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Am J Public Health. 2015 Apr;105 Suppl 2:e23-9. doi: 10.2105/AJPH.2014.302486. Epub 2015 Feb 17.

Improving access and provision of preventive oral health care for very young, poor, and low-income children through a new interdisciplinary partnership.

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Diana L. Biordi, Marjet Heitzer, Eric Mundy, Marguerite DiMarco, Marlene Huff, and Karen Fitzgerald are with the School of Nursing, University of Akron, Akron, OH. Sherrey Thacker is with the College of Health Professions, University of Akron, Akron. Evelyn Taylor and Deborah Marino are with the College of Nutrition and Dietetics, University of Akron, Akron.



We provided oral health care services at 2 sites using a nurse practitioner-dietitian team to increase dental workforce capacity and improve access to care for low-income preschool children.


Our team provided oral health assessments and education, fluoride varnish application, and dentist referrals. The primary endpoint was participants' access to oral health care. Secondary endpoints included increasing the practice scope of registered dietitians through training programs for oral health assessment and the application of fluoride varnishes for children. The oral health and hygiene and dietary habits of the participants were also determined.


From 2010 to 2013, 4360 children received fluoride varnishes in 7195 total visits. Although the proportion of children with dental caries at the first visit was greater at the urban site, both sites were similar by visits 2 and 3. The number of caries declined with increased program visits, which coincided with an increase in the proportion of participants visiting a dentist.


Progress toward eliminating dental health disparities requires addressing barriers to dental care access. We showed that expanding access to oral health services through nurse practitioner-dietitian cooperation improved access to preventive fluoride varnishing use in low-income children.

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