Residency Training in General and Pediatric Dentistry: Advocacy and Care Disparities

The purpose of this project is to build upon existing educational programs and infrastructure to increase the depth and breath of the dental General Practice and Family Medicine Residences' training and clinical experiences in pediatric oral-systemic health. New didactic materials and curriculum, new pediatric dental sedation and operating room experiences and additional electronic resources will be combined in a trans-disciplinary project to achieve our objectives. The 2000 report trom the U.S. Surgeon General on "Oral Health in America" found that those who suffer the worst oral health are found among the poor of all ages with poor children and poor older Americans particularly vulnerable. The Appalachian counties of Eastern Kentucky epitomize national and oral health and general health disparities, having very low socioeconomic status (SES) including very high disease rates for children living below federal poverty levels. Findings from the 2000 Kentucky Children's Oral Health Survey found that 7.7% of children in the Eastern Region had a need for urgent care compared to a state rate of3.9%. In addition the NHANES 2003-2004 survey showed that Kentucky has the highest rate of overweight children with 38% of all children and youth falling into this category as compared to a national rate of 18.8%. The overall purpose of this project is to expand access to an underserved population of young by adding a new service specifically addressing a documented need. Four of the five project objectives directly relate to the HRSA mission to improve and expand access to quality and advanced health care for the underserved. The fifth objective provides the means of documenting these efforts. Objective I: Expand the existing trans-disciplinary curriculum for dentists and physicians to include oral-system health links; specifically pediatric nutrition and overweight/obesity issues. Objective 2: Develop a new didactic and experiential educational component focused on Community, Leadership and Advocacy. Objective 3: Establish a dental surgical suite at Hazard Appalachian Regional Hospital to improve access to quality health care for underserved pediatric patients in that region.