Running head: YWCA PRESCHOOL ORAL HEALTH EDUCATION 1

Community Dental Health Project:

Assessment, Diagnosis, Planning, Implementation, and Evaluation Phases

Maria Dela Cruz

Anupama Ingleshwar

Ngan Tran

Lake Washington Institute of Technology

DHYG 415: Community Dental Health IV

Winter Quarter, 2019

February 19, 2019

YWCA PRESCHOOL ORAL HEALTH EDUCATION 2

Assessment

Our target population are children from three to five years old at the Young Women

Christian Association (YWCA) Early Learning Center in Kirkland. The problem identified is

lack of knowledge in oral health in the majority of the families. There is a need to educate the

parents and children about the importance of preventing and treating oral health problems as

soon as they are diagnosed. By understanding the importance of prevention and the association

of oral health to the whole body, the children and their parents can make changes in their

current health habits and pay attention to their overall health. We collected our data by

discussing with Christina Nolan, the family advocate at YWCA as well as conversing with the

children and parents at the early learning center.

Community profile

The Young Women Christian Association (YWCA) learning center is open for low

income families in the city of Redmond Washington. Current demographics at this particular

location include children from white, Hispanic and non- Hispanic black families who mostly

speak English and Spanish. The Early Learning Center and Head Start program provide full

time care for children from 12-months to 5-years-old (ywcaworks.org, 2018).

Needs Assessment

According to the primary data gathered from Ms. Nolan, the identified need was to

improve oral health knowledge for children from three to five years old. The target population

mostly has state dental insurance which includes dental insurance for most children but does not

cover all adults. YWCA provides high-quality child care and a Head Start program for

preschoolers, located at Family Village Redmond. They offer a safe, supportive, and multi-

cultural, environment for low income children. It is designed to nurture learning and growth,
YWCA PRESCHOOL ORAL HEALTH EDUCATION 3

while preparing the children for kindergarten (YWCA, 2018). Although they offer basic food

and employment services, they do not provide oral health education or dental services of any

kind. YWCA does, however, provide substance abuse treatment. The residents of Redmond

have the option to go to Health Point community clinic which provides a sliding scale based on

their patients’ income. Since there is no oral health education incorporated in any program,

there is a great need for us to provide education for this community. According to the City of

Redmond environment website, all of Redmond's water supply meets or exceeds all

Environmental Protection Agency and Washington State Department of Health drinking water

regulations. Water from each well is treated before it enters the city water supply system

(“Drinking Water,” 2018). Currently, Redmond provides three types of water treatment namely:

fluoridation, chlorination, and pH adjustment (“Drinking Water,” 2018). Also, since the city has

provided fluoridation in the water, there is a need for educating this community about fluoride

benefits.

Literature Review

According to the article, “Parents’ and Children’s Behavior and Knowledge About Oral

Health.” it is shown that we can influence children’s behavior and oral health knowledge by

educating their parents (Beljan, Puharic, Zulec, Boric, Neumuller, 2016). The author also

recommended that health workers should plan interventions to prevent oral disease (Beljan et

al., 2016). Similarly, the article named “Socioeconomic and behavioral determinants of tooth

brushing frequency: results from the representative French 2010 HBSC cross-sectional study,”

also concluded that preventive campaigns should target not only schools but also families,

especially the most disadvantaged sections of the population (Fernandez de Grado et.al., 2018).

The article also mentioned that the message should be designed to fit the target population so
YWCA PRESCHOOL ORAL HEALTH EDUCATION 4

that it will pertain to them and be more effective. Indeed, both articles explained how we have

to target and educate parents since they make a big impact on their children’s oral health habits.

In addition, since our target group is in low socioeconomic status, the need is even greater. The

research recommended educating them at school as well as at home for optimum effect. Given

these points, these articles led us to address the need to educate both parents and children on

oral health.

Furthermore, food insecurity is defined as inadequate access to food shortages, disrupts

eating patterns and hunger. It is found that food insecurity has been strongly associated with

dental caries in low economic families. And food insecurity increases some risky oral health

behaviors such as increasing fermentable carbohydrates intake (Chi, Masterson, Carle, Mancl,

Coldwell, 2014). This creates a need for education regarding the kind of foods to be encouraged

and those to be avoided.

