Addressing Oral Health Disparities...

How the School of Dentistry's Detroit Dental Health Project is Making a Difference in the Lives of Children and their Caregivers

Educating Parents and Caregivers

The information gathered at homes and apartments helped researchers document the magnitude of the oral health problem in Detroit as well as learn more about the oral health habits of children, parents, and caregivers.

But the visits also offered something more – an opportunity to educate.

“We talked to adults about the direct role they have in making sure their child gets the best oral health care possible,” Hicks said. “We wanted to empower them by giving them important and useful information that would make a difference in a child’s life.”

That was especially true, she said, talking to parents with very young children, usually four, five, and six months old.

“We alerted parents about when baby teeth might erupt and what to expect when they do, how to avoid baby bottle decay, the importance of rinsing and wiping an infant’s mouth, and other important oral health concerns,” she said.

The information gathered during Wave I was a stepping stone that led to the creation of a DVD that demonstrated good oral health care habits and practices.

Motivational Interviewing

But before a script was written and filming began, more questions were asked of those participating in the oral health survey. The technique involved “motivational interviewing.”

In essence, the motivational interviews were designed to put parents in direct control of a child’s oral health by asking them about a particular problem or concern and then learning what to do about it.

“We asked the adults, point blank, ‘what do you need to know, or what would it take, to get you to provide better oral health care for your child’?” said Lucille Smith of the Voices of Detroit Initiative.

“It was extremely important for parents and caregivers to buy-in to the idea that they have a major role in the oral health of their children,” she said. “We showed them some simple things they should do, including how to care for baby teeth, how to check an infant’s mouth every day, showing their children how to brush their teeth, or watching their children to make sure they brushed properly, and praising them for a job well done.”

Those efforts paid off.

Information from these encounters was then used to write a script for a video about why proper oral health care is so important. After filming and editing, more than 1,000 DVDs were produced and given to adults.

In follow-up interviews, Ismail and those involved in the research learned something interesting.

Parents and caregivers who participated in the motivational interviews and who also watched the video were almost twice as likely to follow through and apply what they saw than those who did not.

Parents in Control

During the third wave of studies (March 2007 to September 2007), parents and caregivers used the information from the video to take greater control of their child’s oral health.

That included closely monitoring a child’s consumption of food and sugary drinks, supervising their teeth brushing and regularly visiting a dentist.

“The children we saw initially back in 2002 are now between five and eleven years old,” Hicks said.

“We’re hopeful that the parents and caregivers of these children have been actively seeking out dental care.” [Editor’s note: As this article was being written, the results of the third wave of studies were still being reviewed.]

Other Notable Findings

In addition to some of the major findings noted earlier, there were some other discoveries about other reasons for oral health disparities.

Sometimes they exist within a neighborhood, according to Hicks, because of the beliefs, behaviors, and diets of parents or caregivers. Included in that category is a fatalistic view of oral health some adults expressed that “cavities in baby teeth don’t matter since they fall out anyway.” [DentalUM, Fall 2007, pages 68-69.]

Dental phobia may also play a role. Smith, of VODI, said that attitudes are often passed down from generation to generation that have a detrimental effect on the oral health of children and, ultimately, their offspring.

Another notable discovery was a factor Hicks refers to as “religiosity.”

“People who go to church or have strong faith seem more likely to have better oral health than those who don’t,” she said. That was clear when a group of men were encouraged by one church’s educator to get an oral cancer screening at the DDHP clinic on West Grand Blvd. Hicks said social support networks among church members may help to reinforce good behavior while rejecting bad ones.

Smith, of VODI, said the role of faith-based organizations in oral health “may seem to be relatively new, but is probably an outgrowth of other things they do such as providing day care services or offering free blood pressure screenings.”

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