Brighter Smiles

This initiative draws on the power of partnership, facilitated through interpersonal connections, as a core strategy. It is based on the hypothesis that "[c]ollaborative interventions can improve oral health in at-risk children, provide important training, and connect academic, public health, and rural communities."

Specifically, Pediatric Residency Program personnel organised several meetings with the elders of the community and the community health staff; oral health was identified as a problem with the potential to show positive results in a relatively short period of time, and to have a significant impact on a wide range of First Nations issues – from self-esteem to long-term cardiac health. In response, teams of 2 medical residents and a faculty supervisor were formed. Residents were given instruction in oral health, attended a dental clinic, and were provided with information on working with First Nations communities. They then visited the community for 3 days approximately every 6 to 8 weeks, providing well-child clinics at the invitation of the community, and implementing and supporting the oral health programme.

Face-to-face information sharing and the use of awards/recognition as a reinforcement strategy were key elements of the school-based work, which centred around daily school-based brush-ins after lunch each day, supervised by teachers and/or the community health director. Teachers award prizes weekly, monthly, and annually for participation, and the school maintains a wall of photographs of children who are cavity-free as a measure of their success. A weekly fluoride rinse and fluoride varnish applications 3 times in 10 days every 4 months for those under 9 years of age were also provided. The paediatric residents gave classroom presentations about a variety of health topics, including oral health. They also reached outside the classroom, providing dental health anticipatory guidance during well-baby and well-child visits and offering health promotion, injury prevention, science career, and general interest presentations to parents and elders.

Children, Health.

A Health Canada report from August 2000 indicates that dental decay rates range from 3 to 5 times greater than in the non-Aboriginal Canadian population. At the pre-intervention assessment, 92% of children had at least one cavity. Three years later, 32% were cavity-free, and evaluators found that "there was a significant improvement, assessed by questionnaire, in all oral health behaviours, except brushing teeth at home, which decreased, possibly because children were brushing their teeth at school."