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2011-2012 Brush to Crush Cavities Program Collaborating Organizations: Cayuga County Health Department Cayuga Community Health Network East Hill Family Medical, Inc. Genesee Elementary Auburn Enlarged City School District ---PAGE BREAK--- This report was completed by: Deanna Hoey, Public Health Educator Cayuga County Health Department ---PAGE BREAK--- A special Thank You to the following businesses, organizations and individuals: Monetary Donations Xylem, Inc. (ITT Corp/Goulds Pumps) & Marchael Heitmann Lansing Trade Group Cayuga Community Health Network from Mind, Body, Spirit Luncheon Cayuga Community Health Network from Healthy Sliders and Siders event Wal-Mart Donations of Supplies Lifetime Care & Lisa Gabel – Vice President, Provider Relations United Health Care & Jolene Stoutenger Patterson Dental & Geoffrey Snyder Beautiful Smiles CNY, Dr. Nangle & Dr. Ohnezeit Simmonds, Brady & Loi Lesch & Lesch Family Dentistry Skaneateles Dental Associates Kinney Drugs Kinney Drugs & Vin Gleason Tops & Pete Ely, Auburn Store Manager Walgreens Jim Monahan – Store Manager Wegmans Cayuga Community Health Network Shreyas Patel, D.D.S Your support of this program is greatly appreciated by the Brush to Crush Cavities Committee, school administrators, school 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. June 2012 ---PAGE BREAK--- 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 had administered the School-Based Preventive Dentistry Program, funded through the New York State Department of Health. A dental hygienist and dental assistant 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. The Health Department did not reapply for the School-Based Dental grant in 2011. East Hill Family Medical applied for the grant with full support from the Health Department. 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. Beginning July 2011, East Hill Family Medical was awarded the School-Based Preventive Dentistry Program grant. East Hill Family Medical will be conducting dental screenings in County schools, including Genesee Elementary. 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. June 2012 ---PAGE BREAK--- Brush to Crush Cavities Program History 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 1 & 2) 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 June 2012 ---PAGE BREAK--- Brush to Crush Cavities Program Year #1 Results September 2010 – June 2011 In September 2010, a brochure 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. June 2012 ---PAGE BREAK--- Brush to Crush Cavities Year #2 September 2011 – June 2012 Program Overview After year one of the pilot program we surveyed and spoke with school staff members at the teacher recognition luncheon to determine what their barriers were to implementing the daily brushing and any other issues they may have had with the program. When asked what suggestions teachers had to improve this program, the answers included: Make sure new toothbrushes are given out at certain times during the year 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 Have supplies ready to go on the first day of school One request was made to have the brushing supplies available the first day of school to make it easier to incorporate into the daily routine. Monetary donations and donations of supplies were sought for year two of the program and the brushing supplies were available for all students on the first day of school. In September the Cayuga County Health Department had a table at the Genesee Elementary Open House to promote the Brush to Crush Program amongst students, teachers and parents. Also, in September oral health education including how to properly brush and floss was provided to each classroom at Genesee by Public Health Educators working at the Cayuga County Health Department. All students were able to participate in the oral health education sessions. The committee realized that by only screening a few grades 1 & 2) in the first year, we were not capturing the oral health status of all students. We also recognized that it would be difficult in tracking the oral health status of the students from year to year if we did not screen all students each year. Stipulations of the School-Based Preventive Dentistry grant prevented the committee from being able support the dental hygienist’s time to screen all the students. It was determined that the committee would seek funding to support the dental hygienist’s time to screen the remaining grades. This school year was the first year that sixth graders would be housed in the elementary buildings due to the closure of West Middle School. Screenings would be performed on all students in grades K-6. Funding was secured and screenings were performed in October 2011. ---PAGE BREAK--- Brush to Crush Cavities Year #2 September 2011 – June 2012 Screenings A brochure (refer to next page) and letter was sent home with all of the children notifying parents of the Brush to Crush Cavities Program and that we were planning to screen all grades this year. Parents 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. Results of the screenings: 265 students screened Of the 265 screened, 124 (46.7%) had decay and needed treatment. Of the 265, 13 were identified as needing immediate care. This year we took a close look at the screening evaluations and included information on the students who were determined to be in need of better brushing. Of the 265 screened, 112 (42%) were identified as in need of better brushing. We also decided to compare grade levels to determine what grades may be having more oral health problems It was determined that 55.8% of second graders were identified as having a problem and 55.5% of sixth graders were identified as in need of better brushing. Please refer to the chart below for more information. Grade Level Total # Screened Total # with a Problem % with a Problem Total # in need of Better Brushing % in need of Better Brushing K 37 14 37.8% 15 40.5% 1 46 22 47.8% 17 36.9% 2 43 24 55.8% 17 39.5% 3 30 15 50% 13 43.3% 4 42 17 40% 15 35% 5 34 15 44% 15 44% 6 36 17 47.2% 20 55.5% ---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! 