Oral Health in the WIC Program

The WIC Program can play an important role in preventing oral health problems in women, infants, and children through its education and referral programs. The identification of oral health problems is part of the nutrition risk assessment used by local agency WIC staff to establish eligibility for participation in the Program. Depending on local priorities, WIC local agencies may provide nutrition counseling as well as classes to parents and guardians of infants and children on proper care of the gums and teeth at home and feeding practices that reduce the risk of developing nursing bottle caries and other tooth decay. Many WIC local agencies have improved the links between participants and the local oral health community through referral and networking.

USDA's Food and Nutrition Service (FNS), which administers the WIC Program, and WIC state and local agency staff participated in the Head Start and Partners Oral Health Forum held September 1999. Several follow-up activities are planned to disseminate information regarding the Forum and the recommendations made in the scientific papers. For example, a working group of representatives from FNS regional offices and WIC state and local agencies around the country has been formed to provide guidance in developing materials for parents and WIC staff. These materials will be based on recommendations from the Head Start and Partners Oral Health Forum and the scientific papers on nutrition and oral health.

At the federal level, USDA has joined with other departments and agencies to participate in several initiatives in an effort to further improve the oral health of children, including participation in and support of the Surgeon General's Conference on Children and Oral Health that took place June 12-13, 2000.

WIC and Head Start: Opportunities to Work Together on Oral Health
Head Start programs can contact and partner with state and local WIC agencies to obtain oral health educational materials. Many WIC agencies have training modules, protocols for oral health screening and referral, assessment tools, and other oral health resources. For example, the Washington state WIC agency has an excellent oral health program. The Washington WIC Baby Bottle Tooth Decay Prevention Project started at a local WIC clinic and, in 1992, was expanded statewide. Many other organizations and agencies in the state collaborated with WIC to develop the project, including the Department of Pediatric Dentistry at the University of Washington.

The project has three goals: (1) to promote nutrition and oral health education to improve infant feeding practices and reduce the risk of baby bottle and early childhood tooth decay; (2) to encourage caregivers to value their child's baby teeth; and (3) to provide oral health referrals when needed. Washington state has numerous materials on oral health, including two publications–"Healthy Snack Tips"and "Super Smart Snacks"–that provide information on snacks that minimize tooth decay. These materials can be ordered via their Web site: http://www.doh.wa.gov/Publicat/publications.htm. To search, enter "dental/oral" as the subject.

Not all WIC agencies have specific oral health materials or projects, but FNS encourages Head Start programs to inquire and, if needed, to collaborate with WIC to obtain oral health resources for use in Head Start programs. By coming together to identify needs and leverage resources, WIC and Head Start may be able to find creative ways to bring good oral health components to their programs and into the lives of the families they serve.

One of the biggest problems facing local communities is finding dentists and oral health care programs willing to serve low-income participants. Head Start and WIC can work together to publicize this concern in their local areas, identify oral health care services and referrals, and share this information with each other. Working together, the two programs have more power to raise awareness that oral health and access to oral health care are priorities in their communities.

Patti Mitchell is a Nutritionist, Supplemental Food Progam Division, Food and Nutrition Service, U.S. Department of Agriculture, T: 703-305-2741; E: patti.mitchell@fns.usda.gov.

 

Possible Areas of Collaboration between WIC and Head Start

• Invite representatives from WIC to attend your local, state, regional, and national meetings
  
  
• Develop joint staff training opportunities
  
  
• Coordinate health and nutrition screening/assessment
  
  
• Share staff
  
  
• Exchange education approaches and share educational materials
  
  
• Cosponsor community resource fairs and community information sessions
  
  
• Encourage contributions to WIC and Head Start Bulletins and newsletters

A Success Story

A survey of Head Start children in nine villages of the Yukon-Kuskokwim Delta Region of Alaska found that an average of 67 percent of children had baby bottle tooth decay. Both WIC and Head Start staff found that children in Alaskan Native cultures are more often and more consistently given sweets and soft drinks compared to non-native children. This emphasized the need for educating parents and caregivers regarding nutrition and its relationship to maintaining good oral health.

The Yukon Kuskokwim Health Corporation (YKHC) WIC program initiated a demonstration project to address this issue. WIC and Head Start staff conducted home visits to provide training that placed special emphasis on nutrition education to parents and caregivers, tooth brushing and flossing, and referral information on oral health and nutrition. Tooth brushes, posters, pamphlets, and a video were distributed.

The project resulted in improved access to WIC, dental programs, Head Start, and other health programs in the region. It enhanced nutrition services and nutrition education and improved coordination among health providers of these programs by giving them experience in a new approach to collaboration efforts. The project also raised awareness in the community of the prevalent, painful, yet preventable problem of baby bottle tooth decay.