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«Chapter 24 Assorted Errands in Prevention of Children’s Oral Diseases and Conditions H.S. Mbawala, F.M. Machibya and F.K. Kahabuka Additional ...»

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The primary responsible persons for the oral health of eight to twelve years old children are the children themselves. These are supported by mothers, fathers, siblings, helpers, other family members and school teachers. The Medical personnel (Medical doctors and nurses) and Dental personnel (Dentists, Dental Laboratory Technologists, Dental Hygienists, Dental Nurses) have a big role to play in prevention of oral diseases in this age group.

The stakeholders can also be looked at in terms of location. The various locations of interest are the homes, school, health facilities and institutions for children with special health care needs.

10.4. Responsible stakeholders for children’s oral health at homes At homes the stakeholders responsible for children’s oral health are Parents and guardians, children themselves and other children carers (siblings, relatives or helpers).

556 Emerging Trends in Oral Health Sciences and Dentistry

10.5. Responsible stakeholders for children’s oral health at school The stakeholders responsible for children’s oral health at schools are teachers, children themselves and other children carers depending on the school system.

10.6. Responsible stakeholders for children’s oral health at health facilities At Health facilities responsible stakeholders for children’s oral health include Medical personnel (Medical doctors and nurses), Dental personnel (Dentists, Dental Laboratory Technologists, Dental Hygienists and Dental Nurses).

10.7. Responsible stakeholders for children’s oral health at Institutions for children with special health care needs The oral health of children living at institutions is a responsibility of children carers, parents/ guardians and children themselves depending on their level of dependency.

10.8. Universal stakeholders In this chapter, governments, professional associations, Dental products manufacturers, the media and NGOs are considered universal stakeholders because their responsibilities cut across ages and locations. The governments are responsible for policies and governance of all issues pertaining to health. Whereas, professional associations’ responsibilities are to safe‐ guard the health of the people they serve. The dental products manufacturers are responsible to supply products required at all levels of prevention regardless of age or place. The NGOs can at any age and location play any role that falls within the organisation’s governing regulations.

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The different tasks of various stakeholders in the prevention of oral diseases among children are presented with the centre of attention being the four levels of prevention.

11.1. Tasks of various stakeholders in executing primordial prevention of oral diseases among children Under primordial prevention the task is to give education before the risk factor for oral diseases has occurred. The target group is the community without the risk factors.

The responsible individuals and their responsibilities are presented below;

11.2. Oral health personnel

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education (OHE). That is; to inform the community on the common oral diseases and condi‐ tions that affect children, their causes and measures to prevent them. Important messages for the community comprise proper and timely tooth brushing of children’s teeth, sensible use of sugary containing food staffs including avoiding leaving a nipple in the child’s mouth at night.

Other messages include maintenance of playgrounds, blunting sharp edges, securing win‐ dows and stairs as well as shunning slippery floors to protect young children against injuries, regular visit to a dentist for check-up and discouraging misconceptions, beliefs and practices harmful to children’s oral health. As Narksawat et al. [44] put it that parents must be motivated to consistently spend the time required to take care of the primary dentition of their children by regular cleaning and controlling the snacking behavior of their children. Emphasis should be directed to parents of children with special health care needs, motivating and empowering them to realize these preventive strategies. In order to execute primordial prevention, the oral health personnel ought to target the community because this stage is done to a community who do not have the risk factors.

11.3. Community

The obligation of the community that is; parents, school teachers, children and other family members is to receive OHE and make use of the received information in order to avoid the risk factors. Parents of children with special health care needs, require endurance in looking after their children’s oral health.

11.4. School teachers School teachers are responsible to supervise children’s playing activities, maintenance of playgrounds and controlling availability of sugary foods within school premises.

11.5. Universal stakeholders In order for the primordial prevention to succeed, support is required from universal stake‐ holders, that is; Governments, Professional Associations, the Media and NGOs. The support expected is through formulation and enforcement of policies on OHE, provision of funds and personnel to take part in OHE activities as well as support to the profession to air Oral Health Education messages/campaigns through various media.

11.6. Tasks of various stakeholders in executing primary prevention of oral diseases among children Primary prevention targets the community and the children in particular. The goal is to prevent personal exposure to risk factors.

11.6.1. Governments Governments are in charge of policy formulation and implementation. The governm520ents therefore are liable to have in place policies supporting primary prevention of oral diseases in children such as those governing school oral health programmes including those directed to 558 Emerging Trends in Oral Health Sciences and Dentistry children with special health care needs, where required fluoridation of public water and fostering availability of fluoride tablets. They should provide conducive working environ‐ ment, avail funds and give any other support to preventive programmes.

11.6.2. Oral health personnel Primary prevention requires oral health personnel (Dentists, Dental Therapists, Dental Hygienists, Dental Nurses, Community Dental Workers or any other oral health workers) collectively or individually to do oral evaluation, regular dental examinations, dental pro‐ phylaxis, fissure sealants and health education with emphasis on plaque control and use of fluoridated tooth paste twice per day in the morning and evening before retiring to bed. They are also responsible to correct oral habits, and monitor occlusal development so as to prevent malocclusions. These procedures can be done at the chair side but also in communities such as primary schools or reproductive and child health clinics. Moreover, oral health care workers need to devise special primary preventive programmes for children with special health care needs bearing in mind the challenges encountered during dental treatment to these children.

