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20102011 Collaborating Organizations: Cayuga County Health Department Cayuga Community Health Network East Hill Family Medical, Inc. Genesee Elementary Auburn Enlarged City School District Brush to Crush Cavities Program ---PAGE BREAK--- July 2011 A special Thank You to the following businesses, organizations and individuals: Allyn Foundation Americhoice/United Health Care & Jolene Stoutenger An Anonymous Citizen Auburn Education Foundation Branches Dr. Keating Dr. Lesch Dr. Nangle Nick Nebold Patterson Dental Tops Upstate Medical University Wal-Mart Wegmans Welch Allyn Your support of this program was greatly appreciated by the Brush to Crush Cavities Committee, school administrators and staff and most of all by the students. Your donations and support played an influential role in assisting us with the implementation of the Brush to Crush Cavities Program. ---PAGE BREAK--- July 2011 Organizational Background Cayuga County Health Department – Our mission is to promote and protect the health and well-being of the individual families and the community we serve. For thirty years the Health Department has administered the School-Based Preventive Dentistry Program, funded through the New York State Department of Health. Our dental hygienist and dental assistant have visited every public elementary school in the county each year. Services provided by our staff include; dental screening on specific grade levels, sealants and referral to dental providers should a child need treatment. Cayuga County Community Health Network – Founded in 1997, Inc. is a 501(c)(3) not- for- profit corporation, one of 37 Rural Health Networks funded under the New York State Rural Health Network Demonstration Program. The Network strives to improve the overall health of Cayuga County residents by addressing access and service needs of the community. The Network also develops and sponsors prevention and health promotion programs that reduce barriers to health care services. The Network achieves these goals through development of collaborative strategies to assess and articulate the nature and extent of county healthcare needs and securing the resources to address them. East Hill Family Medical, Inc. – At East Hill Family Medical, our mission is to ensure the availability and accessibility of quality health care for every individual. East Hill Family Medical provides comprehensive dental services for children and adults, including preventative services, extractions, restorations (fillings) and dentures. All services are provided on a sliding fee scale. An on-site facilitated enroller is available for health insurance consultation. Genesee Elementary, Auburn Enlarged City School District – Genesee Elementary is a Title I School-Wide Plan building serving approximately 300 children k-5 (2010-2011) and 360 children k-6 (2011-2012). The Title I, School-wide Plan designation allows the school to receive additional federal funding. The school is also required to construct a School-wide Plan designed to meet the educational needs of students and their families. A large part of the Genesee Elementary School-wide Plan is membership in the No Excuses University Network of Schools. No Excuses schools implement 6 exceptional systems in their schools. These systems include: Culture of Universal Achievement, Collaboration, Curriculum Alignment, Assessment, Data Analysis, and Interventions. Another requirement of the School-wide Plan is the coordination with federal, state and local agencies. The school’s involvement with the Brush To Crush initiative meets the criteria for this requirement, and will be included as a formal part of Genesee's School-wide Plan as the partnership continues. ---PAGE BREAK--- July 2011 Brush to Crush Cavities Pilot Program Based on oral health statistics gathered through the Cayuga County Health Department School- Based Preventive Dentistry Program, Genesee Elementary School was identified as a high needs school with a history of significant oral health issues in its students. Local statistics on oral health show the prevalence of tooth decay in 3rd grade children to be 72.2% in Cayuga County. This is compared with New York State percentage being 54.1% and the United States percentage at 53%. The Brush to Crush Committee was established in the Summer of 2010. Meetings took place with committee members to develop a plan to address the oral health issues of the students. Ron Gorney, School Principal was involved in the planning process and welcomed the program. Sandy Lalonde, School Nurse mentioned that many of her students have reported to her that they did not have toothbrushes of their own or at all. A goal of this committee was to develop a model that would provide a more comprehensive