Corrections_Today_July_August_2019_Vol.84_No.4

Juvenile Justice News

of repeated patient education, pro- phylactic treatments and good oral hygiene habit development. All residents were asked upon intake when they last visited their family dentist. Sixty-five percent of the residents we encountered had been to their local dentist and received some type of dental pro- cedure in the past six months, with 35% stating that it had been over two years since being seen. This ques- tion led to the gathering of important information to the resident’s expo- sure to oral health care and to the assessment of the patient’s dental IQ, which would play an important role securing the necessary treatment after release. If residents responded that they saw a dentist in the last six months, it was an indication that the resident had received some education on the importance of obtaining rou- tine oral health care. However, if the resident responded that it had been years since they had seen a dentist, it was an indication that they needed increased oral health education. When working with residents with a low dental IQ, the dentist breaks procedures up into multiple short appointments. During these ap- pointments, the dentist educates the patient about the procedure utilizing the Show, Tell, Do method of train- ing. The dentist shows the patient the problem with their tooth using radiographs or dental models. Next, the dentist tells the patient not only about the procedure to fix their den- tal problem, but also what techniques they will use to numb the area so the patient will not feel pain. Finally, the dentist does the one single proce- dure. This method greatly reduces the dental apprehension of low dental

IQ residents that could limit future engagement in oral health care. During the intake exam, each resi- dent is educated to the importance of dental hygiene and that good oral health contributes to overall general health. All residents receive oral hygiene instruc- tions that include a strong emphasis on preventative dentistry. The dentist and dental assistant give them an overview of the detailed and focused range of dental services available to them ac- cording to their oral health needs. While they receive care from a variety of nurses depending on the time, day and nature of their medical need, the unit nurse plays a vital role in educating them and connecting them to the health care system. All resident housing units have a nurse assigned to their unit. While they receive care from a variety of nurses depending on the time, day and nature of their medical need, the unit nurse plays a vital role in edu- cating them and connecting them to the health care system. Adolescents are more amenable to suggestions

and ideas from adults with whom they have an established relation- ship, as opposed to semi-anonymous authority figures. The unit nurses participate in the ongoing dental education of their units by provid- ing periodic education on good oral hygiene practices. Challenges and solutions The aim of health services is to provide general and targeted oral hygiene instructions from multiple sources across a variety of settings. Changing any health-related behav- ior is unlikely to happen when the instructions and reminders are infre- quent and disconnected from every other aspect of a youth’s daily life. Upon initial assessment with radiographs, the dentist devises individualized treatment plans with a strong emphasis on preventive den- tistry regimes. In many correctional settings, offenders are offered one cleaning a year (or less) due to the large population of the prison and the relatively small dental staff. In rec- ognition of community standards of care and the importance of ongoing prophylactic treatment, we changed our practice to include dental ap- pointments every six months. This included a six-month recall hygiene system as well as sealant placement and the painting of Duraflor (fluoride varnish) on the facial/buccal sur- faces of all teeth. The adding of the recall system allowed the resident to receive two preventive dentistry appointments yearly, which included prophylaxis (cleanings) as well as replacement of sealants if needed and fluoride varnish. Moreover, if new carious lesions (cavities) were found during the recall/annual

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