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Oral Health Role of School Nurse by hedongchenchen

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									     Oral Health
Role of School Nurse
Hope Saltmarsh, RDH, M.Ed.
  Nancy Martin, RDH, MS.
          Oral Health & Learning


   Severe decay
       Failure to thrive
            Nutrition
            Sleep
       Speech problems
       Poor concentration
       Reduced self-esteem
       Behaviors
         Oral Health & Learning


   Avg. 3 missed days/100
    students

   Low income 12x more
    missed days
                          Adults
   Systemic-oral health links
       Cardiovascular disease
       Stroke
       Diabetes
       Preterm, LBW babies
   Diminished work potential
       Appearance
       Health
            Military
                         Assessment
   Urgent Concerns
       Pain and/or Infection
            Refer to a dentist for evaluation/treatment ASAP
            Medical neglect
       Abscess
            Urgent
            With or without discomfort
Abscess
                                Causes
                                    Decay
                                    Trauma
                                Appearance
                                    Fistula
                                         pus
                                    Swelling
                                    Redness
                                Symptoms
                                    Pain
                                    Taste

Illustration: Linda Buchhalter
www.simplestepsdental.com
                              Abscess
   Sequelae
       Cellulitis
       Ludwig’s angina
   Treatment urgent
       Antibiotic
       Extraction
       Root canal




                                         photo:
                          http://dermatlas.med.jhmi.edu/derm
                           Death
   2007 - 2 children died from severe tooth
    infections
       12 yr old in Maryland
            Diamonte Driver
       6 yr old in Mississippi
   Both eligible for Medicaid
   Total deaths unknown
 Abscess

                   Urgent

                   Medical neglect




photo: www.smilesforlife2.org
                                   Trauma
   Avulsion
       Primary
            Do not reimplant
            Dentist within 24 hrs.
       Permanent
            Emergency
            Reimplant
                  20-60 minutes
                  2 hrs.
            Storage solution
                          Trauma
   Broken tooth
       Save tooth segment that broke off
       Refer to dentist if primary tooth
       Refer to dentist 12-24 hrs. if permanent
       If broken, soft diet, avoid extremes of
        temperature
       If reddish tinge or bleeding – pulp
            Can be extremely painful
            Dentist ASAP (12-24 hrs)
             Common complaints
   Loose teeth or loose SS crown
   Lost filling
   Decay discomfort
       Food impaction
       Sensitivity
   “broken tooth” - premolar erupting with two
    cusps
   Ectopic eruption
   Orthodontic
                      Prevention
   Assess students
   Counsel parents
   Identify community resources
   Promote oral health
       Candy as reward
       Vending machines
           Hi sugar beverages
       Snacks
                         Prevention
   Classroom Education
       K-3 Tooth Time
          NH Elementary Schools
          DHHS & Northeast Delta Dental

   Resources for teachers
       http://www.ncdhhs.gov/dph/oralhealth/education/index.htm
       www.healthyteethorg
       http://www.mchoralhealth.org/knwpathoralhealth.html#EducationSchoo
        ls
       Powerpoints for grades K-12 from Missouri DHHS
            www.dhss.mo.gov/oralhealth/OralHealthEducation.
             html
Why do we need our teeth?
Eating:
  To chew our food. That’s an
  easy one! Can you imagine
  trying to eat an apple, carrot
  or a hamburger without teeth?


It would be pretty hard,
   wouldn’t it?
                     Oral/perioral piercings can cause:
            Chipped or cracked teeth
            Infection of the
            pierced site as well
            as an infection in the
            bloodstream
            Abscesses or cysts
            Nerve damage
                                                 www.mcgrathdental.com

            An allergic reaction
            to “cheap” metal
            Increased risk for
            Hepatitis, Tetanus, HIV
“The Perils of Oral Piercing”; RDH, March 2006
                       Prevention

   Build Relationships with dentists
       Children’s Dental Health Month is February
        Give Kids a Smile 2/4
            NH Dental Society 225-5961
   Case-by-case requests
    School-based dental program
   Conduct a screening to survey oral health needs
    of your students
       ASTDD Basic Screening Survey
       http://www.astdd.org/basic-screening-survey-tool/
   Treat students without access to care
       Cleaning, fluoride varnish, sealants
       1-2/visits per school year
   Follow-up
       Link students to treatment
                  Success Story

   Lancaster elementary school in Salem
       1st year: 14% treated, 68% with cavities
       3rd year: 8% treated, 15% with cavities
   Comprehensive program
   Great school support
       RN initiated, principal advocate
    Tell us your stories…or problems

   Nancy Martin
   nmartin@dhhs.state.nh.us
   (603) 271-4535

								
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