During their annual preventive visit, I ask patients routine questions regarding their oral health and dental hygiene practices. "How many times a day do you brush your teeth?" "Do you floss?" "When was your last dental visit?" "Are you having any problems with your teeth, gums, or anything else in your mouth?" Patients eagerly respond if all answers are affirmative but appear embarrassed when they have neglected this part of their overall health. The link between periodontal disease and systemic conditions such as diabetes, cancer, heart, and lung disease has been well established.
Healthy People 2020 lists oral health (OH) as one of the leading health indicators or high-priority health issues facing the country.1 The goal of the OH-7 objective is to "increase the proportion of children, adolescents, and adults who used the oral health care system in the past year." Baseline data from 2007 noted that 44.5% of individuals age 2 years and older had visited the dentist in the past year, and the 2020 target is 49%. In 2015, however, the proportion dropped to 43.4%.1
Maintaining proper oral healthcare is tied to gender, age, access to medical insurance, and socioeconomic factors, such as education level, income, race, ethnicity, and geographic location. What is the nursing profession doing to improve the OH of the nation's population?
Oral Health Nursing Education and Practice
As part of the National Interprofessional Initiative on Oral Health, Oral Health Nursing Education and Practice (OHNEP), a national nursing OH initiative, was created at New York University Rory Meyers College of Nursing in 2011 under the executive director Judith Haber, PhD, APRN-BC, FAAN. "As a national voice promoting interprofessional oral health integration, OHNEP advocates, educates, creates, and promotes resources that educators and clinicians can use to improve the quality of oral health care in their patients. The OHNEP website serves as a knowledge center and portal for best practices."2
Nurses work along with other OH champions from family medicine, pediatric, physician assistant, and dental professions. A commonly used resource is Smiles for Life: A National Oral Health Curriculum, which consists of eight free interprofessional, self-paced courses for practicing clinicians and educators. Topics include the relationships between oral and systemic health; the oral exam; separate courses focusing on the child, adult, geriatric, and pregnant patients; acute dental problems; caries risk assessment; fluoride varnish; and counseling.
The importance of proper oral healthcare practices
OHNEP offers two other curricula specific to pediatrics: Chemo Without Cavities: Oral Health For Children With Cancer and Babying Our Babies: Promoting Oral Health In Infants. Promoting them this month is most appropriate because February is National Children's Dental Health Month, and February 1 is Give Kids a Smile Day. A child's OH starts during the mother's pregnancy, so education is key. You can find additional information on OH online in articles published in The Nurse Practitioner. Remember the mouth during all assessments and emphasize the importance of proper oral healthcare practices. Advocate for increased access to dental services for all patients. "The mouth is the window to the health of the body."
Jamesetta A. Newland, PhD, FNP-BC, FAANP, DPNAP, FAAN
EDITOR-IN-CHIEF [email protected]
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