Moreover, “Oral health and nutrition have a multifaceted relationship. Oral infectious

diseases, as well as acute, chronic, and systemic diseases with oral manifestations, impact an

individual's functional ability to eat and their nutrition status. Likewise, nutrition and diet can

affect the development and integrity of the oral cavity and progression of oral diseases”

(Touger-Decker & Mobley, 2013, p. 615). This matter also calls for a need for collaboration

between the oral healthcare providers and dieticians. Therefore, we can express a necessity to

help this collaboration with dieticians in order to address this issue.

By the same token, fluoride is an integral part of cavity prevention. That is to say

fluoride can help enamel remineralization and helps in prevention of tooth decay. Different

types of fluorides are available which can be delivered systemically or topically. Researchers

recommend for patient who are at an elevated risk of developing dental caries, the use of
YWCA PRESCHOOL ORAL HEALTH EDUCATION 5

specific topical fluoride agents such as 2.26% fluoride varnish, 1.23% fluoride gel, or a

prescription-strength fluoride toothpaste (Weyent et. al., 2013). These recommendations are

based on the evidence that the benefits of fluoride outweigh its potential harm.

Diagnosis

First of all, it is most important to educate parents and then children regarding home care

for good oral health maintenance. Secondly, it is also essential to educate them about the

prevention of cavities by introducing fluoride and sealants as well as maintaining regular dental

visits. Lastly, it is key to educate them about nutrition so they can make healthy dietary choices

for optimum oral and overall health.

According to the website YWCAworks.org, YWCA provides health access with

continuous education for parents. Our target population is children ages three to five years old

and their parents. This group includes approximately 30 families located in Redmond,

Washington. We selected this group because these families belong to a low socioeconomic

status, and parents are less likely to have a strong health background. Since it is vital to prevent

oral disease as early as possible, and providing knowledge to children and their parents. We will

hopefully impact on their overall and oral health.

Planning

Project Goal and Objectives

It is our goal to increase oral health knowledge for children ages three to five at Young

Women’s Christian Association community in Redmond, Washington. Our objectives are to

increase knowledge of oral hygiene, oral disease prevention and nutrition in children of YWCA.

In order to measure the goal and objectives, we will conduct pre and post-test. This will

determine whether there was a gain in knowledge.

YWCA PRESCHOOL ORAL HEALTH EDUCATION 6

Timeline

1. Agency contact Apr 12, 2018

2. Meet with group May 16, 2018

3. Plan educational component May 29, 2018

4. Plan with YWCA face to face July 15, 2018

5. Follow up with YWCA Jul 21, 2018

6. Order supplies/Orientation schedule Aug 25, 2018

7. Intervention Oct 25, 2018

8. Initial evaluation Oct 25, 2018

9. Evaluate process/compliance Nov 15, 2018

10. Make improvements Dec 8, 2018

11. Gather data Jan 2019

12. Write reports Feb 2019

13. Full plan implementation Mar 13, 2019

YWCA PRESCHOOL ORAL HEALTH EDUCATION 7

Lesson Plan

We plan to divide into three groups that each will be responsible for 10 students. Each

group will have an activity to perform which is related to each projected theme.

The activity for the oral hygiene group is the human floss activity. The children will be

organized into two groups. Four children will represent teeth and 4 will do the flossing activity.

The teeth group will stand side by side representing teeth. Half the flossing group will be in

front and the other half will be in back of the teeth group. After our demonstration, they will

have the opportunity to floss the sides of the teeth (human) with a rope in “C” shape, with a

sliding motion. We will use words to instruct them to floss the teeth under the gums to remove

plaque and leftover debris.

The prevention group will show the participants the importance of fluoride in oral health

by doing the egg and vinegar activity. We will need hard boiled eggs, vinegar, fluoride gel and

containers. One egg will be dipped in fluoride gel for five minutes and the other one will stay as

is. We will place the two eggs in separate containers and put vinegar inside both containers. We

will encourage participants to spot the difference between the egg which has been treated with

fluoride versus the one without. We will ask them to touch the eggshell and describe their

texture. This will then lead to a conclusion of how beneficial fluoride is to tooth enamel.