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: Xylem, Inc. Lansing Trade Group Wal-Mart Lifetime Care United Health Care Patterson Dental Beautiful Smiles CNY Simmons, Brady & Loi Lesch & Lesch Family Dentistry Skaneateles Dental Associates Kinney Drugs Tops Walgreens Wegmans Shreyas Patel, D.D.S Brush to Crush Cavities! An Oral Health Initiative for Genesee Elementary School A Healthy Child has a Healthy Smile! ---PAGE BREAK--- Brush to Crush Cavities! 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 The program will feature five components: Education (K-6) Supervised daily brushing Screening and evaluation* Referral for follow-up care Options for treatment Screening and evaluation will be provided to students in Kindergarten-6th 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 for restorative work (X-rays, fillings, and tooth extractions). June 2012 Who is eligible for the educational demonstration? * All students (K-6) Who is eligible for the screenings? * Students (K-6) Who is eligible for treatment? * Students (K-6) 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--- 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. June 2012 ---PAGE BREAK--- Max Molar says, AT GENESEE ELEMENATRY Make sure you….. Brush to Crush Cavities! * 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--- Bulletin Board located in the School Nurse’s Office June 2012 ---PAGE BREAK--- National Children’s Dental Health Month February is recognized as National Children’s Dental Health Month. An article promoting oral health, the Brush to Crush Cavities Program, thanking our sponsors ran under Elane Daly’s People’s Health Column. Elane is the Director of Cayuga County Health & Human Services. ---PAGE BREAK--- National Children’s Dental Health Month – February 2012 School-wide Brushing Challenge In recognition of this, a month long school-wide brushing challenge was developed to re-energize the students and teachers. Each student was given a calendar to verify the daily brushing took place during the school day. 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 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--- February 2012 Sunday Monday Tuesday Wednesday Thursday Friday Saturday 1 2 3 4 5 Brush All Week – Get an APPLE! 6 7 8 9 10 11 12 Brush All Week - Get Carrot Sticks! 13 14 15 16 17 18 19 20 21 22 23 24 25 26 Brush All Week - Get A Silly Band! 27 28 29 1 2 3 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--- Brush to Crush Cavities Spring 2012 In April, a SUNY Cortland Health Education Student Teacher 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. Also in April, the Brush to Crush Committee applied to the Allyn Foundation for a grant to support the Brush to Crush Cavities Program for the 2012-2013 school year. In June, bags were packed and included a toothbrush, toothpaste and dental floss for students to take home over summer break. It is important to provide the children with these supplies in order for the children to continue to value oral health and keep up a healthy habit. It is important to the Brush to Crush Committee that we communicate with the school staff as they are the ones who implement the daily brushing. We want to know what challenges they face and if there are any problems so we can work to resolve them. We asked that school staff complete a questionnaire prior to the Teacher Recognition Luncheon. The questionnaire is an anonymous tool that the Committee uses in order to obtain honest feedback from staff who may not feel comfortable expressing their thoughts or opinions in any other way. The results of the questionnaire are listed on the following two pages. ---PAGE BREAK--- Brush to Crush Cavities Program Genesee Elementary Feedback from Teachers 13 Surveys Completed 1. This is the second year of the Brush to Crush Program, are you familiar with the program and its purpose? Circle: YES (13) / NO 2. Did having the supplies available to you the first day of school help you to incorporate the daily brushing into your schedule? Circle: YES / NO / Didn’t answer question 3. Are you aware of the oral health needs of the students of Genesee? Circle: YES (13) / NO 4. Do you feel school staff should play a role in providing students with this daily brushing opportunity? Circle: YES (10) / NO YES/NO (3 circled both) If NO, why not? It is great for kids who can do it themselves, but too time consuming for younger grades. It is difficult to monitor inside the classroom Don’t mind doing it, but shouldn’t be a requirement of the teacher. Teachers that said YES had the following comments: Helps students, families and the community in the long run At younger grade levels where the bathrooms are located in the classrooms When it works for them 5. Did you implement the in-school daily brushing? If YES, how did you implement it in your classroom? Every morning Every day after lunch At the end of the day In-class 1 at a time once work was completed. Rotated 2 students at a time during the morning activities Students were divided into two groups, one group brushed in the morning, the other group brushed in the afternoon Tried difficult to maintain If NO, what was your reasoning for not? Time constraints, difficulty getting all students into bathroom