intervention that would address the oral health issues children at Genesee Elementary were facing. A pilot project, Brush to Crush Cavities was created. The emphasis of this program would be to incorporate daily brushing into the school day. Monetary donations and donations of supplies were sought. Supplies were purchased and some services were offered in-kind. The program would incorporate: Screenings Referral for treatment and follow-up In-class education by County Health Department Public Health Educators Daily brushing in school Reinforcement of brushing at various times throughout the year Sending children home with dental packs at the beginning and the end of the year ---PAGE BREAK--- July 2011 Brush to Crush Cavities Pilot Program Genesee Elementary September 2010 – June 2011 In September, a brochure (see on next page) and letter was sent home with all of the children notifying parents of the Brush to Crush Cavities Pilot Program. Parents of children in grade levels identified for being screened were asked to send a form back if they did not want their child to be screened. We used this reverse consent method which was recommended by school staff as this method was identified as working best for getting a response from parents at this school. Screenings were performed on children in grades K, 1 and 2 at Genesee Elementary School in September by Joanne Elser, Dental Hygienist with the School-Based Preventive Dentistry Program (Cayuga County Health Department). Results of screening: 115 children were screened Of the 115 screened, 63 (54.7%) had decay and needed treatment. Of the 63, with decay and needing treatment, 12 (19%) were identified as needing immediate care. Other information gathered through this screening was that 33 children (28.6%) had one or more fillings and 52 children (45.2%) had no decay or fillings. The 12 children needing immediate care had an average of 8.75 cavities/child. Follow-up was conducted by the School Nurse and Health Department staff. Genesee Elementary sent the screening information home and requested parents return the letter to notify the school of what they were doing about their child’s teeth. There was very little response with letters being sent back, so Cayuga County Health Department staff called the families of the 12 students identified as needing immediate care. Our focus was to get these children in for care ASAP. Follow-up was conducted on the other 51 children needing treatment after follow-up on the 12 immediate cases was conducted. We found that there were four children who needed to be referred to Syracuse and Rochester for more extensive treatment. The parents of these children expressed their concerns for their children’s oral health needs, but had limited means for transportation. While Medicaid will transport, they will not if the family has a car that is broken down. Paying for gas and taking time off from work to take their child were two big factors that parents considered. In the future we would like to develop a plan, so that if this occurs again we will have a plan that outlines our role in providing transportation or reimbursement for gas. ---PAGE BREAK--- Children NEED Oral Health for: Freedom from pain and infection Ability to study & learn Normal facial development Ability to eat nourishing food Self-esteem Children’s teeth are meant to last a lifetime! An Oral Health Initiative for Genesee Elementary School Brush to Crush Cavities! A collaboration between: Auburn Enlarged City School District Genesee Elementary Cayuga Community Health Network Cayuga County Health Department East Hill Family Medical, Inc. A special thanks to our sponsors: Allyn Foundation Americhoice Auburn Education Foundation Branches Wal-Mart An Anonymous Citizen Dr. Michael Keating Nick Nebold Patterson Dental Upstate Medical University A Healthy Child has a Healthy Smile! Brush to Crush Cavities! ---PAGE BREAK--- July 2011 Brush to Crush Cavities! This oral health initiative is a collaboration between: Auburn Enlarged City School District Genesee Elementary East Hill Family Medical, Inc. Cayuga Community Health Network Cayuga County Health Department Brush to Crush Cavities! The program will feature five components: Education (K-5) Supervised daily brushing Screening and evaluation* Referral for follow-up care Options for treatment Screening and evaluation will be provided to students in Kindergarten-2nd grade and conducted by the dental hygienist. If a problem is found, parents will be notified and a referral can be made to their private dental provider or East Hill Family Medical, Inc. with parental consent. Restorative work (X-rays, fillings, and tooth extractions) will be provided by East Hill Family Medical Inc. Who is eligible for the educational demonstration? * All