It may require outreach programmes to visit children at their schools where tailor-made information and instructions are given to the children.

11.6.3. Medical personnel (Medical doctors and nurses)

The medical personnel who see children for various ailments should join oral health personnel by mentioning prevention of oral diseases when they talk about prevention of other diseases particularly those sharing common risk factors such as diabetes, heart diseases, hypertension and cancers. The medical personnel attending children with special health care needs are liable to emphasise prevention of oral diseases.

11.6.4. Parents and community at large

The responsibility of parents and other community members is to advocate the use of Fluoride as a caries preventive agent and plaque control for prevention of gum diseases. Fluoride tooth paste used during tooth brushing twice a day in the morning and before retiring to be bed is universally accepted to prevent dental caries. Therefore, parents are responsible to brush their children’s teeth from the eruption of the first tooth to six years of age. From age seven to 10 years, parents should supervise children’s tooth brushing. In older children, parents should supervise flossing, use of dental rinses and medicinal mouthwashes. Furthermore, parents are responsible to facilitate the use of Xylitol and mouth guards if indicated. Parents should take their children for regular dental visits so that children’s oral health can be monitored. Super‐ vision and facilitation of using dental rinses and medicinal mouthwashes is another parents’ task. Parents of children with special health care needs should pay special attention to prevent oral diseases for their children. This is particularly important given the hassles encountered in the dental settings by parents and oral health workers during dental treatment of children with special health care needs.

Assorted Errands in Prevention of Children’s Oral Diseases and Conditions 559 http://dx.doi.org/10.5772/59768

11.6.5. School and sports teachers

School children spend most of their day time at schools and therefore in contact with school teachers. The teachers are obliged to facilitate preventive actions against oral and other diseases. They can supervise tooth brushing or mouth rinse activities. They can support other programmes like Fluoride application or fissure sealing.

11.6.6. NGOs

Various national and international NGOs have funds and volunteers to support preventive programmes. They can arrange and participate in community services such as oral health screening, Fluoride application or fissure sealing programmes by giving funds and organising for personnel to take part in various programmes.

11.6.7. Dental products manufacturers

The dental product manufactures supply a wide range of products that are used to realize primary prevention of oral diseases among children. They are responsible to avail good quality products at affordable prices the dental products for prevention of diseases; tooth brushes, tooth paste, mouthwashes, fissure sealants, fluorides, dental floss, mouth mirrors as well as dental supplies including gloves, antiseptics etc.

11.7. Tasks of various stakeholders in executing secondary prevention of oral diseases among children Secondary prevention involves actions which halt the progress of a disease at its incipient stage and prevents complications.

11.7.1. Governments In order to facilitate provision of services to children at early stages of oral diseases so as to halt their progress and prevent complications, governments are required to provide conducive dental clinic working environments, avail funds, have in place and enforce policies on dental supplies. Governments are also responsible to oversee activities related to prevention of oral diseases in children in public sectors, private sectors and insurance companies.

11.7.2. Oral health personnel (Dentists, dental therapists, dental hygienists, dental nurses, community dental workers or any other oral health workers) The Oral health personnel working in public or private sectors are responsible to provide or take part in treatment of various oral diseases and conditions. They should use Fluo‐ ride [45] on incipient caries, restore decayed teeth or perform root canal treatments where necessary, professional tooth cleaning and if indicated periodontal debridement. They should keep abreast with new knowledge, procedures, techniques and materials to facilitate them offer quality treatment of oral diseases at their early stages. Oral health care work‐ ers providing dental treatment to children with special health care needs should equip 560 Emerging Trends in Oral Health Sciences and Dentistry themselves with techniques to address the challenges encountered during dental treat‐ ment to these children.

11.7.3. Medical personnel (Medical doctors and nurses) The medical personnel who see children for various ailments are liable to do early diagnosis of oral diseases and make prompt referral. Whereas Rozier et al. [46] demonstrated that nondental professionals can integrate preventive dental services into their practices, the American Academy of Pediatrics recommends physician interventions in addressing dental caries to include oral health screening and referral when indicated, provision of oral hygiene instruc‐ tions, dietary information, and anticipatory guidance to parents, as well as prescription of fluoride supplements. In so doing they will facilitate early identification of oral diseases, promote their readily treatment and prevention of adverse sequelae.

11.7.4. Parents

Parents have a significant role to play to aid the oral health personnel in executing secondary prevention of oral diseases among children. They have to take their children for dental consultation at early stages of the disease. For the parents to achieve this task they have to develop a practice of looking into their children’s mouths and consult dentists for any abnormal development principally so for children with special health care needs. After consulting the dentists they need to comply with appointments and instructions given by professionals.

11.7.5. Dental products manufacturers

A diverse list of materials and supplies is needed to support oral health personnel in delivering secondary prevention of oral diseases among children. The dental products manufacturers are responsible to avail required materials and supplies at affordable prices and of good quality.

The requirements range from instruments, dental materials and dental supplies to dental equipment.

11.7.6. School teachers Since school teachers spend most of their working time with children, their role in secondary prevention of oral diseases among children is to remind and motivate parents as well as children to consult dentists as per professional recommendations.

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11.8. Tasks of various stakeholders in executing tertiary prevention of oral diseases among children

There are a few actions at the level of tertiary prevention of oral diseases among children:

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