To emphasize fluoride benefits and to help these children in choosing foods that contain

fluoride, we will show them pictures of these healthy foods. Then to ensure the children will

remember these foods, we will incorporate a game for them to play. The game is composed of

two baskets where the kids can place the foods containing fluoride on one basket and the ones

that don’t in the other basket. The group that finishes first, wins a pack of fluoride rich food.
YWCA PRESCHOOL ORAL HEALTH EDUCATION 8

The nutrition group will include a soda and egg demonstration. We will boil eggs, soak

them in soda for six hours and bring them to school. First, we will talk to the children about

similarities between the eggshells and tooth enamel while explaining to them how soda stains

teeth just like soda stains the eggshells. Second, we will let them observe and compare the both

eggs. We will then distribute toothbrushes with toothpaste and have the children brush the

eggshells. While they are brushing, we will encourage them to differentiate between the parts of

the soda eggshell that was brushed vs the ones that weren’t. This way the children can have a

visual image of what soda can do to their teeth as well as the benefits of tooth brushing with

toothpaste. For this demonstration, we will need ten eggs (five for soda soaking and five

regular) ten toothbrushes and toothpaste.

The other option for the nutrition group is bone and coke experiment. Calcium in the

bone represents the enamel and coke represents the acids produced by bacteria due to sugary

drinks like coke and other sodas. We will soak a chicken bone in coke for 24 hours the previous

day and keep another bone as control. We will make sure to take before and after photos to

show the children the coke’s effect on the bone. On the day of our presentation, we will show

the difference between the two bones. This will help the children understand since coke

damages the bone (tooth), it should, therefore, be avoided.

YWCA PRESCHOOL ORAL HEALTH EDUCATION 9

Budget

Items Proposed Cost Actual Cost

Transportation $20 $0

Arts & Crafts $20 $5

Pencils and papers $5 $0

End of presentation survey $5 $0

printouts

Visual Aids $10 $0

1.5 dozen eggs $5 $0

Fluoride Gel $16 $0

Snacks $20 $12

Toothbrush & Floss $50 $0

Other supplies to giveaway $20 $0

Bags $5 $0

TOTAL COST $176.00 $17.00

YWCA PRESCHOOL ORAL HEALTH EDUCATION 10

Summary

Our main problem is the lack of oral health knowledge for children and their parents at

the YWCA Early Learning Center. Due to the absence of oral health education services

provided by the government, there is a need to help improve oral health knowledge, oral disease

prevention, and nutrition counseling in this community. We have planned our interventions and

our next step will be implementation.

Implementation

We communicated with Ms. Nolan by email at the beginning of October and decided to

do the presentation on October 25th from 3pm to 5pm. YWCA facility didn’t have computers

available for us so we adjusted our oral presentation to fit with the facility. Ms. Nolan wanted

our presentation to focus on tooth brushing. The children brush daily after their afternoon snack,

so having a review on brushing technique and its importance would be very beneficial for them.

Abiding with Ms. Nolan, we made sure to focus greatly on tooth brushing, ensuring that each

child had practice during our visit. Using two classrooms at YWCA, we presented to two

classrooms, for a total of 20 students. We spent 30 minutes at the first classroom and 25 minutes

at the second class room, due to a smaller amount of students in the second class. We used 5

minutes for the pretest and 5 minutes for the post test. The rest of the 30-40 minutes we used for

presentation, letting students practice on brushing and flossing and passing out toothbrushes,

toothpaste and apples.

The visual aids we used included a poster board showing the different types of “always”

foods that we should consume on a daily basis and “sometimes” foods that we should consume

occasionally. We also used the teeth model and toothbrushes to show the children the correct

way of tooth brushing technique. The flossing technique was shown using a “human floss.” We
YWCA PRESCHOOL ORAL HEALTH EDUCATION 11

had one of our members stand straight, to represent a tooth, to demonstrate how to make a letter

“C” using a scarf as floss. We also used an egg that had been treated with fluoride varnish on it

to show the preschoolers how the fluoride can help strengthen teeth and fight cavities. We

demonstrated how sealants work and how they can protect the teeth from getting cavities,

especially on the chewing surfaces. We did this demonstration with a tooth model and a small

blanket. We told the preschoolers that sealants are like the blanket which covers the chewing

surfaces of the teeth, thus preventing the food from getting into the teeth grooves and preventing

cavity formation.