students (K-5) Who is eligible for the screenings? * Students (K-2) Who is eligible for treatment? * Students (K-2) and students who have been identified by the school nurse. Where can the child be treated? * If a child has dental insurance, they will be referred to their private dental provider. If the child has Medicaid, they can be seen by East Hill Family Medical. If the child does not have dental insurance, East Hill Family Medical will work with families to provide treatment at low cost or no cost to the families. ---PAGE BREAK--- Joanne Elser, Dental Hygienist with Cayuga County Health Department School – Based Preventive Dentistry Program The Citizen – September 20, 2010 Article by: Kelly Voll ---PAGE BREAK--- ---PAGE BREAK--- ---PAGE BREAK--- In-Class Education & Distribution of Supplies In October, Deanna Hoey and Kim Abate, Health Educators with Cayuga County Health Department provided in class education to students on the importance of brushing and flossing daily, how to brush and floss properly and snacks that are healthy for their teeth. Each child was given a storage pack for school with supplies (toothpaste, toothbrush, toothbrush cap, floss, timer) and they were also given a bag with supplies for home. ---PAGE BREAK--- July 2011 A mascot was introduced to the students, Max Molar. Max would make announcements about brushing on the school intercom. Posters with pictures of Max Molar were posted throughout the school to remind students to brush their teeth at school each day. The poster is included on the next page. ---PAGE BREAK--- July 2011 Brush to Crush Cavities! Max Molar says, AT GENESEE ELEMENATRY Make sure you….. * Brush your teeth two times a day! * * Floss your teeth one time a day! * * Visit the dentist two times a year! * Take good care of your teeth… They are meant to last a lifetime! NO EXCUSES for not taking care of your teeth! ---PAGE BREAK--- July 2011 Bulletin Board located in the School Nurse’s Office ---PAGE BREAK--- July 2011 Brush to Crush Cavities One-Month Challenge In April, SUNY Cortland Health Education Student Teacher Margaret Hartmann gave classroom presentations on oral health and healthy eating. She reinforced the importance of daily brushing and helped coordinate the one-month school-wide brushing challenge. The one-month challenge in April was a school-wide competition to re-energize the students and teachers. Each student was given a calendar to verify the daily brushing took place. At the end of each week incentives were distributed to the classes who brushed the most. The incentives included mini-apples donated from Wegmans, baby carrot sticks donated from Tops, tooth- shaped silly bands and stickers. At the end of the one-month challenge, pizza parties were held for classes that brushed the most during the entire month. A copy of the calendar is included on the next page of this report. ---PAGE BREAK--- July 2011 April 2011 Sunday Monday Tuesday Wednesday Thursday Friday Saturday 1 2 3 Brush All Week – Get an APPLE! 4 5 6 7 8 9 10 Brush All Week - Get Carrot Sticks! 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Brush All Week - Get A Silly Band! 25 26 27 28 29 30 Classes who brush the most get a pizza party! Max Molar says, “Don’t give your teeth a break… BRUSH & FLOSS YOUR TEETH ALL WEEK!” ---PAGE BREAK--- July 2011 Brush to Crush Cavities Pilot Program Genesee Elementary Feedback from Teachers In May 2011, surveys went out to the teachers and below are the questions and responses from ten teachers: 1. In September, when this program was introduced, did you understand the program and its purpose? YES (10) NO 2. Were you aware of the oral health needs of the students of Genesee? YES NO 3. Do you feel school staff should play a role in providing students with this daily brushing opportunity? YES NO 4. Did you implement the in-school daily brushing? a. If yes, how did you implement it in your classroom? Worked it in throughout the day Brushed after lunch during story time Brushed at the end of the school day Set up by the sink in classroom, children signed up to brush teeth, so there was order (1 child @ a time) Some students brushed in the morning, some brushed at the end of the day (due to time and too many students we didn’t do it after lunch) We brushed (tried) everyday in the afternoon Class was broken into four groups and brushed at certain times of the day Chose a time (1:30-1:45) daily to have students brush teeth Students took turns at the end of the day b. If no, what was your reasoning for not? The sink in the class is used for hand-washing and filling water bottles, it was often too busy 5. What did you like most about this program? The children’s enthusiasm for it That they actually brushed their teeth. Some come to school without brushing Whatever the