Oral Health Program: Land Manor, Inc.

Sonya Bautista & Anna Nguyen

Lamar Institute of Technology: Dental Hygiene

Sonya Bautista
Anna Nguyen
March 09, 2016
Part I: Oral Health Program
Oral Health Program: Land Manor, Inc.
Description of Site
Land Manor, Inc. Franklin House North was founded in 1969. This organization is
offered to up to 24 women along with specialized female services to women who are pregnant, or
have children, and women who are trying to regain custody of their children. The role of this site
is to provide services to the indigent alcoholic and drug addictive females. Franklin House North
is state funded by the Texas Department of Health Services, Orange County and Jefferson
County Revenue, Texas Department of Assistive and Rehabilitative Services, and Medicaid. The
facility is located on 5670 Concord Rd, Beaumont, Texas. Their contact number is 409-896-5911
(1) (2).
Description of Target Group
The target population consists to up to 24 female adults that are 18 years of age or older
and have a dependent child. Females that do not have children are also welcome to the facility.
The females are an indigent population that are alcohol and drug addicts and in need of a
rehabilitation center. The target population in this facility is in need of parenting skills, building
self-esteem, independence, and empowerment in regards in trying to get their lives together and
recover their children (1) (2).

Description of Staff Population

The Franklin House North has about 18 total staff members at their facility. They have 3
total licensed chemical dependency counselors, 3 counselor interns, and about 12 house
managers. The responsibilities of the licensed chemical dependency counselors are to be able to
educate the women about alcohol awareness, narcotic awareness, basic life skills and hygiene.
The responsibilities of the counselor interns are to assist the licensed chemical dependency
counselors with lesson plans and daily education activities with the group. The responsibilities of
the house managers are to maintain, a clean, sanitary, and comfortable environment for the
members of facility. They are also responsible for prepping, cooking, and serving meals
throughout the day for the members (1) (2).
Descriptions of Services Provided
The counselors of the Franklin House also coordinate all the activities that are carried out
at the facility. These services are focused on and offered to the female population dealing with
substance abuse. Scheduled events for the Franklin House North include Alcohol Awareness, and
Narcotic Awareness for the members housed at the facility. Outpatient Care classes are also
scheduled for the members. The future plans of Franklin House North are to continue the
program to further assist females in need. Women at the facility are expected to wake up at 6
A.M., have classes regarding everything in life, alcohol awareness classes, narcotic awareness
classes, and hygiene classes. Their daily routine ends at 10 P.M. when it is time for bed (1).
Other Pertinent Data
The community water source of Beaumont, Texas is currently 0.70 mg/L for the surface
water. The amount of community water fluoridation is at the optimal level for Beaumont, TX (3).

Information Related to Dental Health

Hygiene classes are offered at the Franklin House North on a daily basis to the women
housed at the facility. These hygiene classes also serve as preventive measures for the women.
Donations are given to the Franklin House from food banks which help promote dental health.
The dental hygiene program from Lamar Institute of Technology has previously presented oral
hygiene programs at Franklin House. The results of these oral hygiene programs have been
successful. Franklin House enjoys having Lamar Institute of Technology dental hygiene students
at their facility. The staff at Franklin House must be knowledgeable and have at least a high
school diploma or GED. The counselors who are in charge of educating the women at Franklin
House must have at least a bachelors degree.
Dental Health Status
1. Dental Caries:
In the National Health and Nutrition Examination Survey, dental caries that are treated or
untreated in adult ages from 20-64 years old have declined from the early 1970s until most
recently in 2004. The prevalence of dental caries in adults 20-64 years old would be that 92%
have had dental caries in their permanent teeth. About 26% of adults in the same age group have
untreated dental decay. The severity of the dental caries would be an average of 3.28 decayed or
missing permanent teeth and 13.65 decayed and missing permanent surfaces. The link between
dental health and socio-economic status is well established which then contributes to untreated
caries (4).
2. Periodontal Disease:

Periodontal disease and dental caries are the two biggest threats to dental health today.
The most recent CDC report provides data including that 47.2% of adults aged 30 years and
older have some form of periodontal disease and of course they all increase with age. Risk
factors also associated with periodontal disease would be smoking, diabetes, poor oral hygiene,
malocclusion, underlying immune-deficiencies, xerostomia from medications, female hormonal
changes, such as with pregnancy or the use of oral contraceptives, and drug abuse. Populations
that are in the lower social class are more likely to smoke, which is another contribution to
untreated periodontal disease causing more complications in the future (5).
3. Oral Hygiene:
With the increased amount of people who are now living longer, the importance of oral
health and a healthy mouth has increased. Over the years, the number of older adults (60 years
and older) who have no dentition has decreased from 31% to 25%. People are now wanting to
keep their teeth longer. Over 40% of poor adults (20 years and older) have at least one dental
decay that has been untreated compared to the non-poor adults. Most adults today show signs of
gingivitis which progress to periodontitis if not treated or maintained to a healthy state. The most
common pain of the mouth or face that is reported by adults would have to be toothaches. Social
disadvantages also cause health disadvantages, which can then affect oral health. Overall, these
different conditions are affected by daily oral hygiene (6).
4. Oral Cancer:
According to the SEER program, about 291, 108 people had oral cavity and pharynx
cancer in the United States in 2012. Each year 11 out of 100,000 men and women present new
cases of oral cancer. Oral cancer is also found twice as more in men than in women. Alcohol and

