Community based dental care for young children in Suriname
To improve the dental health of babies and young children in Suriname, TNO has carried out the project Surismile in close collaboration with the foundation for dental healthcare for youth in Suriname, the ‘Jeugdtandzorg West’ in The Hague and the Medical Center of the University of Groningen, Netherlands. In this project, parents have been referred to a dental care worker by the youth health consultation desk in a very early stage. The dental care worker was following a new method for dental care prevention named the Non Operative Caries Treatment Program. The main focus of this program is a behavioral change to achieve healthy teeth. With motivational interviews parents are educated to brush their teeth twice daily with toothpaste containing fluoride and to eat and drink not more than seven times a day. During the interview sessions the dental care workers also assessed the risks for caries and determined the interval period for future consults for each child. Children with a high risk had to apply more often than children with a low risks for cavities.
Context specific approach
The benefits of the Non Operative Caries Treatment method are that it can be adapted to education, culture and health literary of the parents. The project has been carried out in two regions named Wanica and Brokopondo. The project objectives were:
1. To provide insights to dental care workers about the knowledge, attitude and behaviour of mothers relating the dental and oral hygiene for their babies and young children based on education and cultural affiliation;
2. To use those insights as baseline and repeat the measurements after two years to determine the effectiveness of the educational program;
3. To get an indication how often the mothers really visited the dental care workers after getting a referral.
During the consults, mothers were asked to fill out a questionnaire. The answers of the questionnaires showed that there was not only a lack of knowledge, but also many mothers had wrong cognitions about dental care. For instance, some mothers believe that milk and light soft drinks will not harm primary teeth.
Information about good behaviour and harmful cognitions will help to increase the dental health of young children. Parents will be educated not to brush the teeth with molasses or honey and before bedtime to let children drink water instead of giving them fruit juice, milk or soft drinks in their bottles. Parents will also be trained to clean the teeth with a wipe for extra cleaning after teeth brushing by the children until the age of ten. Demonstrations from dental care workers and practicing by parents during the consults are very important, to make sure that the parents will do it in the right way.
An important outcome of the evaluation was that in Wanica only 20% of the mothers really visited the dental care workers after the referral by the health consulting organization. In Brokopondo the results were much better, more than 84% of the mothers went to the dental care workers. With an improved education program based on the results of the project evaluation, an increase is possible for Wanica.
Annemarie Schuller, senior scientist for dental epidemiology of TNO and manager of the Surismile project, expects that further implementation of the intervention will improve dental and oral health of babies and young children in Wanica and Brokopondo significantly.
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