The oral health zone solution: Fighting dental caries among at-risk kids

BY Amos S. Deinard

In July 2008, the Minnesota Department of Health began a two-year project aimed at addressing the rising oral healthcare crisis among at-risk children in the state. Funded by the Health Resources and Services Administration, or HRSA, and the Centers for Disease Control and Prevention, the Oral Health Zone, or OHZ, project is a subproject of the state’s overall commitment to HRSA and CDC to develop for Minnesota a public oral health infrastructure.

The overarching goal of the OHZ project was to assist the participating counties in addressing the dental caries crisis affecting Minnesota’s high-risk children. Caries — the disease process, the end result of which is the cavity, or “hole” — has reached silent epidemic proportions among the nation’s high-risk children. Among these high-risk children, it is estimated that as many as 20% of 2-year-olds and 50% to 60% of 5-year-olds have caries. Caries is the most common chronic disease of childhood, five times more prevalent than asthma and seven times more prevalent than hay fever. Though mortality from caries is rare, in 2007, a 12-year-old boy in Maryland and a 6-year-old boy in Mississippi each died — one from a brain abscess, the other from a generalized infection. In both cases, the underlying pathology was an abscessed tooth for which the child’s caregiver could not find a dentist to provide care.  

Morbidity from badly decayed teeth is common. It can range from simple cosmetic effects, which may have an impact on self-esteem, to more significant health problems, including, pain, abscess, difficulty eating secondary to pain, delay in growth and development, speech problems, and poor facial and jaw development. Left untreated, such systemic, long-term effects as increased risk for cardiovascular disease and difficulty controlling diabetes mellitus can occur. 

Children in pain experience poor school performance and miss school days. In 1999, an estimated 51 million hours of school time were lost due to children experiencing severe pain. For each child who misses school, a parent has to stay home with the child; if the parent works, this often leads to lost wages and potentially loss of employment.

But because caries is an infectious disease, it is theoretically preventable through early intervention and application of fluoride varnish and caregiver education.  

The basis for the Minnesota OHZ project was originally established with a generous founding grant from the 3M Foundation and support from the National Children’s Oral Health Foundation, or NCOHF. The project’s initial objective required training primary care medical providers in Minnesota to integrate caries prevention intervention, or CPI, into the well-child examination. The training included instruction on how to do a gross oral examination; perform a paper-and-pencil caries risk assessment; offer anticipatory guidance to caregivers about caries etiology and the caregiver’s role in prevention; apply fluoride varnish on a quarterly basis to the teeth of a high-risk child starting at age 1; and how to instruct caregivers that fluoride varnish is neither a sealant nor is it a substitute for a dental home for comprehensive care, and that it is critical to establish the dental home by the child’s first birthday.  

From late 2008 to September 2010, CPI training was implemented in 130 practices in a variety of medical settings, including, small groups, small networks, large networks and health systems, located in large and small cities throughout Minnesota. More than 80% of clinics that received the training have since integrated CPI into their examination of high-risk children. 

The second objective of the project was to begin to establish OHZs in communities throughout Minnesota in a collaborative effort to improve the oral health of high-risk children in those areas. 

The basic approach of the OHZ project is to convene a meeting involving all community stakeholders, including, but not limited to, primary care physicians (i.e., pediatrics, family medicine and obstetrics); nurse practitioners and physician assistants;  dentists (general and pediatric) and dental hygienists; pharmacists; social workers; public health nurses and school representatives. Communities were also encouraged to identify and add additional stakeholders that made sense to partner in the project.  

Once community stakeholder groups have been convened, OHZ project staff performs a review of the community’s caries statistics, and provide assistance and support to help community stakeholders take ownership of, and begin to solve, the problems in their areas. Several possible strategies for addressing the caries problem have been identified, including:

Early childhood primary care providers and dental hygienists counsel caregivers about caries etiology and prevention and, on a quarterly basis, apply fluoride varnish to the teeth of high-risk children; 

Caregiver education during the third trimester of prenatal care;

Dentists better prepared to provide necessary restorative work for young children; and

Educators, dental hygienists, and public health nurses work to improve oral health literacy of community residents.

Amos S. Deinard, M.D., holds a masters degree in public health and is an associate professor at the University of Minnesota Department of Pediatrics/School of Public Health.


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Lil’ Drug Store Products launches new ad campaign supporting RepHresh

BY Michael Johnsen

CEDAR RAPIDS, Iowa — Lil’ Drug Store Products on Monday will unveil a pair of new commercials to communicate how RepHresh Vaginal Gel can eliminate common, but embarrassing, feminine hygiene issues.  