and monitor behavior Not a classroom teacher Not enough time in the day to help primary students 6. Did you incorporate oral health education lessons into your classroom activities throughout the year? Circle: YES / NO were not classroom teachers If YES, what activities did you conduct? Student teacher from Cortland conducted 5 lessons centered around oral health Dental health month with a focus on healthy dental lessons Discussions, worksheets, book read out loud Demonstration by Student Teacher on brushing and flossing How to brush, how often, results of not brushing Teachers that said NO had the following comments: Not throughout the year, just at the beginning Mentioned the benefits of good dental practice ---PAGE BREAK--- 7. What did you like most about this program? Introduced the concept and routine of oral health Watching children take pride in their teeth Students seem to enjoy it, they look forward to it, seems to increase their awareness of the importance of brushing Students feel good, can sit at a close range and there not be any bad breath Started students on good habits/routine Bring dental health a bigger role in their lives Great idea Free stuff for kids That the children were brushing Kids get good practice Wish there was one when I was in school, being from an alcoholic family dental care was not a top priority Helps students develop good health habits 8. What did you like least about this program? Some students could not handle it and were using the time inappropriately I can’t think of anything negative Time constraints during class schedules Organization/storage (that is my issue, however) Maintaining the cleanliness of the sink area and storage containers The containers – for the past two years there has been at least one or more students that uses someone else’s toothbrush or dumps the whole drawer of toothbrushes on the floor It can be messy and this year the toothbrushes were a little long for the containment unit Lack of time for brushing/supervision/accountability Not having the adult support/time to implement daily brushing Trying to replenish supplies, brushes should be changed every quarter at least 9. What suggestions do you have to improve this program? Give teachers a case of toothpaste so we don’t have to bother the nurses At the beginning of the program, supply extra tooth pastes (case) for the classroom teacher so we don’t have to bother the health office Tailor it to each teacher’s schedule so it works for them Just the storage units, but I hope the more we do this the more the students will get used to using the units I wish there wasn’t a need for this program (good habits formed at home, parent’s responsibility), but I am thankful the need was recognized and a solution formed. More communication to parents on a basis, because dental focus has to continue at home Change brushes more frequently June 2012 ---PAGE BREAK--- Teacher Recognition Luncheon The Brush to Crush Committee acknowledges that the success of this program is in the hands of the Genesee Elementary School staff. We recognize the efforts made by classroom staff to incorporate the daily brushing into the school day, janitorial staff for having to clean excess toothpaste out of the sinks, health office staff for distributing supplies and being a resource for students and staff and school building office staff for distributing information on the program. On June 20, 2012 the Brush to Crush Committee hosted a luncheon to recognize the efforts made by the school staff in implementing the daily brushing into their classrooms. We also took this time to thank them for their continued support of this program. Representatives from the Brush to Crush Committee were present including Health Department staff members Joan Knight, Director of Community Health Services, Deanna Hoey, Public Health Educator and Kim Abate, Senior Public Health Educator. Irving Lyons, Executive Director from the Cayuga Community Health Network was also present. An overview of the program was shared with school staff including oral health statistics gathered this year. Staff members were asked to share their thoughts, suggestions and feedback on the Brush to Crush Program. Staff expressed their gratitude for the program and appreciated having supplies available for the first day of school. Some suggestions were offered about the oral health supplies and the storage containers. Kelly Voll from the Citizen newspaper was also present at the luncheon. She featured the article in the paper on Thursday June 21, 2012. The full article is on the following page. June 2012 ---PAGE BREAK--- ---PAGE BREAK--- The Future of Brush to Crush Cavities Program A special thank you to Auburn Enlarged City School District Superintendent J.D. Pabis who retired at the end of the 2011-2012 school year and to Genesee Elementary Principal Ron Gorney, who is leaving Genesee Elementary to become Principal at Casey Park Elementary. We must recognize these two individuals for their commitment to the oral health of students and for continuing to offer this program to students. For the 2012-2013 school year, we are fortunate enough to have received a grant from the Allyn Foundation to support the Brush to Crush Cavities Program. This funding will allow us to support the dental hygienist’s time to screen all of the students and purchase supplies for the brushing kits. Two brushing kits will be given to each student in September, one kit for school and the other for home. Toothbrushes will be replaced periodically and toothpaste and floss will be replenished as necessary. Education will be provided in the fall by the Health Department and screenings will be provided by East Hill Family Medical. June 2012