tobacco are both major risk factors for developing oral cancer. According to NIH, PAR analyses
found about 65 percent of women with oral cancer were from combined alcohol and smoking.
Those who are suspected to have oral cancer and display possible signs and symptoms of oral
cancer should see a dentist or physician. The earlier a person is diagnosed, the more successful
the results. Several cancer treatment options, include medications and radiation, which can be
given to oral cancer patients. Treatment may cause unwanted side effects that may affect the oral
cavity (7) (8).
5. Utilization of Dental Services:
According to the CDC, in the year 2009, 65.9% of women in the United States utilized
dental services while only 57.9% of American men used dental services. More Asian women in
the United States, ages 18-64, had more dental visits than any other race with a percentage of
65.8%. Women, ages 18-64, belonging to both black and white, had the lowest percentage for
having dental visits with a percentage of 45.3%. White women, ages 28 -64 had a higher
percentage rate of 66.3% compared to 48.1% of Hispanics that had dental visits. Those that fell
under the 400% or more poverty level had a higher percentage rate of utilizing dental visits with
a percentage of 77.9% compared to those that fell below 100% poverty level with a percentage
of 42.7% of utilizing dental services (9).
Goal Statement:
To provide the knowledge and skills to improve oral health for the women of Franklin House
North facility.
Objective Statements:
1. Develop a dental health resource lists in the surrounding areas to utilize.

2.
3.
4.
5.

To increase the dental health knowledge of the women by 25%.

To decrease dental plaque by 15%.
To establish a daily routine of proper oral hygiene for the women of the facility.
To incorporate oral hygiene education into the living skill courses in the facility.
Rationale: Review of Literature
It is important to educate these women on oral health education so that they can further

contribute to their overall health throughout the rest of their life. They can also take the
information learned and teach it to their current children or future children and pass on the
importance of oral hygiene. Oral health education can help prevent oral diseases, future decay,
and future periodontal disease.
The Maternal and Child Oral Health Grant Program is provided to help increase
awareness and also to enhance the quality of oral health services that can be offered to women
and children. This program can be beneficial, especially for low-income individuals. For the
Franklin House women, this program could benefit them by improving their access to dental
care. Not only would the women receive benefits, but the children would too (10).
The MCAH Oral Health Program assists women and children in low-income families.
They help ensure the oral health needs of these women and children are met by facilitating their
access to dental care and dental preventive services. This program not only deals with the women
and children alone, but also gets involved with the staff to target oral health diseases that could
potentially be present. This program would be great to include in a facility like Franklin House
because it targets low-income women and improves their access to dental care. It can educate the
staff and help identify which women at the Franklin House facility could potentially have oral
diseases (11).

The Oral Health Program at the Department of State Health Services is designed to help
residents of Texas to promote the maintenance of good oral health. The program has been
successful in past years because they work with several partners across the state to determine the
oral health needs of the public and the resources to help aid those needs. The program includes
dental public health professions that provide oral health education and preventive dental services
to those that are eligible low-income and are underserved in the state of Texas. The oral health
program staff is located across the state of Texas in cities such as Austin, Lubbock, Tyler,
Houston, San Antonio, and Midland. This program relates to our program because they are
promoting oral health education to an indigent population (12).
Program Design
The program plan is designed to educate not only the women but also the staff on how to
incorporate oral hygiene in everyday life. The educational sessions will consist of teaching basic
oral hygiene skills and dental knowledge including topics such as plaque and gingivitis. These
sessions will also include the importance of brushing, flossing, and visual activities to further
help understand the material. The sessions will be implemented weekly at the Franklin House
Facility.
1. Session 1 (Week 1):
A. Franklin House staff
An introduction will be given to the staff about the oral education that will be given to the
women of the facility.
1. Discuss the importance of oral education to these specific women in need of oral
education.

2. Discuss the risk factors such as drug abuse and the association to oral health.
3. Discuss how to implement a daily plaque control such as brushing in their daily
routines.
4. Discuss the areas offering dental services for restorative treatment for the indigent
women.
5. Discuss the use of the LIT Dental Hygiene Clinic for preventive dental services for
the women.
6. Discuss the importance of oral education to be included in their daily lesson plans.
This first session will require 30 minutes and will only include the Franklin House staff
members.
2. Session 2 (Week 2):
A. Women of the Franklin House facility
This session will be directed toward the women who are members of the facility.
Educational topics and activities will be implemented in this session. Topics will
include plaque and brushing.
1.
2.
3.
4.
5.

