International Partners in Health
Dental and Nursing Students Bring Caries Prevention Program to Honduras

The Colleges of Dentistry and Nursing conducted their first joint community-based oral health screening, education, and prevention program outside of the United States in late April, when a team of 13 students, faculty, and administrators from both colleges traveled to Honduras on a six-day mission to prevent tooth decay in children.

Three pediatric residents and a dental hygiene student screened 232 three-to-six-year-old children in the villages of Nuevo Armenia, Choncó, and Boca del Monte in the mountains near the Guatemalan border. Two Spanish-speaking students from the Bachelor's Degree in Nursing Program, who had been trained to work with underserved populations, and a student from the Master's Program in Global Public Health with a concentration in Oral Public Health, provided the children with preventive oral health education and trained school teachers and community health workers from Arte Accion, a local non-profit organization, to apply fluoride varnish to children's teeth every three months. Children with severe decay were referred to a temporary clinic erected by NYUCD in the regional capital of Copan Ruinas to handle emergency treatment for the children from the remote villages, as well as for extractions, restorations, root canals, sealants, and fluoride varnishes for 600 adults and children from Copan Ruinas and its suburbs.

Planning for the mission began in April 2008, when Dr. Donna Shelley, Director of Interdisciplinary Research and Practice, and Ms. Erin Abu-Rish, Nurse Coordinator of the College of Nursing mobile health van, interviewed 70 residents from the region, using qualitative research methods to identify healthcare needs in the area. They concluded that while much health care is needed, the greatest gaps are in oral health.

"Oral health problems are pervasive," Ms. Abu-Rish said. "Oral hygiene is not generally practiced in the villages. Most people can't afford to see private dentists, so they pull teeth themselves; they get abscesses."

"Based on our needs assessment, we decided that the most effective way to make a sustainable impact on oral health was to develop an education and prevention program targeting young children before they develop serious decay," said Dr. Shelley. "When we returned to the area in April 2009 to implement the program, we gathered the children in their local schools and showed them a Spanish-language DVD produced by the nursing students, which demonstrated the importance of maintaining good oral hygiene as well as the proper way to use a toothbrush."

"Although the kids were mesmerized by the DVD, we don’t know whether any of them actually used the toothbrushes we distributed to them at the screening because this is not a common practice at home. When Arte Accion visits the schools to reapply the fluoride varnish, they will help the children decorate cups in which the children will keep their new toothbrushes. This is one way that teachers can make sure that the children’s teeth are brushed at least once a day."

"When a dentistry-nursing outreach team returns to the villages in April 2010 for a follow-up visit, we hope to see a 50 percent reduction in the spread of tooth decay among the children," said Dr. Stuart M. Hirsch, Associate Dean for International Programs & Development, and the mission's clinical director. "We also plan to provide basic treatments, such as extractions and sealants, while also arranging for those children requiring more extensive treatment to be transported to Copan Ruinas, where we will once again set up a clinic for patients requiring restorative, endodontic, and surgical care."

In addition to Dr. Hirsch, Dr. Shelley, and Ms. Abu-Rish, the outreach team included Dr. Mark Wolff, Associate Dean for Pre-doctoral Clinical Education and Professor and Chair of the Department of Cariology & Comprehensive Care; Dr. Charles Larsen, Clinical Assistant Professor of Pediatric Dentistry; Dr. Paddy Smithwick, Advanced Education Program in Pediatric Dentistry, '09; Dr. Christine Marcelo, Advanced Education Program in Pediatric Dentistry, '10; Dr. Feras Bokhamsin, Advanced Program in Pediatric Dentistry for International Dentists, '09; Ms. Nancy Duclonat, BS in Dental Hygiene, '09; Ms. Brittany Bluth, BS in Nursing, '09; Ms. Andrea Vogel, BS in Nursing, '09; Ms. Sukrita Matta, MPH; Ms. Amanda Meissner, Program Administrator, Office of International Programs and Development; Dr. James Toppin, Clinical Assistant Professor of Oral & Maxillofacial Pathology, Radiology & Medicine; Dr. James Apltauer, Clinical Assistant Professor of Cariology & Comprehensive Care; Dr. John Weise, Clinical Assistant Professor of Endodontics; Dr. Brendan O'Connor, Clinical Assistant Professor of Oral & Maxillofacial Surgery; Ms. Jill Fernandez, Clinical Associate Professor of Pediatric Dentistry; Dr. Aneta Mejia, Instructor in Cariology & Comprehensive Care; and Ms. Rachel Hill, Program Administrator in the Office of International Programs & Development.

Additional team members included Ms. Imani Holland, a sterilization technician; Dr. Marianna Delgado, Advanced Education Program in Endodontics, '10; Dr. Sanjit Singh, Advanced Program in Endodontics for International Dentists, '09; Dr. Ismael El-Khouly Castilla, Advanced Program in Comprehensive Dentistry for International Dentists, '09; Dr. Takanori Suzuki, Advanced Program in Comprehensive Dentistry for International Dentists, '09; Ms. Karen Milkosky, '10; Mr. Ryan Lee, '10; Mr. Aaron Land, '10; and the following students from the DDS Program Class of '09: Dr. Matt Shih, Dr. Cecilia Sorelle, Dr. Stacy Wolf, Dr. Andrew Young, Dr. William Wolff, Dr. Chinar Mahadkar, Dr. Nicholas Zeik, Dr. Lauren Petlick, Dr. Nicole Smith, and Dr. Dip Desai.