Dental Public Health

Model Core Program Planning The B.C. Ministry of Health has produced a Core Public Health Functions Framework. It defines and describes the core public health activities of a comprehensive public health system. The Framework provides a tool for health authorities to strengthen their public health infrastructure by reviewing their existing programs with those defined in the Framework. Through the Core Public Health Functions Framework a model core program paper for Dental Public Health has been developed. This evidencebased paper will be used to determine opportunities for improving dental public health in Vancouver Coastal Health. Achieving success in dental public health is only possible if health authorities, local government and community partners work together.

The health of the teeth and gums and the prevention of diseases like tooth decay and periodontal disease has a significant impact on the general health and well-being of the population. Although there have been significant decreases in the extent of tooth decay in the past 30 years, there continues to be high levels of tooth decay among vulnerable populations.1 Because of its impact on health, and unequal access to dental care among the population, dental public health is a core function of public health. Current Dental Public Health Programming Currently, the VCH Dental Public Health Program provides oral health promotion, education, and preventive services to children and their families living in VCH. Target populations are babies and toddlers that do not have a dentist or cannot access a dentist; and preschool and primary grade schoolaged children accessed through schools, community agencies, and other healthcare and childcare providers. Due to limited resources, VCH focuses many of its current activities on vulnerable children and their families. Examples of activities that VCH currently administers are: fluoride varnish applications, distribution of dental health promotional materials, and screening of Kindergarten students for tooth decay. Dental Public Health Performance Improvement Planning Using the Model Core Program Paper for Dental Public Health, the VCH Regional Dental Practice Council reviewed current dental public health activities to determine whether these exceed recommended best practices; meet recommended best practices or currently do not meet recommended best practices. To identify strategies to improve the dental public health of the residents of the Vancouver Coastal Health region, the Council then compared these activities to the three major components for dental public health: Dental health promotion Prevention of dental diseases, with a focus on childhood dental disease Surveillance, assessment and evaluation of dental health status and dental health programs.

1 Vulnerable populations include persons living in poverty, persons with developmental disabilities, adults and seniors with chronic health issues and/or living in care, persons with addiction issues, persons living with mental illness, underserved Aboriginal populations, new immigrants, and pregnant women at risk of having low birth weight or pre-term deliveries.

Core Public Health Functions Framework

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Dental Public Health Performance Improvement Plan

Strategies for Improvement Although opportunities to improve dental health exist for all age groups, the Regional Dental Practice Council acknowledged that strategies for improvement must conform to mandated provincial initiatives, many of which address dental health in early childhood (ages 0-5). As such, the Council identified the following strategies for improvement: Dental Health Promotion Establish a VCH Dental Practice Lead The VCH Dental Practice Lead would further develop partnerships and collaboration with individuals and organizations such as public health professionals, community groups, professional associations (e.g. the BC Dental Association), and governments. The Dental Practice Lead would then strengthen the implementation of the following strategies. Advocate for Dental Public Health and Population Health Initiatives Link dental health programs with current initiatives for children and vulnerable populations. Advocate for the provision of equitable dental health services for Aboriginal and vulnerable populations. Develop an advocacy strategy to increase support for water fluoridation. Develop Best Practice Guidelines Partner with other health authorities to develop and standardize dental health promotion and disease prevention best practice guidelines. Incorporate best practice guidelines into health care provider orientation. Share best practice guidelines with community groups and promote dental public health to the community. Prevention of dental diseases, with a focus on childhood dental disease Provide Dental Health Promotion, Prevention and Early Intervention of Early Childhood Dental Disease Further enhance dental health promotion, prevention and early intervention of Early Childhood Dental Disease, with a focus on early childhood. Collaborate with community groups and other health care providers to provide programs intended to prevent Early Childhood Dental Disease.

The VCH Dental Practice Lead would further develop partnerships and collaboration with individuals and organizations such as public health professionals, community groups, professional associations, and governments.

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Dental Public Health Performance Improvement Plan

For more information, contact: For the North Shore Carole Charbonneau Dental Hygienist Tel 604 904 6200 Carole.Charbonneau@vch.ca For Richmond Lisa Enns Dental Hygienist Tel 604 233 3197 Lisa.Enns@vch.ca For Vancouver Tana Wyman Dental Hygienist Tel 604 253 3575 Tana.Wyman@vch.ca Outside Metro Vancouver Toll Free 1 877 892 2231 Jennifer Scarr Policy Consultant, Core Public Health Services Vancouver Coastal Health 8th Floor, 601 West Broadway Vancouver, BC V5Z 4C2 Tel 604 875 5600, Ext 62832 Fax 604 875 5229 Jennifer.Scarr@vch.ca

Provide Dental Health Promotion and Prevention of Dental Disease for Vulnerable Populations Establish dental health promotion and disease prevention programs for vulnerable populations. Collaborate with community groups and other health care providers to provide programs intended to prevent dental diseases. Surveillance, assessment and evaluation of dental health status and dental health programs Measure Regional Dental Health Trends Determine the most appropriate dental health data to collect. Develop a method to collect, measure, and analyze regional dental health data. Use dental health data to develop and improve dental health programs.

The above strategies will be implemented over the next three years. It is anticipated that through the implementation of the above strategies, VCH will establish best practice guidelines that will support the development, enhancement, and evaluation of dental public health programs and policy, as well as the enhancement of Early Childhood Dental Disease prevention services. The Regional Dental Practice Council will be responsible for measuring and reporting the progress towards the three-year performance targets. Successful implementation of an effective dental public health program requires: strong support from the board and management; allocation of sufficient resources; clear mechanisms of reporting and accountability; and an opportunity to celebrate successes and achievements. The Dental Public Health Performance Improvement Planning process, along with the ongoing reporting and monitoring of this plan, will provide an excellent foundation for continued performance improvement.

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