For the nutrition part of the project, we had our display board with “always” foods

which included foods like apples, cantaloupes, oranges, berries, carrots, broccoli, peas, and

healthy grains like brown rice, and lentils. Our display board also displayed “sometimes” foods

which included chocolates, chips, cookies, sugary juices, and sodas. After the brushing, human

floss, fluoride and sealant activities, we displayed the nutrition board to the children and asked

them to identify different foods. Most of them were very attracted to the “sometimes” foods.

Since our target population was very young, they hardly knew the benefits or harm caused by

the food on the board. We explained to them that there are foods we should be eating every day

so that our teeth and the rest of our body become strong and healthy. In addition, and there are

foods that we should not be eating every day because they are not healthy and could harm our

teeth and the rest of our body.

Finally, the purpose of using the pre and post-tests was to evaluate our success in

obtaining our objectives. Ultimately, we have achieved our goal, which was to impart

knowledge about oral health to three to five years old children at the YWCA. At the end, they

knew how many times they should be brushing daily and understood “C” shaped flossing
YWCA PRESCHOOL ORAL HEALTH EDUCATION 12

technique. They also were able to comprehend that fluoride makes our teeth stronger, and that

sealants protect our teeth from “sugar bugs” (microorganisms). In addition, the children learned

that fruits and vegetables are every day, healthy food choices and chocolates and chips are not

an everyday healthy food.

Summary

We went to the YWCA classrooms with a goal of improving oral health knowledge for

three to five-year-old children. The presentation showed them how to properly brush and floss.

Our presentation showed them how effective fluoride is, as well as how sealant can protect the

teeth and prevent cavities. We also made sure they understand which foods are “sometimes” and

which are “always” foods. Students appeared to be very engaged and excited to practice

brushing as well as pointing out “sometimes” food and “always” food. We hope we made a

good impact on them. Ms. Nolan informed us that International Community Health Clinic will

visit with them soon, so our presentation will be greatly beneficial in preparing them for that

visit. The next stage will be to evaluate our original objectives and analyzing pre and post test

results.

Evaluation

Evaluation is critical in improving the quality of any public health program. As we were

developing our project, we had anticipated that since out target group age was very young, we

wanted to keep the amount of time spent on our presentation low, as well as trying to engage

them as much as we could. We also wanted to create activities that were age appropriate. As far

as pre and post-tests, we wanted to keep the questions short and simple so that the children

could easily understand them, as well as correctly evaluate their improvement of knowledge.
YWCA PRESCHOOL ORAL HEALTH EDUCATION 13

The project had many strengths and we achieved what we had planned. We were able to

keep the presentation nice and short so that the children were able to focus and engage in the

activities we presented. In addition, bringing the tooth models was a great idea. Each child had a

chance to come up and practice brushing. We felt that we succeeded in conveying a message

that brushing is good for them and could be a very fun activity. We were able to show the

children with visuals how the bacteria can cause tooth decay. Judging only by the surprised

looks on their faces, we could tell we made an impact by showing them what could happen if

they don’t brush their teeth. The biggest success was the colorful poster board that had “always”

food vs “sometimes” food. Almost all of the children came over and sat right next to the poster

and responded really well to that part of the presentation. The goodie bags containing apples

were a great idea as well since the children loved them and half of the class ate them right away.

It was a nice reinforcement showing the children that always food can be a delicious option.

Along with our strengths, we had some areas that we could improve. We planned our

pre and post test questions thinking the children would be able to understand and answer them.

We didn’t anticipate that the age of our target group could not comprehend our questions. After

the first group, we re-evaluated our questions and made them simpler so that the children could

understand the questions better. In addition, another activity also needed improvement. We used

the human floss activity as a tool to teach the children how to floss, but their young minds could

not see and conceptualize the idea of having a human as “teeth”. So for the second group, we

used our tooth model and the children actively participated in the activity.