students needed was supplied. Group came to do a class lesson on care Children were excited about teeth brushing. Health workers that came in to show children how to brush their teeth. It was a lot easier than I thought it would be. Students were given the tools to take care of their teeth Opportunity to address a chronic health need Students got excited and enjoyed brushing their teeth. It got them talking about brushing their teeth Kids taking the responsibility of taking care of themselves. Their teeth are more healthy Showing that tooth brushing is important ---PAGE BREAK--- July 2011 Brush to Crush Cavities Pilot Program Genesee Elementary Feedback from Teachers (continued) 6. What did you like least about this program? The cleaning and sanitizing of the storage containers Some thought it was social time instead of brushing health Cleaning the toothbrush trays – that still is disgusting to me It was difficult to always fit in/concerned about the spread of germs Facilities Time consuming The time, the storage, unsanitary storage 7. What suggestions do you have to improve this program? Maybe a mid-year toothbrush exchange (for new toothbrushes) Make sure new toothbrushes are given out at certain times during the year After Thanksgiving, Beginning of New Year, after winter and spring breaks How are parents involved in the responsibility More sinks, link to lunch or breakfast Have kids do it at home and log it, get parents more involved Other comments: Thought it was very easy to manage, great for kids, and our nursing staff did a great job of making themselves available to help in anyway (cleaning out container, getting new brushes and extra paste) ---PAGE BREAK--- July 2011 Teacher Recognition Luncheon On June 22, 2011 we hosted a luncheon for the teachers and other school staff. The purpose of the luncheon was to thank everyone involved for making the program successful this past school year. We took this time to recognize the teachers who went above and beyond to make sure they provided a time for the children to brush their teeth each day. Chariman Peter Tortorici, Mayor Michael Quill, and Superintendant J.D. Pabis were present for the certificate presentation. Teachers who were recognized included: Mrs. Siddall Mrs. Garrett Ms. Vasile Mr. Musso Mrs. Ridley Mrs. Gilmore Mr. Zambito Also recognized were Principal Gorney and Mrs. Lalonde, School Nurse. ---PAGE BREAK--- July 2011 Teacher Recognition Luncheon Representatives from the Health Department, Joan Knight, Director of Community Health Services, Deanna Hoey, Public Health Educator and Kim Abate, Senior Public Health Educator lead a discussion. An explanation of why the pilot program was implemented and an overview of the program results was presented. Teachers and school staff were asked to give honest feedback as to what their likes and dislikes of this program were, how they incorporated it into the school day and how the program could be improved. Feedback was positive. Teachers asked that this program be introduced at the beginning of the school year so students can get into a routine. Kindergarten teachers requested that a volunteer assist with helping the children brush their teeth. It was hard for the Kindergarten teachers to supervise the class and assist students at the sink with brushing. Teachers also thought more education would be helpful to the students. The thought would be to have Health Educators come more often during the school year. Suggestions were offered for different supplies. ---PAGE BREAK--- July 2011 ---PAGE BREAK--- July 2011 The Future of Brush to Crush Cavities Program For the 2011-2012 school year, we hope to continue the Brush to Crush Cavities Program for a second year. Our goal for the coming school year for this initiative would be to continue the components of the first year but also to expand screening to include all the children at Genesee Elementary grades K-6. This expansion will give us the opportunity to begin evaluating the impact of the initiative on the overall oral health of the children. This coming year will also see changes in the school-based preventive dentistry program. The Cayuga County Health Department did not apply for the new grant cycle of the New York State Department of Health funding that started July 1, 2011 opting to support the application submitted by East Hill Family Medical, Inc. While the final award announcements have not been made to date, we remain committed to improving the oral health our county children. We believe that the partnerships that have developed between public and private agencies and individuals to implement the Brush to Crush Cavities program has laid a strong foundation for a comprehensive preventive model that in time could be replicated in more schools throughout the county.