Mouradian Wendy E, Schaad Douglas C, Kim Sara, Leggott Penelope J, Domoto Peter S, Maier Russell, Stevens Nancy G, Koday Mark
Department of Pediatric Dentistry, University of Washington, Seattle 98159, USA.
J Dent Educ. 2003 Aug;67(8):886-95.
Providing oral health care to rural populations in the United States is a major challenge. Lack of community water fluoridation, dental workforce shortages, and geographical barriers all aggravate oral health and access problems in the largely rural Northwest. Children from low-income and minority families and children with special needs are at particular risk. Family-centered disease prevention strategies are needed to reduce oral health disparities in children. Oral health promotion can take place in a primary care practitioner's office, but medical providers often lack relevant training. In this project, dental, medical, and educational faculty at a large academic health center partnered to provide evidence-based, culturally competent pediatric oral health training to family medicine residents in five community-based training programs. The curriculum targets children birth to five years and covers dental development, the caries process, dental emergencies, and oral health in children with special needs. Outcome measures include changes in knowledge, attitudes, and self-efficacy; preliminary results are presented. The program also partnered with local dentists to ensure a referral network for children with identified disease at the family medicine training sites. Pediatric dentistry residents assisted in didactic and hands-on training of family medicine residents. Future topics for oral health training of family physicians are suggested.
为美国农村人口提供口腔保健是一项重大挑战。缺乏社区水氟化、牙科劳动力短缺以及地理障碍，都加剧了美国西北部广大农村地区的口腔健康和就医问题。低收入和少数族裔家庭的儿童以及有特殊需求的儿童面临的风险尤其大。需要以家庭为中心的疾病预防策略来减少儿童口腔健康方面的差异。口腔健康促进可以在初级保健医生的办公室进行，但医疗服务提供者往往缺乏相关培训。在这个项目中，一所大型学术健康中心的牙科、医学和教育教员合作，为五个社区培训项目中的家庭医学住院医师提供基于证据、具有文化胜任力的儿科口腔健康培训。该课程针对出生至五岁的儿童，涵盖牙齿发育、龋齿过程、牙科急诊以及有特殊需求儿童的口腔健康。结果指标包括知识、态度和自我效能的变化；并展示了初步结果。该项目还与当地牙医合作，确保在家庭医学培训地点为确诊疾病的儿童建立转诊网络。儿科牙科住院医师协助对家庭医学住院医师进行理论和实践培训。文中还提出了家庭医生未来口腔健康培训的主题。