It was necessary to evaluate the program as we were carrying it out. During the

presentation day, as we were moving from classroom one to classroom two, we were able to do

our formative evaluation. As we saw the opportunity to improve our human floss presentation,
YWCA PRESCHOOL ORAL HEALTH EDUCATION 14

we decided to use the tooth models for the flossing education and the results were much better.

Also, we noticed that the pre and post test questions were too complicated for their age. Thus,

for the second group we made the questions simpler and shorter. It worked and we had more

correct answers, since the questions for the second group were more age appropriate.

After implementation, our summative evaluation included interventions to help our

presentation go smoother next time. Revising the questions so that all groups have the same

questions and answers as well as similar experiences. Also, instead of groups of seven we can

divide them into even smaller groups. This will reduce the time required for them to concentrate

and increase individual brushing and flossing practice time.

Based on appendix D, results of oral hygiene pre-test averaged out to be 53%, Fluoride

pre-test was 10% and nutrition pre-test was the highest at 70%. Not all children paid attention

and gave us answers, therefore the results appeared to be lower percentage than expected. A

little more than half of the children provided correct answers. Post test results were 66.79% for

oral hygiene, 16.65% for Fluoride and Sealants and 86.65 for nutrition. This reflected a 13%

overall gain in oral hygiene knowledge, 6.65% for fluoride knowledge and 16.65 for nutrition

knowledge. Based on results, the knowledge gain was not equally dispersed. More gain was

focused on oral hygiene and nutrition knowledge versus fluoride prevention. This was due to

the complicated nature of how fluoride works, thus, it was not easy to explain it to three to five-

year-old children. We found that most of the children already had good basic knowledge on

which foods are good or bad for their oral health. So our presentation was a good time to

reiterate what they already know. The cost for this project was $17 from arts and crafts and

apples for snacks. All others were donated to us by previous student.

YWCA PRESCHOOL ORAL HEALTH EDUCATION 15

The limitations that we encountered were the ages of the children, the complex topics,

our ability to present our topics in an age appropriate manner. The children there at YWCA

were instructed to brush their teeth daily after lunch. Therefore, brushing was the most familiar

topic to them. Similarly, diet is a common daily topic, as we presented “always” foods versus

“sometimes” foods, the children were able to catch on easily. They were able to differentiate

which category the food fit with. With this new knowledge, they can practice brushing in their

daily lives leading to good foundation in oral hygiene and nutrition. Based on the age of the

target group, we should implement more visual aids and age appropriate languages. This will

ensure the target group can understand the message we try to give out. Luckily we had the

opportunity to do some modifications in the second class that were beneficial and can definitely

be included if we were to present this project again. We changed the human floss activity,

which we deemed ineffective from the first classroom into flossing on the tooth model,

consequently yielded better results.

Overall, based on an increase in knowledge from pre-tests and post-tests, statistics

showed we met our goals and objectives. The project made a big positive impact on the YWCA

pre-school children on improving their oral health and nutrition habits.

YWCA PRESCHOOL ORAL HEALTH EDUCATION 16

References

Beljan, M., Puharić, Z., Žulec, M,.Borić, D., & Neumuller, KR. (2016 September). Parent's and

children's behavior and knowledge about oral health. Acta Med Croatica.70(3):165-71.

Retrieved from https://www.ncbi.nlm.nih.gov/p-ubmed/29064207

Chi, D. L., Masterson, E. E., Carle, A. C., Mancl, L. A., & Coldwell, S. E. (2014).

Socioeconomic status, food security, and dental caries in U.S. children: mediation

analyses of data from the national health and nutrition examination survey, 2007–2008.

American Journal of Public Health, 104(5), 860–864. Retrieved from

https://doi.org/10.2105/AJPH.2013.301699

Drinking Water. (n.d.) Retrieved May 30, 2018, Retrieved from

https://www.redmond.gov/Environment/DrinkingWater/

Early learning center and head start. (n.d.). Retrieved May 30, 2018, Retrieved from

https://www.ywcaworks.org/programs/early-learning-center-head-start

Fernandez de Grado, G., Ehlinger, V., Godeau, E., Sentenac ,M., Arnaud ,C., Nabet, C.,

Monsarrat, P. (2018 January 29). Socioeconomic and behavioral determinants of tooth

brushing frequency: results from the representative French 2010 HBSC cross-sectional

study. J Public Health Dent. 2018 Jan 29. doi: 10.1111/jphd.12265.Retrieved from

https://www.ncbi.nlm.nih.gov/p-ubmed/29377143

The soda and egg experiment (2011, November 25). The Soda and Egg Brushing Experiment.

