Preventing Caries in Preschoolers: Testing a Unique Service Delivery Model in American Indian Head Start Programs

Preventing Caries in Preschoolers: Testing a Unique Service Delivery Model in American Indian Head Start Programs

An intensive intervention of specially trained paraprofessionals, called community oral health specialists (COHS), administering on a quarterly basis for 2 years fluoride varnish and oral health promotion education, compared to usual care, will reduce decayed, missing, and filled tooth surface measures at 2 years for children in American Indian Head Start Programs.

The study design will be a clustered randomized design. Fifty-two head start classes in a Southwest American Indian Reservation will be randomized, 26 to the intervention program and 26 to usual care. The intervention will be comprised of specially trained paraprofessionals, called community oral health specialists (COHS), administering fluoride varnish and oral health promotion education quarterly for 2 years. Baseline and annual measures of decayed, missing, and filled tooth surfaces (dmfs) of the children, and surveys of their caregivers' dental knowledge, attitudes, and behaviors will be completed. The study will be a 5-year study, with 2 years for intake/accrual, and 3 years of follow-up.

Inclusion Criteria:

• Children ages 3-5 enrolled in Head Start Centers on a Southwest Indian Reservation and having a primary caregiver (preferably mother, or the child's legal guardian as documented by the HSC)
• American Indian, as defined by the tribe, or
• Children of other racial/ethnic groups who are in the Head Start classes on the Reservation
• Parent/caregiver able to read, understand, and sign the study consent form, and
• Willing and able to follow the study procedures and instructions

Exclusion Criteria:

• Allergy to any of the components of the fluoride varnish
• Ulcerative gingivitis
• Stomatitis
• Other conditions resulting in disrupted or irritated oral mucosa
• Any other conditions or findings that, in the opinion of the investigators, would interfere with or preclude participation in the study.