A pretest will be given to the women to assess basic oral health knowledge.
Discuss the definition of plaque and the formation of plaque.
Discuss the correct brushing techniques that should be applied.
Record plaque score with disclosing solution to assess the initial plaque score.
The women will then use the techniques learned and demonstrate on themselves by

proper brushing.
6. Record plaque score by using disclosing solution.
7. Modify the brushing techniques in order to be successfully plaque free.
8. Emphasize the importance of applying the lesson and skill into everyday life style.
This session will require 1.5 to 2 hours and will include the Franklin House women and
possibly the program director.
3. Session 3 (Week 3):

A. Women of the Franklin House facility

This session will be directed toward the women who are members of the facility.
Education topics from session 2 along with new education topics and activities
will be implemented in this session. Topics will include flossing, periodontal
disease, and oral disease that arrive from drug abuse.
1.
2.
3.
4.
5.
6.
7.
8.

Review topics discussed in session 2.

Discuss the definition of periodontal disease and the formation of periodontal disease.
Discuss proper flossing technique to access plaque in interproximal areas.
The women will demonstrate proper brushing prior to flossing.
The women will demonstrate the proper flossing technique on themselves.
Record plaque score with disclosing solution.
Modify the flossing technique if needed.
Emphasize the lack of flossing and proper brushing can lead to the progression to

severe periodontal disease.

9. Discuss risk factors that can contribute to oral disease such as drug abuse.
10. A post-test will be given to the women to assess knowledge gained from overall oral
program.
This session will require 2 hours and will involve the women from the Franklin House
facility and possibly the program director.
4. Session 4 (Week 4):
A. Franklin House women
This session will be directed toward the Franklin House women. Educational
topics and activities will be implemented in this session. Topics will include
plaque and brushing.
1. Discuss the definition of plaque and the formation of plaque.
2. Discuss the correct brushing techniques that should be applied.
3. Record plaque score with disclosing solution to assess the initial plaque score.

4. The women will then use the techniques learned and demonstrate on themselves by
proper brushing.
5. Record plaque score by using disclosing solution.
6. Modify the brushing techniques in order to be successfully plaque free.
7. Emphasize the importance of applying the lesson and skill into everyday life style.
This session will require 1.5 to 2 hours and will involve the women from the Franklin
House facility and possibly the program director.
5. Session 5 (Week 5):
A. Franklin House women and program director
This session will be directed toward both the Franklin House women and the
program director of the facility.
1. Discuss and emphasize the importance of regular dental care.
2. Discuss local and accessible dental resources to the women.
This session will require 30 minutes and will involve both the Franklin House women
and the program director.
Constraints and Alternative Strategies
The program is designed to educate and help members understand oral health education.
During the program it is easy for members to become distracted with limitations or restrictions
called constraints. To ensure adequate information is reached out to the members, there will need
to be alternative strategies to make sure the members are maintaining interest and participation.
1. Constraints:
There could possibly be a lack of interest with the members during lesson plans and
presentation.

Alternative Strategy:
An alternative is to have activities that involve participation in order to encourage
participation and interest.
2. Constraints:
Participants are on a 60-day turnaround and may not be up to the same education level as
current participants.
Alternative Strategy:
Provide additional strategies, such as pamphlets and brochures to ensure new arrivals are
at the same educational level.
3. Constraints:
The financial status of these women could possibly impede them from finding dental
resources.
Alternative Strategy:
Emphasize the Lamar Dental Hygiene Clinic and the affordable prices they offer toward
the general public and public assistance citizens.
Resources
The following resources will be used to implement this program:
1. Personnel:
a. Julie King (Program director) in session 1 and 5.
b. Franklin House women for sessions 2 to 5.
2. Supplies:
a. 25 sets of adult toothbrushes, toothpaste, and floss

b. Disclosing solutions, napkins, cups, cotton swabs, tongue depressors, gloves,

masks, safety glasses, and lab coat
3. Evaluation material:
a. Written pre-test
b. Plaque Index forms
c. Written post-test
d. Program plan evaluation
4. Supplements:
a. Educational pamphlets provided by the NIH
b. Brochures provided by the NIH
c. Dental resource flyers developed by us.
Budget
The oral health program is estimated to cost as follows:
1.
2.
3.
4.
5.
6.
7.
8.

