WHO Collaborating Center: Report 2002-2006
Atraumatic Restorative Treament (ART) Training and Service Programs
ART training workshops have been conducted to prepare faculty and students to participate in ART projects. The first training was conducted in Mexico City with Dr. Jo Frencken and included participants from the Ministry of Health Oral Health Department of Mexico. A selective course in ART was offered to dental students in 2003 and 2004 at the School of Dental Medicine. 370 restorations and 193 sealants using ART were provided to 118 children in an underserved community in Mexico and evaluated over a two-year period. Results indicated that ART is acceptable and effective in controlling and preventing decay in a socio-economically deprived community (see citation below).
Evaluation of activity
• Publication and dissemination of findings of research component contributing to the body of knowledge of this treatment approach (American Journal of Public Health, August 2005 Vol 95 No 8).
Results supported.
• Duplication of the workshop in the Ministry of Health Oral Health Department. Using the train-the-trainer approach, the Ministry of Health Oral Health Department reports that ART workshops have been conducted in several regions/provinces in Mexico and ART is being used in these provinces.
Diversity, Culture and Oral Health Project: Research and Service Program to an Underserved Ethnic Community
Description of project
This project has a research and service component and aims to initiate oral health services in an underserved Hispanic community and African immigrants in Philadelphia. It also aims to identify oral health beliefs and attitudes that influence oral health seeking behaviors in this population. This project is being done in collaboration with the Esperanza Health Center, a non-profit, faith-based organization that offers a range of medical and social services to underserved minorities, and with AFRICOM, a coalition of African communities that is focused on service to African refugees and immigrants in Philadelphia.
The program aims to develop and implement oral health promotion and prevention programs and dental services to this selected patient population. Information gathered from this initial study will lead to studies on other ethnic groups in the future and will be published and used as a tool in educating health care providers to be culturally competent in their delivery of care.
Expected outcomes
• Identification of oral health beliefs and attitudes of Hispanics, Africans, and other ethnic minorities living in Philadelphia. A survey of the utilization of oral health services and oral health beliefs of African immigrants in West Philadelphia was conducted in 2004 and 2005.
• Oral health education and health promotion in the community, and specifically of this particular ethnic population.
• Initiation of dental services at the Esperanza Health Center.
Evaluation of activity
• Compilation of a body of information on oral health beliefs and attitudes.
• Faculty and students have participated in various health fairs sponsored by Esperanza Health Center. Preliminary studies on establishing oral health services have been initiated. Donations of dental chairs and instruments have been solicited.
• Preliminary results of the study of oral health attitudes and behaviors of African immigrants were presented during the American of Public Health Association annual meeting in 2005.
• A study of obesity and oral health in the Hispanic immigrant community in Philadelphia was completed as part of Dr. Andres Pinto's Master of Public Health program and a paper will be submitted for publication.
• Annual participation in the African Health Fair in West Philadelphia.
Recruitment and retention of minority students in dental schools
Description of activity
The US Surgeon General's report on the Oral Health in of America cites the relatively small percentage of minority dentists in comparison to the increasing proportion of minorities in society. There is a need for more dentists from these minority groups to provide culturally competent care. A research project that aimed to determine reasons for decision to enroll in, and complete, a dental school dental education from the perspective of minority students themselves was conducted in 2002 using surveys of US dental schools.
Expected outcomes
• Identification of reasons for decision to enroll in a particular dental school from the perspective of minority students.
• Publication and dissemination of findings to dental schools for enhancement of recruitment and retention efforts for minority students.
Evaluation of activity
• Establishment of a recruitment program among underrepresented students in Philadelphia high schools called STEP (Short Term Enrichment Program) was started in 2002. This program continues to be conducted bi-annually.
• Publication of the study of the STEP program. Results of the study were published in the Journal of Dental Education Vol 67 2003.
Minority Outreach Oral Health Initiative
The Division of Community Oral Health received funding from the Health Resources Services Administration to expand community oral health outreach activities by providing education, screening, referral and dental care services to preschool and elementary school children in West Philadelphia. This program has two major components: the oral health education, screening and referral program, and the provision of dental care on both the mobile dental van and at the UPSDM pediatric dental facility. Program staff will select, refine and implement an oral health education program with 2100 children in preschool, kindergarten, 3rd and 7th grades, and with 25 school nurses, school district personnel and resource staff members. Program staff will plan and implement oral health screening and referral for dental care programs with the same 2100 children, and track the number of children who receive follow up care at the UPSDM.
Expected outcomes:
• Collaboration with the public school system in oral health education and provision of oral health care services to the school children.
• Increase in the number of school children who have access to oral health care.
• Initiation of a continuing venue for the provision of oral health care to school children in the West Philadelphia district through a mobile van.
Evaluation of outcomes:
• A total of 4,142 children from 35 elementary and middle schools were screened as part of the PennSmiles program. About 94% of screened children were African American and the majority of them were from low income families. Dental disease and conditions were prevalent among them: more than 50% had dental caries, nearly 46% had gingival inflammation, and 73% had detectable dental plaque. However, only 14% of children had dental sealants. About 9% of children needed urgent care. Logistic regression analysis results indicate that children who had soft tissue lesions (OR=5.89), tooth fracture (OR=3.22), or caries (OR=21.20) were more likely to need urgent dental care. In addition, children who had a higher number of restored teeth (OR=0.52) or sealants (OR=0.46) were less likely to need urgent dental care. Results indicated that oral health status was poor among low-income school children in West/Southwest Philadelphia.
• Investigation is ongoing related to tracking the children who have received dental care.
• The Minority Outreach Oral Health Initiative provided the impetus for increasing the education, screening and referral programs at Penn Dental Medicine. Below is a chart showing the increase in number of programs for both children and adults from 2001 to the present:
Years |
Number of
Community Programs |
Number of
Individuals Served |
2005 - 2006 |
427 |
20,697 |
2004 - 2005 |
396 |
21,686 |
2003 - 2004 |
285 |
23,255 |
2002 - 2003 |
279 |
21,591 |
2001 - 2002 |
162 |
12,400 |
International student and faculty exchange programs
Twenty-seven dental schools have formal linkages with Penn Dental Medicine for student and faculty exchanges. These programs have created an awareness of differences and commonalities in oral health education and delivery of oral health services in the US and other countries.
Expected outcomes
• Increased awareness of differences and commonalities in oral health education and delivery of oral health services in the US and other countries.
• Increased understanding of social and cultural factors that influence and determine oral health status, beliefs and practices among different groups.
• Continued collaborative activities with sister institutions in countries with limited resources, i.e., joint project on ART in Gambia with University of Witten, Germany.
Evaluation of outcomes
• Over 40 dental students from the School of Dental Medicine and an equivalent number from schools outside the US participated in these programs annually.
• Faculty from the University of Ibadan, Nigeria have visited the dental schools for short term training programs through the MacArthur Foundation Grants: two participants in 2004 and 2 participants in 2006.
Sharing of educational resources with institutions in countries with limited resources
Books, journals, school syllabi, and instruments were sent to the Ghana Medical School/Faculty of Dentistry, University of Ibadan Faculty of Dentistry in Nigeria and the Universidad Mayor de San Simon in Bolivia.
