Title: Developing a Preventative Dental Care intervention with young adults in Lower East Side, NY
1. Scope of the Problem –
From the census done in 2015, Lower East Side (LES) has a population of 168,298 people, with the highest ethnicity of Asian 34%, follow by Caucasian 31%, and Hispanics 25%. 54% of them speak foreign language other than English, 47% of the people living there are between 18 to 44 years old. 16% of the population in LES does not have health insurance.
The access to oral health care is becoming a concern, there is oral health disparities in the community because many active adults have a busy schedule on their daily lives and, so they would often neglect their daily oral health care routine necessary to prevent dental decay and periodontal disease. The most common cause for tooth loss in adults is periodontal disease. Research studies believe that the bacteria that causes periodontal disease could also be involved in systemic diseases such as cardiovascular disease, oral cancer, or eating disorder. The early detection of oral disease can lower the risk of permanent damage to the teeth, gums and mouth. It can also prevent further expensive dental treatments and excruciating tooth pain.
2. Planning –
• Encourage primary care providers to advice patients to visit the dentist too
• Control the fluoridation of drinking water: New York City water is treated with 1.0 part per million (ppm) fluoride since 1964. The level of fluoride is said to be safe and the addition of this chemical was to protect the teeth of New Yorkers, but studies reveal that children and young adults have high concentration of fluoride in their body. Arguments suggest that water is not a good way to have people expose to: everybody drinks water at different levels and it is hard to estimate how much people drink, fluoride is not an essential element in our diet and studies reveal that its deficiency does not contribute to tooth decay.
• Increase sources for more community dental clinics: there are only two of them Betances Health Center and Catherine M. Abate Health Center.
• Promoting oral health in schools for the children to talk about the subject at home with their family and encourage them to have more routinely dental visits.
• Integrate the importance of educating the Lower East Side young adults about preventative oral care, how factors such as tobacco, alcohol use, and poor choices of food can lead to oral diseases among others.
• Educate the LES population about the common misconception about oral health
• Have comprehensive, culturally competent education campaigns to help with the literacy level of the LES population: English, Chinese, and Spanish.
• Increase the public awareness movement by partnering with stakeholders to secure foundation support
• Have an ecological study to understand the overall LES population that would need preventative oral care
The key to have stakeholders from many specialties like health care providers, social workers, health educators, and teachers to buy in the LES neighborhood outreach for oral health education interventions
Convince professional organizations, education institutions, the Task Force on Special Dentistry who represents many dental schools in New York to look into our preventative approaches and provide recommendations and financial support.
Have The New York City Coalition Against Artificial Fluoridation to take part on our effort to start a sectional study to understand the real concentration of fluoride in the LES young adult population.
Work with stakeholders who are in the health insurance providers, policymakers, Medicaid state officials to renew guidelines for preventive oral health services and reimbursement policies for oral care.
Communicate with the Community leaders of LES about the proposed interventions and to seek support from them to be able to organize educational street fair on days that there are public fairs like in Chinatown or Little Italy.
This public health program is intended to help the LES population in the long term due to its preventative care approach, in the long run there would be reduction of dental disease therefore there will be less pain and more savings in the financial aspect.
3. Development & Dissemination of the Intervention –
The main goal is to educate the LES population about the important of preventative oral health care.
Minimized the barriers to care and treatment from fear to pain and underestimate the importance of oral health
Increase the number of oral health centers in the LES neighborhood
We could incorporate dental services in more community clinics that do not have yet. Should analyze the cost for preventative oral care including treatment services for young adults to negotiate the cost with insurance companies. Encourage the nonprofit community services like Chinese American Planning Council that helps the community on public services, to educate its clients about dental care.
This program would require funding to outreach the LES young adults in places such as the public library, high school, clinics, and the use of social media to inspire them to visit the dentist at least yearly. In the social media the use of advertisement can be constant, it would also be helpful to use advertisements in subways lines such as F, J, M, Z, D, B that pass through LES.
4. Evaluation & Maintenance –
The evaluation would be yearly since the recommended dental visits is once every six months. Should study the records in the dental clinics to see if the number of new patients has increase. A longitudinal study would be appropriate to understand if the incidence of oral disease had decrease.
If the interventions become unsuccessful, with the help of volunteers to distribute a survey to understand what went wrong: questions such as what would encourage you to visit the dentist? Or do you know what happens if you have a tartar buildup? Based on our survey we can make modifications in the future such as focusing more in educating the LES population.
This LES neighborhood is expanding, more and more modern buildings are being built, which will increase its population. The programs implemented should stay as the new incoming of people to this growing neighborhood would provide more demands for health care including oral care and the influx of people would also increase the tax revenues in this area.
Sources:
https://www1.nyc.gov/assets/doh/downloads/pdf/data/2015chp-mn3.pdf
https://www.cdc.gov/nchs/fastats/dental.htm
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD012771/full
https://med.nyu.edu/sites/default/files/asian-health2/chnra_chinese_0.pdf
http://www.nyc.gov/html/dep/pdf/wsstat00b.pdf
http://www.freedentalcare.us/ci/ny-new_york
https://www.health.ny.gov/prevention/dental/docs/oral_health_plan_2014.pdf
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