the Oral Healthcare Initiative, please contact Kim Thomas, Project Coordinator, at kthomas@ccc-sd.org or (619) 542-4347.