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Brighter Smiles

Service Learning, Inter-professional Collaboration and Health Promotion in a First Nations Community

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Abstract

Objective: The goal of Brighter Smiles was to improve children’s dental health in a remote First Nations community in British Columbia in the context of a service-learning experience for pediatrics residents.

Setting and Participants: The provincial Ministry of Health had competitive funds available for collaborations between remote communities and medical educators. Hartley Bay (Gitga’at), a tribe of the Tsimshian Nation, responded by declaring children’s dental health to be a primary health concern. This northern community has an on-reserve population fluctuating around 200 people and is accessible only by air or water.

Intervention: A convenience sample of children had a baseline dental exam; parents also completed a questionnaire about dental health behaviours. Only 31% (4/13) of pre-kindergarten and 8% (2/26) of kindergarten to Grade 12 children had no dental caries. Planning of the Brighter Smiles intervention involved community leaders, teachers, parents, Elders, health care staff, pediatrics residents, and dental and medical faculty from the University of British Columbia (UBC). Brighter Smiles includes school-based brush-ins, fluoride programs, classroom presentations, and regular visits by UBC pediatrics residents to Hartley Bay to provide well-child care that includes age-appropriate dental counselling to parents at the clinic visits.

Outcomes: An early success indicator was a significantly increased proportion of dental service provider’s time scheduled for preventive maintenance services rather than dental rehabilitation (restorations and extractions).

Conclusions: The goal of providing a service-learning experience for trainee pediatricians in a remote community has been achieved. In addition, early indicators demonstrate improvements in child oral health.

Résumé

Objectif: Le projet Brighter Smiles visait à améliorer la santé dentaire des enfants d’une communauté éloignée des Premières nations, en Colombie-Britannique, dans le contexte d’une expérience d’apprentissage des services à l’intention des médecins résidents en pédiatrie.

Lieu et participants: Le ministère provincial de la Santé disposait de fonds concurrentiels pour des mesures de collaboration entre des communautés éloignées et des professeurs en médecine. La Bande indienne de Hartley Bay (Gitga’at), une tribu de la nation tsimshiane, a répondu à l’appel en déclarant que la santé dentaire des enfants était l’une de ses principales préoccupations en matière de santé. Cette communauté nordique a une population d’environ 200 personnes vivant dans une réserve et n’est accessible que par avion et par bateau.

Intervention: On a administré un premier examen dentaire à un échantillon de commodité composé d’enfants; les parents ont aussi répondu à un questionnaire sur les habitudes de santé dentaire de leurs enfants. Seulement 31 % (4/13) des enfants qui ne fréquentaient pas encore la maternelle et 8 % (2/26) des enfants de la maternelle à la 12e année n’avaient aucune carie dentaire. Pour planifier le projet, on a fait appel à des dirigeants communautaires, des enseignants, des parents, des aînés, du personnel médical, des médecins résidents en pédiatrie et des membres des facultés de médecine et de soins dentaires de l’Université de la Colombie-Britannique (UBC). Le projet comportait des séances de brossage des dents en milieu scolaire, des programmes de fluorure, des présentations en salle de classe et des visites périodiques à Hartley Bay par des médecins résidents en pédiatrie de UBC pour offrir des services de consultation pédiatrique, y compris des conseils dentaires aux parents adaptés à l’âge de l’enfant.

Résultats: L’un des premiers indicateurs de réussite du projet a été la proportion significativement accrue du temps des dispensateurs de soins dentaires réservé aux services d’entretien préventif plutôt qu’à la réhabilitation orale (restaurations et extractions).

Conclusions: L’objectif d’offrir aux stagiaires en pédiatrie une expérience d’apprentissage des services dans une communauté éloignée a été atteint. De plus, des indicateurs précoces montrent que la santé bucco-dentaire des enfants s’est améliorée.

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Authors and Affiliations

  1. Department of Oral Health Sciences, University of British Columbia Faculty of Dentistry, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada

    Rosamund L. Harrison DMD, MS

  2. Department of Paediatrics, University of British Columbia Faculty of Medicine, Canada

    Andrew J. MacNab MB, MD & Damian J. Duffy

  3. Village of Hartley Bay, Canada

    David H. J. Benton BComm, LLB

Authors
  1. Rosamund L. Harrison DMD, MS
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  2. Andrew J. MacNab MB, MD
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  3. Damian J. Duffy
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  4. David H. J. Benton BComm, LLB
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Corresponding author

Correspondence to Rosamund L. Harrison DMD, MS.

Additional information

Disclaimer: The results and conclusions are solely those of the authors and not necessarily those of First Nations Inuit Health Branch, Health Canada, or the Ministry of Health of the province of British Columbia.

Financial support: Ministry of Health, Special Populations Initiative and Northern Health - Aboriginal Health Initiatives Program British Columbia

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Harrison, R.L., MacNab, A.J., Duffy, D.J. et al. Brighter Smiles. Can J Public Health 97, 237–240 (2006). https://doi.org/10.1007/BF03405594

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