“We understand that talking about feminine odor and discomfort is awkward for most women, sort of like placing a box of tampons on the checkout counter for all to see,” stated Kristin Stewart, director of marketing for RepHresh. “That’s why we took a unique approach with this new campaign. We want to educate women with an engaging, relatable message to ease the embarrassment on all levels.” 

In one commercial, a woman disguises herself with Groucho glasses and a mustache to discuss how vaginal pH imbalance can cause feminine odor. “The Groucho glasses are a lighthearted portrayal of both the way women want to hide when they have feminine odor and the way some feminine products try, unsuccessfully, to mask feminine odor,” Stewart said.  

The other commercial features a quintet of ballerinas representing various feminine hygiene products, including RepHresh Gel in the forefront. As the ballerinas attempt to balance “en pointe,” RepHresh dances on as the others fall in unballerina-like fashion. “Our research shows that women are becoming better educated about how important pH is to feminine health, but they are confused by the claims they see at the shelf,” Stewart noted. “They see products that are labeled pH-balanced and think these products are going to have an effect on their personal pH. We’re trying to expose this misconception. There is a big difference between a pH-balanced product and a product that truly helps a woman’s pH.” 

“These new TV commercials are a breakthrough in the feminine hygiene category,” commented George Kase of Chicago Film Works and creative director for the campaign. “Using a wry sense of humor to convey a confidence and approachability for the brand, these spots offer a solution to consumers in a way that demonstrates a clear understanding about the problem. At the same time, these ads differentiate RepHresh from competitors by speaking candidly and providing women a strong promise of solving their problem without just masking the issue.”

In a survey of 3,000 women 18 years and older, 54% said that they had experienced vaginal odor in the past 12 months, and 29% had suffered three or more times. Vaginal pH imbalance can occur for many reasons, including hormone fluctuations, intimacy, menstrual cycles, some personal care products, contraceptives, diet and stress. 




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May I Help You? Really.

BY Dave Wendland

Perhaps I have become too cynical. But really, when did providing customer service become an inconvenience for some retail staff? Too often I have witnessed reluctance on the part of shoppers to seek help — and if they do, it almost always begins with, “Sorry for interrupting, but …” Think about that. “Sorry for interrupting” what? A paying customer, the reason for the store’s existence, apologizing for asking staff members for help. As if sales associate job descriptions don’t require them to provide assistance to shoppers.

If I managed a retail staff, I would ensure that everything they do is focused on customer service. This means tending to the little things that improve the ability to shop the store. From fronting products on shelves to rotating stock and building useful end caps and displays, my staff would not be sitting idly, or wasting time texting their friends and family. Not while they are on the sales floor. If staff is taking advantage of so-called “down time” to tend to personal business, they are robbing store management of useful and productive time.

Personalized, one-to-one service is one differentiator that can never be replaced by a computer. But maybe the futurists are right who predict that storefronts are no longer necessary, and all shopping transactions can be accomplished over the Internet. Maybe shoppers don’t want help.

I personally may be in denial, but I don’t for a moment believe that thoughtful customer service has been lost forever. The truth is that shoppers can’t be replaced by computers either, so their natural human tendency to expect good service will not disappear.

When I get into conversations with fellow passengers on my cross-country flights, and they learn that my company is involved in enhancing retail healthcare consumer experiences, they are always willing to share a shopping horror story. And just think, if they feel comfortable complaining to me — a perfect stranger — of their tribulations, imagine what they’re sharing with their friends. People are generally far quicker to point out deficiencies in customer service and overall customer experiences at retail than to share incredible examples of outstanding care.

Let’s remind shoppers what “service” means, and offer access to an attentive, professional sales force on the floor. I’d love to hear some success stories. And perhaps I’ll be lucky enough on a future flight to be seated next to a delighted retail shopper.

Hamacher Resource Group, Inc. (HRG) Vice President Dave Wendland, a 20+-year retail industry veteran, is a popular presenter and discussion facilitator available to speak at corporate and association events on a variety of retail-related topics. HRG is a research, marketing, and category management firm specializing in consumer healthcare at retail. Product manufacturers, healthcare distributors, retailers, technology partners, and others rely on HRG for strategic and creative solutions to help build their business. Learn more at


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J.HEWITT says:
Jun-28-2013 01:43 pm

Let’s remind shoppers what “service” means. Today, all business are having to re-learn this lesson in order to survive...

J.JHON says:
Jun-19-2013 02:27 am

It will always be good to just accept the error in addition to apologize correctly. One really needs to be flexible adequate to just accept their error simply because stubbornness solely ends up with split up in the marriage. ohhh!! I am sorry quotes get from here