Nicholas Capezio Presents at National Oral Health Conference on GSDM’s Oral Health Program in Nicaragua
Nicholas Capezio, DMD 18, presented a poster at the 2017 National Oral Health Conference on April 24-26, 2017 in Albuquerque, New Mexico. His poster entitled, Preschool-Based Fluoride Varnish and Toothbrushing Oral Health Promotion Program in Esteli, Nicaragua, addressed GSDM’s oral health promotion program in Esteli. Dr. Michelle Henshaw served as a research mentor on this project.
Nicholas Capezio received a grant for his research through the American Association of Public Health Dentistry (AAPHD) Foundation Small Grants Program. Grants are awarded to projects which will benefit dental public health or strengthen innovative education. Support was also provided by the Henry M. Goldman School of Dental Medicine (GSDM).
In July 2015, GSDM sent a team to Estelí, Nicaragua to explore the best way to introduce a fluoride varnish program to at-risk children. Preventative efforts, such as fluoride varnish and toothbrushing programs, have proven effective in low-resource settings within the United States. A study by GSDM in 2014 found dental decay in 83% of 1st and 2nd grade children in five Estelí elementary schools, highlighting the urgent need for better dental care programs. The country’s public Centro de Desarollo Infantile (CDI) preschools were selected as the best way to reach at-risk children up to five years old.
The program was designed to provide a feasible and sustainable oral health promotion program for preschoolers to decrease the prevalence of dental caries in Estelí. Teachers were trained in November 2015 on both how to apply fluoride varnish as well as oral health basics such as diet, toothbrushing, and the benefits of fluoride varnish. Teachers then began applying the fluoride varnish quarterly, reaching 784 children across 12 preschools during the first seven fluoride varnish applications. At the five pilot CDIs, 23 toothbrush holders, toothpaste, and 420 toothbrushes were distributed.
Six months into implementation, GSDM sought feedback from the teachers and a focus group of CDI directors. While the protocol was easily adopted, several barriers were identified; including structural (limited storage space), environmental (dust and insects), and temporal (end of school year). As the program continues, GSDM is collaborating with each school to develop site-specific storage solutions and to implement the program in all 12 sites. Annual oral health assessments will continue in order to assess program effectiveness. The program was expanded in July 2016 with the introduction of a toothbrushing program, which was requested by the local Ministry of Health. In coming years, a sealant program will be included as well.