Prevention Of Dental Caries- Health Promotion Activity

1. Health Promotion Activity January 9, 2022

2. Introduction Having dental caries, suffering from malnutrition, suffering from cardiovascular disease, type 2 diabetes, and tooth decay are all correlated with poor nutrition. Poor diet is attributed to several risk factors related to the health disparity among Aboriginal and Torres Strait Islander People and non-Indigenous Australians. Low fruit and vegetable intake is one of them (Ju et al., 2019). Health promotion is best defined as the process of enabling the community and the people to have increased control over their health and its determinants as well, which will ultimately lead to an overall improvement in health for the people (Grabowski et al., 2017). 2 January 9, 2022

3. Health Promotion and Target Group Environmental destruction, resource depletion, and limited access to good food and certain other socioeconomic resources necessary for health, especially in rural and isolated areas, threaten food security for several Aboriginal communities. As a consequence, nutrition-related health problems impact many Indigenous peoples excessively throughout their lives (Gwynn et al., 2019). Poor food intake amongst Aboriginal people is complicated, with roots in displacement, discrimination, and impoverishment, and is exacerbated by their socioeconomic, environmental, and geographic issues. In the broad sense, few Australians follow dietary guidelines for healthy foods, and this is especially true for Aboriginal people, who get 41 percent of their energy from budgetary foods and drinks (that are high in saturated fat, additional sweeteners, and/or salt). On the contrary, only 35 percent non-Indigenous people consume a processed food diet (Whalan et al., 2017). On aggregate, Aboriginal Australians eat 25% extra free sugar every day than non-Indigenous Australians, with the majority of this coming from sugary drinks (67 percent vs. 51 percent); this disparity is much more pronounced in children (Tonkin et al., 2020) 3

4. Prevention of Dental Caries The research shows a variety of risk variables for dental caries in children, which may be thematically categorized as socio- demographic traits, dental hygiene, nutrition, dental service usage, and environmental (water fluoridation). Housing affordability and income, which is a reference for larger material variables that contribute to health literacy, spending power, and overall health awareness, are one of the socioeconomic variables. A disparity in the socioeconomic determinants of oral health, such as Indigenous and non-Indigenous disparities in education, employment, financial stability, and discriminatory experiences is also a contributory factor. Around 1 in every 4 children, approximately 24% of children between the age group of 6-14, have experienced dental caries in their permanent teeth. This proportion is higher when it comes to indigenous children, around 36% when compared with non-indigenous children who have caries in around 23% of the population (AIHW, 2019). 4

5. Health Promotion Aims The health promotion in this particular age group will focus on the Aboriginal children residing in the rural communities of New South Wales. The promotion strategy is based on the risk factors identified in the community of school-going children, such as – consumption of high sugar diet in terms of beverages, a lack of a healthy diet, low intake of vegetables, fruits, and fiber in the diet, lack of toothbrush availability and inconsistent brushing of teeth with a fluoride toothpaste. The specific aims for this promotion will include – promotion of healthy eating habits- increasing intake of fiber, fruits, and vegetables in the diet, promotion of teeth brushing as a part of daily routine in schools in about three months, increasing the knowledge of children about their dietary habits and oral hygiene by the end of three months and promoting the consumption of water by decreasing the dependency on cold beverages. Also, it will be aimed at developing a school garden, with the help of the children to make the school self-sufficient in producing its own set of healthy fruits and vegetable 5

6. Prevention perspective This health promotion program falls in the preventative category that is primary prevention whereby, the aim is to promote healthy behaviour and inculcate habits in people which helps in the promotion of good health and eventually prevents the occurrence of the disease altogether. The idea here is to motivate the children and their families; parents and community as a whole to make maintenance of a healthy diet a part of their daily routine...Involving the children and the community in developing a school garden will help in involving the community to work in the garden and promote a healthy diet, for the community as well (Browne et al., 2020). The provision of education and awareness around healthy dietary consumption and distribution of toothpaste and toothbrushes to children will be categorized as a primary health promotion perspective (Farias et al 2020), since it aims to prevent the occurrence of disease and promote healthy dietary behavior. 6

7. Stakeholder and Community Consultation Their inclusion will help in the promotion of the program at the family/community level and reduce the apprehension of the children and their families concerning the program. Also, a Healthy Diet Promoter will be selected from the community for each of the three schools who will be supervising the children in their food distribution and consumption during lunch hours, followed by supervision of teeth-brushing activity in the school, with or without the help of the class- teacher; depending upon the subjective requirement. In this way, the cultural and social acceptability of the program will increase, and it will help in making it successful. The local community members and leaders will be involved in the process, by participating in the building of the school garden. Hence, the involvement and positive participation of stakeholders from the community and the management and government side are equally imperative for the success of this health promotion program. The specific stakeholders involved in this school-based healthy diet promotion project will include community elders from the indigenous/Aboriginal population, the school authorities, the school children, selected trained healthy diet promoters from the community, and the community itself. 7

8. Activity Description The health promotion activity will entail the following main activities- at the beginning of the pilot for the oral health program, distribution of fruits, vegetables and appropriate amounts of nutrients will be done for the students during lunch hours. The distribution and the eating of the food will be supervised every day by the school nurse and the local nurse-healthy diet promoter selected from the community. The healthy diet -promoter-nurse will be chosen from the community, to produce cultural sensitivity. Secondly, there will be free distribution of dental toothbrushes and fluoridated toothpaste for the families and communities on a three-monthly basis, to the students. This will help in improving the accessibility of oral health aides to the Aboriginal community and help in encouraging the act of tooth-brushing as a societal norm. Thirdly, it will involve school health education sessions in the school for children and healthy diet awareness sessions at the local community center for elders and families. The sessions will be delivered at the beginning of three months and will continue in the form of six sessions, one session every fifteen days. Lastly, there will be an installation of refrigerators and water filters to ensure clean drinking water for the children to dissuade them from consuming beverages. 8

9. Evaluation Proposal •The program will be evaluated by using surveys conducted at the commencement of the program and the end of the three-month interval. The indicators for measuring oral hygiene will include the DMFT score that is, the number of decayed, missing, and filled teeth in the children. •The oral examination will be conducted at the baseline for each child, and will then be conducted at the end of the first three months, post distribution of the tooth-brushing kit and compulsory tooth-brushing activity. A decrease in the DMFT score for the children or no further increase in the DMFT score will indicate a positive impact of the program on the population. •Another indicator to be used will include a basic questionnaire survey to be conducted baseline and post the first three months as well. The survey will include questions about a healthy diet, the significance of sugar reduction in diet, and the importance of increased fruit and vegetable intake. •The responses to the survey questionnaire will be assessed using the SPSS software. 9

10. Conclusion It can be concluded that health promotion, when designed and practiced by utilizing the local community and by making it culturally sensitive, helps in achieving a better success rate. The chances of implementation and uptake of healthy attitudes and behavior also improve. This activity helped in understanding the technique, importance, and methodology of how to design and implement a health promotion strategy. 10

11. Thank You