Retrieved from https://ourmontessorihome.wordpress.com/2011/11/25/soda-and-egg-

brushing/
YWCA PRESCHOOL ORAL HEALTH EDUCATION 17

Touger-Decker, R., & Mobley, C. (2013). Position of the academy of nutrition and dietetics:

oral health and nutrition. Journal of the Academy of Nutrition and Dietetics, 113(5), 693–

701. https://doi.org/10.1016/j.jand.2013.03.001

We are the people’s home for health care (2018, May 31). Overview. Retrieved from

http://www.healthpointchc.org/about-us/overview

Weyant, R. J., Tracy, S. L., Anselmo, T. (Tracy), Beltrán-Aguilar, E. D., Donly, K. J. & Frese,

W. A., The American Dental Association Council on Scientific Affairs Expert Panel on

Topical Fluoride Caries Preventive Agents. (2013). Topical fluoride for caries

prevention: Executive summary of the updated clinical recommendations and supporting

systematic review. Journal of the American Dental Association (1939), 144(11), 1279–

1291.

YWCA. (2018, May 31). Health & Safety | YWCA. Retrieved from

https://www.ywcaworks.org/health-safety
YWCA PRESCHOOL ORAL HEALTH EDUCATION 18

Appendix A
Lesson Plan

TITLE: “Become a good dental child” TARGET GROUP: Children 3-5 years old of Young
Women’s Christian Association early learning center in Redmond.

ESTIMATED LENGTH: 30 minutes INSTRUCTIONAL METHOD: Tell-Show-Do

EDUCATIONAL GOAL:
To increase oral health knowledge for children ages 3-5 at Young Women’s Christian
Association community in Redmond, Washington.

INSTRUCTIONAL OBJECTIVES:
1. To increase knowledge of oral hygiene in children of YWCA.
2. To increase knowledge of oral disease prevention in children of YWCA.
3. To increase knowledge about nutrition in children of YWCA.

INSTRUCTIONAL MATERIALS:
Human floss
Brochures and display boards illustrating foods that prevent decay
Egg and Fluoride varnish
Red colored paper flag
Green colored paper flag
Tooth model and toothbrush

LEARNING ACTIVITY:
Quiz—RED colored paper flags for wrong and GREEN colored paper flags for right for all
quizzes
-Always food and sometimes food: Apple vs chocolate. Encourage children to place red flag for
sometimes food and green for always food.
-C shape or I shape floss (straight up and down, no hugging tooth), which technique is correct?
Test knowledge by having them differentiating which method is correct. The C-shape floss
should receive green flags and I shaped should receive red flags for incorrect technique.
-Tooth that is covered with Fluoride and tooth with sealants blankets. Are they good for the
teeth? YES, or NO question.
YWCA PRESCHOOL ORAL HEALTH EDUCATION 19

Instructional Set:
We are excited to be here to discuss how foods can attract sugar bugs on your teeth; and will
eventually cause cavities. We will also show you how to protect the teeth as well as how to best
take of them.

Body
1. Distribute handout to parents for tooth decay process and preventing tooth decay through
proper homecare, Fluoride, sealants and nutrition.
2. Explain the pictures of “always food” (apple, broccoli, cantaloupe, berries, carrots, peas,
lentils) and “sometimes food” (chocolate, cookies, soda).
3. Quiz activity: 1. Point to one of the always food like apple or carrot and ask if it is an
“always food” or “sometimes food” 2. Point to one of the sometimes food like chocolate or soda
and ask if it is “always food” or “sometimes food.” Answers will be measured by the number of
green (always food) or red (sometimes food).
4. Discussed that parents should brush their teeth after they brush because their parents have
better dexterity. Also educate them that they should brush for 2 minutes each time to remove all
sugar bugs that could cause cavity. Demonstrate the right way to brush with the Colgate model;
c-shape floss by doing the human floss activity. QUIZ: demonstrate 2 techniques of flossing; 1
is straight up and down, the other is c shape, hugging the tooth. Let them determine which
technique is correct and put a red for wrong vs. green for right technique. Let the children come
up 1 by 1 to give their answer. Ask if they should brush for 1 minute or two minutes. Ask if
their parents should brush their teeth after they brush them.
5. Show and explain how Fluoride can make teeth stronger and healthier using an egg with a
Fluoride varnish, and compare it with an egg that was dipped in vinegar: representation of an
acidic food.
6. Show and explain how sealant can benefit them in preventing tooth decay using a tooth
model and a “sealant” blanket.
7. Distribute the green and red flags for the quiz activity.
8. Positive reinforcement by giving out snacks after the quiz activity.
Closure:
We have talked about how important it is to take care of your teeth, choosing food that does not
attract sugar bugs and how to prevent them by brushing and flossing, by going to the dentist to
“seal” your teeth and applying topical Fluoride. If you have any other questions about that we
might be able to help you with, please contact us at the Lake Washington Institute of
Technology Dental Department.
YWCA PRESCHOOL ORAL HEALTH EDUCATION 20

Appendix B
Pre Test 10/25/2018

1. How many times do we brush a day?

a) 1 time
b) 2 times
2. Should parents brush your teeth at night?
a) YES
b) NO
3. Do we floss teeth using hugging Style-C shaped (plus demonstration)?
a) YES
b) NO
4. Does Fluoride make our teeth strong?
a) YES
b) NO
5. Do we “seal” our teeth to stop sugar bugs entering our teeth?
a) YES
b) NO
6. Is apple an “always” food?
a) YES
b) NO
7. Is chocolate a “sometimes” food?
a) YES
b) NO

Since our target population is 3-5 -year-old kids, we will not be handing papers for the test. We
will instead ask questions verbally in addition to demonstration and have them answer through
green (Yes) and red (No) flags. We will make a video recording and take pictures during this
pre and post Q&A session. The number and color of the flags will evaluate our program.
YWCA PRESCHOOL ORAL HEALTH EDUCATION 21

Appendix C
Post Test
Same day 10/25/2018
1. How many times do we brush a day?
a) 1 time
b) 2 times
2. Should parents brush your teeth after you brush?
a) YES
b) NO
3. Do we floss teeth using hugging style-C shaped (plus demonstration)
a) YES
b) NO
4. Does Fluoride make our teeth strong?
a) YES
b) NO
5. Do we “seal” our teeth to stop sugar bugs entering our teeth?
a) YES
b) NO
6. Is apple an “always” food?
a) YES
b) NO
7. Is chocolate a “sometimes” food?
a) YES
b) NO
YWCA PRESCHOOL ORAL HEALTH EDUCATION 22

APPENDIX D - Table

Oral Hygiene

# OF CHILDREN TEST/SCORE HIGHEST LOWEST AVERAGE

SCORE SCORE SCORE

8 in classroom 1 PRE TEST 10/15=66.7% 4/15=26.7% 8/15=53.3%

7 in classroom 2

8 in classroom 1 POST TEST 14/15=93.3% 5/15=33.3% 10/15=66.7%

7 in classroom 2

Average % gain results 26.6% 6.6% 13.4%

Fluoride and Sealant

# OF TEST/SCORE HIGHEST LOWEST AVERAGE

CHILDREN SCORE SCORE SCORE

8 in classroom 1 PRE TEST 2/15=13.3% 1/15=6.7% 10%

7 in classroom 2

8 in classroom 1 POST TEST 3/15=20% 2/15=13.3% 16.65%

7 in classroom 2

Average % gain results 6.70% 6.6% 6.65%

Always vs Not Always Food

# OF TEST/SCORE HIGHEST LOWEST AVERAGE

CHILDREN SCORE SCORE SCORE

8 in classroom 1 PRE TEST 12/15=80% 9/15=60% 70%

7 in classroom 2

8 in classroom 1 POST TEST 14/15=93.3% 12/15=80% 86.65%

7 in classroom 2

Average % gain results 13.3% 20% 16.65%