The Children's Oral Health Initiative: an intervention to address the challenges of dental caries in early childhood in Canada's First Nation and Inuit communities

OBJECTIVE: The objective of the Children's Oral Health Initiative (COHI) is to increase access to preventive oral health services provided to First Nations and Inuit (FN/I) children living on federal reserves and in remote communities. PARTICIPANTS: COHI targets preschool children; 5-7-year-olds; pregnant women; and parents/caregivers in FN/I communities. SETTING: The program was piloted in 2004 by Health Canada and is potentially available to all FN/I communities. However, the community must consent to the program's implementation and agree to support a community member to be trained as a COHI aide. INTERVENTION: Dental therapists and hygienists screen eligible children, apply fluoride varnish and sealants to children's teeth, and stabilize active dental caries with glass ionomer. An innovation was the development of a community oral health worker, the COHI Aide. The COHI Aide is a community member who serves as an advocate for preventive oral health in the community and provides instruction to children, parent/caregivers and expectant mothers in preventing dental caries. RESULTS: COHI was piloted in 41 communities in 2004. By 2014, the program had expanded to 320 FN/I communities, which represents 55% of all eligible FN/I communities. In 2012, 23,085 children had received COHI preventive oral health services. CONCLUSION: The results demonstrate COHI's success as a preventive oral health care delivery model in remote communities. Implementation and delivery of preventive oral health services has been enhanced by the sustained presence of a community-based COHI Aide. KEY WORDS: Indigenous health services; pediatric dentistry; oral health; dental caries; community health worker OBJECTIF: L'Initiative en sante buccodentaire des enfants (ISBE) vise a elargir l'acces aux services de sante buccodentaire preventifs offerts aux enfants inuits et des Premieres Nations (IPN) vivant dans les reserves federales et les communautes eloignees. PARTICIPANTS: L'ISBE cible les enfants d'age prescolaire, les enfants de 5 a 7 ans, les femmes enceintes, et les parents et aidants vivant dans les communautes IPN. LIEU: Mis a l'essai par Sante Canada en 2004, le programme est potentiellement disponible dans toutes les communautes IPN. Toutefois, la communaute doit consentir a la mise en reuvre du programme et accepter de soutenir la formation d'un membre de la communaute comme representant ou representante en sante dentaire pour l'ISBE. INTERVENTION: Des therapeutes et des hygienistes dentaires filtrent les enfants admissibles, appliquent un vernis fluore et un scellant sur les dents des enfants et stabilisent les caries dentaires actives avec du verre ionomere. L'une des innovations du programme a ete la creation du poste de representant ou representante en sante dentaire pour l'ISBE. Cette personne plaide en faveur de la sante buccodentaire preventive dans la communaute etdonne des instructions aux enfants, aux parents ou aidants et aux femmes enceintes sur la prevention de la carie dentaire. RESULTATS: L'ISBE a ete mise a l'essai dans 41 communautes en 2004. Dix ans plus tard, l'initiative etait presente dans 320 communautes IPN, soit 55% des communautes IPN admissibles. En 2012, 23 085 enfants avaient regu des services de sante buccodentaire preventifs de l'ISBE. CONCLUSION: Ces resultats indiquent que l'ISBE est un modele efficace de prestation de soins buccodentaires preventifs dans les communautes eloignees. La mise en reuvre et la prestation des services de sante buccodentaire preventifs sont rehaussees par la presence continue d'un representant ou d'une representante en sante dentaire pour l'ISBE. MOTS CLES: services de sante autochtones; dentisterie pediatrique; sante buccodentaire; caries dentaires; auxiliaires de sante communautaire La traduction du resume se trouve a la fin de l'article. Can J Public Health 2016;107(2):e188-e193 doi: 10.17269/CJPH.107.5299
Approximately 4% (1.4 million people) of the Canadian population self-identify as being of Aboriginal descent. Of these individuals, over 314,000 live in 636 communities, also referred to as federal reserves, [...]