The primary objectives of my field experience include enhancing of practical knowledge and awareness in the field of private pediatric dental care in Jeddah, to aid the parents in interpretation of dental care knowledge and to offer dental services for low income individuals. I noticed while working in the private clinic that there was a great need for education in the area. Despite the fact that parents had a lot of questions about oral health; the dentist did not have enough time to educate the patients and answer all of the questions. Furthermore, some patients might have the knowledge, however, their self-efficacy was lacking. It made a huge difference to actually hold the typodont (the teeth model) and show the parents how to brush their kids’ teeth. Sometimes, it was important to teach them with the help of their child how to floss. Also, I noticed that the first visit for a new patient was always chaotic. The visit was divided between addressing the patient’s chief complaint, which is usually an emergency visit to relieve the pain, and trying to introduce them to the clinic. From these observation I came to the idea of my capstone project. It is a development of a children’s book that will be distributed among the patients after them making the appointment. In such a way they would be able to read to their child and have some information about the proper way of oral hygiene for themselves as well. It is important to provide patients in any health care settings with accessible information on oral health. There is not a lot of books on oral health that is attractive to children and have scientific information for parents.
The Capstone Project:
After reviewing the literature and the field experience, I wanted to create an educational children book. The objectives of the book are the following:
• Provide anticipatory guidance for new parents.
• Introduce children to the dental environment to familiarize them at their first visit.
• Take the child on a dental journey from a baby that is able to do a lap exam visit to a child that is able to sit on the dental chair for a full clinical and radiographic exam.
Methodology:
The target population is children between the age of 6 months to 3 years old. The reason I selected this target population is that according to the AAPD guidelines it is of crucial importance that parents schedule a visit to their dentist within 6 months of the eruption of first tooth and no later than 12 months of age (Statement on Early Childhood Caries, 2000). The second reason is that there is no children’s book that I am aware of from my search on the web that target children this young and which will help to educate their parents about their first visit to the dentist. At least such book is not of a direct accessibility. It is written in a simple language to spark their interest because the book has illustrations of the dental clinic with bold colors and rhyming words. The book also will encourage conversation between parents and children by putting simple question like “How many teeth do you have?”. In addition, the book has important information about anticipatory guidance like the importance of timing of the first dental visit and how many teeth they should expect to see.
The content of the book was reviewed with Dr. Alene Delasio. She is a senior pediatric dentist at children's hospital of Pittsburgh whom I worked with during residency. We selected the information that I should present in the book according to her long experience in the field. The pictures in the book were drawn with the help of the computer program “Paint”. We selected cartoonic figures with bright colors to attract the children to the book. The book included a bedtime story for children that talks about brushing their teeth time because they will meet the dentist soon. And it included some words like the dentist would use like “open wide”, counting the teeth. These are very common words that most pediatric dentist use during their appointments. Also, it included some common metaphors for the instruments that child will see at the dental office, for example, Mr. Thirsty, tickler and toothbrush. Also, we included some information for the parents at the end of each page about various topics like parental anxiety, times of annual brushing and annual visit and when they should start brushing teeth for their children.
Pilot study Research Project:
In the project proposal done with Dr. Noella Dietz, a pilot study was recommended to test the likeability of the test before the wide adoption process begins.
The community partner. Dr. Osama Basri from Dr. Samia Felemban Private dental clinic helped with the distribution of the book. We distributed the book as a PDF file. Dr. Osama emailed the book to a random list of patients. Also, initially I distributed the book through “Whatsapp” application to people I know that have children in the same age group.
I sent four simple open-ended questions as a survey. Questions were:
1- Did you find the information in the book helpful?
2- Did you think reading this book for your child will affect his behavior during the first visit to the dentist?
3- Do you have any feedback for me?
4- How can we make the book better?
We sent out twenty copies of the book electronically via email. We did not get any responses for a couple of days. So I sent a test sample through “Whatsapp” and people started responding. So, I generated a survey monkey and started sending reminder messages. Please, find the link attached
https://www.surveymonkey.com/r/brushybrushtime
Initially, I received various responses and most were very positive. Some mothers did not fill out the “Whatsapp: survey. However, they left a positive comment about the book. One parent said that her daughter really liked the drawings and she understood that she had to brush her teeth every day and how to do it. All of the parents said the information was beneficial to them. However, some responses I received were questions about tongue brushing and flossing. Which is not indicated in this age group, as the presence of the primary teeth spacing is normal. Also, all of them said that the graphics were useful. However, some parents requested more pictures. All the parents I surveyed said that they think their child’s behavior will be positively affected since they read the book for them. Overall, they liked the material of the book because it was simple and clear for their children.
All the patients were asked if anything can be done to make the e-book better or easier to understand. I received a lot of suggestions such as advice to use prezi to make it more interactive and have sound effects. I increased the font of the book. And added 4 more pictures instead of the separator page “it is brushy brush time”. Next, based on the feedback I received from those who saw the book, I made adjustments to incorporate their suggestions. Also, many parents found some of the information confusing because it did not specify if the information was for them. So, I added a side note for parents to know that this information was written for them. After these adjustments were done, the book was presented to some of the people in the initial survey to get their feedback and they liked it better now. One of the limitations of this simple field project is that the sample was a convenience sample that turned into a snowball sample. In a positive note, it has really encouraged me that people do want to know more about this book. People are really looking for books to read for their children about the dentists and that confirmed my research that there is not many children books out there. However, since this is a convenience sample there is definitely bias in it. I am not sure now that all the people that did the survey had children in the researched age group. Also, these groups that responded to the survey are usually interested in the book and wanted to share their opinion. One of the biggest limitations of my project was the time frame limitation. It took me a while to do the drawings and to come up with the script. So, I was not able to find a sponsor this semester despite the fact that my community partner tried to help me to find a sponsoring company that is affiliated with their clinic. I am optimistic to show them the results of the pilot study and show them a proof of likability and ensure widespread adoption.
In summary, this book is not profitable and is for the general knowledge of the public. It is expected to educate parents in Saudi Arabia about oral health and raise the awareness about the importance of the first dental visit. More important it will help to make a nice positive visit since it reduces the children’s anxiety from the fear of unknown.
References
ADA. (2000). Statement on Early Childhood Caries. Web. 18 Apr. 2016.