Toothbrushes, toothpaste, floss (28 each)

Gloves (200 count)
Napkins
Cups
Cotton swabs
Tongue depressors
Pamphlets, brochures
Copies

Donated by Colgate
$5.00
$2.00
$4.00
$5.00
$2.00
Donated by NIH
$0.50________
TOTAL:

$18.50

Timetable
There will be 5 sessions that will be implemented at the Franklin House North over a time period
of 5 weeks. Resources will be provided prior to the sessions. The dates for these sessions are as
follows:
Session 1: Week of March 21 25, 2016
Session 2: Week of March 28 - April 1, 2016

Session 3: Week of April 4 8, 2016

Session 4: Week of April 11 15, 2016
Session 5: Week of April 18 22, 2016
Evaluation
A. Formative Evaluation:
1. A weekly evaluation of plaque scores will be conducted for the women in an
attempt to modify brushing techniques as needed for optimum plaque control.
2. A weekly consultation with the program director will be made to ensure proper
implementation of the program in meeting the educational needs and adjust any
concerns at the moment if needed.
3. An oral review will be conducted at every session for the women about the
information that was presented during the previous sessions to promote better
understanding and memorization of the information.
4. After each presentation, a verbal quiz will be assessed to the women by asking
questions and as a result, will know if they understood the presentation by their
answers.
5. A weekly review with the women will be scheduled to ensure proper oral hygiene
skills, so that any problems the women may have are addressed.
B. Summative Evaluation:
1. The program planners will provide information on a written flyer with providers
that offer affordable dental care and also leave some with the facility.
2. A pretest and posttest will be administered to the women to evaluate and compare
their level of dental knowledge in oral health care information.
3. The program planners will assess all plaque scores from each session and
compare the ending scores with the beginning scores to help evaluate the
effectiveness of the program.

4. The program planners will combine the assessments of plaque scores, pretests,
and posttests to determine the daily routine of proper oral hygiene is met.
5. The program planners will stay in contact with the program director and this will
help evaluate the rate of implementing our program into the living skill courses in
the facility.
6. The program planners will obtain a questionnaire from the women, and staff of
Franklin House to be able to evaluate the overall success of the oral health
program.

References
1. King, Julie. (2016, February 11). Needs Assessment Interview
[Personal interview].
2. Land Manor, Inc. (n.d.). Chemical Dependency Treatment Services including HIV Testing and
Case Management. Retrieved from
http://www.landmanor.org/employmentopportunities.html
3. My Water's Fluoride. (n.d.). Retrieved from

https://nccd.cdc.gov/DOH_MWF/Default/WaterSystemDetails.aspx
4. National Institute of Dental and Craniofacial Research. (n.d.). Dental Caries in Permanent
(Adult) Teeth. Dental Caries (Tooth Decay) in Adults (Age 20 to 64). Retrieved from
http://www.nidcr.nih.gov/DataStatistics/FindDataByTopic/DentalCaries/DentalCariesAd
ults20to64.htm
5. Periodontal Disease. (2015, March 10). Retrieved from
http://www.cdc.gov/oralhealth/periodontal_disease/index.htm
6. Oral Health for Adults. (2013). Retrieved from
http://www.cdc.gov/oralhealth/publications/factsheets/adult_oral_health/adults.htm
7. National Cancer Institute Surveillance, Epidemiology, and End Results Program. (n.d.).
Statistics at a Glance. SEER Stat Fact Sheets: Oral Cavity and Pharynx Cancer.
Retrieved from http://seer.cancer.gov/statfacts/html/oralcav.html

8. Claudio Pelucchi, Sc.D.; Silvano Gallus, Sc.D.; Werner Garavello, M.D.; Cristina Bosetti,
Sc.D.; and Carlo La Vecchia, M.D. (2006). Cancer Risk Associated with Alcohol and
Tobacco Use: Focus on Upper Aero-digestive Tract and Liver. Health Risks, Vol. 29, No.
3.Retrieved from http://pubs.niaaa.nih.gov/publications/arh293/193-198.pdf
9. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention,
and National Center for Health Statistics. (2010). Dental Visits in the Past Year, by
Selected Characteristics: United States, selected years 1997-2009, page 316. Health,

United States, 2010 with Special Feature on Death and Dying. Retrieved from
http://www.cdc.gov/nchs/data/hus/hus10.pdf
10. U.S. Department of Health and Human Services. (n.d.) Maternal and Child Oral Health Grant
Program. Oral Health: Women & Children. Retrieved from
http://www.hrsa.gov/publichealth/clinical/oralhealth/maternalchild.html
11. California Department of Public Health. (2016). MCAH Oral Health Program (OHP)Fact
Sheet. Oral Health Program. Retrieved from
http://www.cdph.ca.gov/HealthInfo/healthyliving/childfamily/Pages/OHP.aspx
12. Department of State Health Services. (2015, December 09). Oral Health Program. Retrieved
from http://www.dshs.state.tx.us/dental/

Appendix
Plaque score
Lesson plans
Pre-test/Post-test
Program evaluation