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Dental Public Health Activities: Descriptive Summaries

The Republic of Marshall Island's Early Childhood Caries Prevention Program

Practice Number: 58002
Submitted By: Ministry of Health, Republic of Marshall Islands
Submission Date: October 2005
Last Reviewed: October 2005
Last Updated: October 2005
Best Practice Approach Example -
Before 2001, there were no active Dental Preventive Projects in the Marshall Islands. In 2001, a prevalence study on Early Childhood Caries was done in Majuro (the capital of the Republic of Marshal Islands) and found that 50% of children had cavitated lesions in their teeth by the age of 2 years and 92% by the age of 5 years. The extremely high percentage of children with Early Childhood Caries resulted in developing an Oral Health Plan for the Marshall Islands in 2002. The Plan included implementing an Early Childhood Caries Prevention (ECC) Program targeting children starting from one year of age. The funding from the HRSA/MCHB, State Oral Health Collaborative Systems (SOHCS) grant program provided the Republic of Marshall Islands the opportunity to develop the ECC Prevention Program. During the 1st year of the Program (September 2003 to August 2004), a total of 1,400 children were targeted for services. In the 2nd year (September 2004 - August, 2005), the Program expanded to include delivering services to the outer island atolls to reach more children and to integrate promotion of oral health into MCH prenatal care. Service provided through the Program during Year 1 and 2 included:

1. Toothbrushes and fluoridated toothpastes were purchased and distributed three times for 50% of Head Start and Kindergarten enrollees and for 10% of children 1 to 5 years old in Majuro, in the capital of the Marshall Islands and distributed to an additional 10% of the Head Start and Kindergarten children and their younger siblings in the outer islands.

2. Fluoride varnish was purchased and applied three times to 10% of 1 to 5 years old children and 50% of Head Start and Kindergarten children and applied once for the outer island children.

3. New flip charts and posters on Dental Health Education in the Marshallese language with Marshallese pictures have been developed to increase awareness of the community. The flip charts and posters are being placed at dispensaries and Head Start Centers.

4. A portable dental chair and a dental light have been set up at the MCH Prenatal Clinic and all pregnant mothers are being screened at their first pre-natal care visit which makes it easier for the moms to get the dental screening done together with their 1st prenatal visit to MCH

5. Dental preventive assistants have been trained to provide oral health education and distribute toothbrushes and fluoride toothpastes to the pregnant mothers.

6. Dental preventive assistants provide free prophylaxis to pregnant mothers and priority is given to pregnant women to receive needed dental treatment in the Ministry of Health's dental clinics.

The ECC Program established collaboration nationally between the Ministry of Health and the Ministry of Education and Head Start program in the Republic of Marshall Islands and internationally with consultants from Hawaii State Dental Department and the University of Washington. The initiative promoted awareness of the community and motivation of the care providers, teachers and other health care providers to work in partnership with the dental care providers to reduce the level of dental caries in our children. With the support of the Ministry of Health of the Republic of the Marshall Islands and the HRSA/MCHB SOHCS grant, the ECC Program in the Marshall Islands will continue to expand with the objective of reaching mothers during pregnancy to prevent dental caries in children as early as possible. For the 3rd year of the project in FY 2005-2006: (a) workshops will be conducted to teach pregnant mothers on effective toothbrushing, health snacking, nutrition, feeding habits and having their children seen by a dentist starting from 6 months of age, (b) distribution of toothbrushes and fluoride toothpastes will continue, and (c) fluoride varnish will be applied until the children enter elementary schools.

Contact Person(s) for Inquiries:

Dr. Ohnmar Tut, Ministry of Health, Republic of Marshall Islands, P.O. Box 16, Majuro, Marshall Islands, MH 96960, Phone: 011-692-625-3355 Ext 2101 or 2102, Fax: 011-692-625-4372, Email: