For a child, a visit to the dentist is a routine affair: Playing with toys or coloring in the waiting area, a gentle call back to see the dentist, growing anxiety as the tools are prepared, and a series of questions: “Have you been brushing? Have you been flossing?” Then, the dentist asks about the child’s diet and has them step on the scale.
For now, that last part may not be so common, but a new collaboration between faculty members in the Department of Social and Behavioral Sciences and Temple’s Maurice H. Kornberg School of Dentistry aims to incorporate nutrition and obesity screenings into regular dental care.
The joint effort makes sense, says Gina Tripicchio, assistant professor of social and behavioral sciences, who is leading the nutrition and obesity prevention component of the project with David B. Sarwer, associate dean for research and director of the Center for Obesity Research and Education (CORE). The same foods and factors that lead to dental decay—think sugary foods, sodas, candy and the rest of the list likely plastered on your dentist’s wall—also contribute to childhood obesity. So, when dentists are looking for signs of tooth decay, they’re also looking for a kind of forensic evidence of poor nutrition. Since the child, caregiver and a medical provider are already together in one place, why not use the opportunity to talk about diet?
It’s part of a larger effort to train dentists to be more holistic healthcare providers, thanks to a $1.5 million grant awarded to Kornberg by the U.S. Health Resources and Services Administration. Each year, Kornberg receives funding to develop new curricula, community-based clinical rotations and other activities to improve students’ ability to provide dental services to children younger than 5 years old. The grant, led by Vinodh Bhoopathi of Kornberg, aims to equip students with an understanding of social determinants of health and teach them to apply population health principles while providing care to underserved children.
After receiving that grant, the Kornberg School of Dentistry reached out to Sarwer and Tripicchio to create a curriculum for dental students on pediatric obesity and child nutrition. Over the 2017–18 academic year, they developed a child nutrition and healthy weight screener and trained the dental students on healthy eating behaviors, screening for obesity or other signs of poor nutrition, and counseling on proper nutrition with patients and parents. Starting in the fall, the team will test the dental students on their ability to administer the screener, adding scales and stadiometers to their usual tools of drills, probes and scalers.
When discussing nutrition with dental patients, the approach differs depending on age. For ages 2 or younger, students were trained to ask caregivers about early feeding practices, such as bottle or breastfeeding, and the introduction of specific food items, like juice. For older children, they learned to discuss sleep and screen time, sugary drink consumption, and bedtime routines based on recommendations from the American Academy of Pediatrics. Despite the obvious connection, dental curricula across the United States typically don’t include training on nutrition. It’s a missing piece for the dental curriculum, says Tripicchio, who led two lectures and a clinical orientation for the dental students.
The team is working to turn the curriculum into a guidebook that can be disseminated to other schools and dental professionals. They also hope to continue training the Kornberg students in the future and to eventually bring similar training to other fields and professions; for now, they’re evaluating the success of the dental curriculum with the hopes of conducting a long-term analysis over the next year.
“There’s an opportunity to teach people,” said Tripicchio. “As a nutritionist and obesity researcher, you know that everybody isn’t thinking about these things as much as you are. It’s great to see how interested the dental students are and to make the connections between these very related and important aspects of child health.”