Pediatric and Adolescent Clinic Services at Sacred Heart Hospital -
Allentown, PA
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Program Description |
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The Pediatric and Adolescent Clinic Services at Sacred Heart Hospital has almost 15,000 visits/year serving especially low income children. We also sponsor seven school based health centers which care for school aged children and their younger siblings. We have 5 pediatricians and 4 nurse practitioners in a general pediatric setting who are responsible for hospitalized, nursery and ambulatory patients. We are a teaching site for Family Practice residents who rotate through our pediatric service throughout the year. Sacred Heart Pediatric department participates in the Pa AAP IC program for chronic children and the Pa AAP IEP program for vaccine education.
Allentown is a city of 100,000 with an 80% Latino population. 20% of our patients are Afro-American. We service over 5000 children, of which over 2100 visits last year were aged 0-3. Our catchment area is the downtown urban district, where many of our patients are dependent upon public transportation. Approximately 95 % of our patients are on medical assistance with 5% being self-pay. We also care for CHIP patients at our Pediatric Associates practice. This office is also housed in the Sacred Heart Hospital. Our rate of transient patients is very high. Compliance for follow up is poor and it is necessary to make reminder telephone calls.
Sacred Heart Hospital is a 263-bed Catholic medical center located in central Allentown, Pennsylvania. Founded in 1912, Sacred Heart Hospital offers a full range of advanced medical services, ranging from gastric bypass surgery and cardiac services to oncology, orthopedics and women's health. A comprehensive range of home care services, including visiting nurses and hospice care, is also available. A network
of physician practices throughout Lehigh and Northampton Counties providing complete primary and pediatric medical care to the
region's residents.
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Preceptor |
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Dr Norman Tinanoff received his dental degree from the University of Maryland in 1971. After receiving his certificate and Masters Degree in Pediatric Dentistry at the University of Iowa, he spent another year at the V.A. in Iowa City. Dr Tinanoff's two-year military service was at the Army Institute of Dental Research at Walter Reed Army Medical Center. For 23 years he was at the University of Connecticut Health Center where he was director of the Pediatric Dentistry graduate program for 16 years. In 1999, he became Chairman of the Department of Pediatric Dentistry at the University of Maryland. In 2003 he became Chairman of the Department of Health Promotion and Policy, which includes Pediatric Dentistry, Dental Hygiene and Community Dentistry; and in 2005, graduate program in Advanced General Dentistry, Clinic Managers and Special Patient Care were added to the Department. Dr Tinanoff has authored or co-authored over 130 full-length publications, primarily on fluoride mechanisms, antimicrobials, caries risk factors, early childhood caries and prevention. Recent books/monographs include "Dental Care for the Preschool Child", in Dental Clinics of North America; "Proceeding of the Early Childhood Caries Conference", in Community Dentistry Oral Epidemiology; and "The Oral Cavity" in Nelson Textbook of Pediatrics. His current interests are concerned with and preventing dental caries and oral health access in underserved child populations.
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| Training Day |
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Despite the fluoridation of Allentown's city drinking water the incidence of dental decay is all too prevalent in the toddlers and preschoolers seen in our pediatric clinic. This leads to pain suffering and a less than perfect smile. Concern with this growing problem prompted Dr Leslie Carroll to apply for and obtain an educational grant from AAP to enable the staff of the pediatric clinic to receive instruction in the early recognition of dental decay and application of fluoride varnish in the at-risk population.
The program, which took place on March 6, took the form of a very informative and enjoyable presentation by Dr Norman Tinanoff, a pediatric dental specialist and preceptor for the AAP Oral Health Initiative program. The program covered the recognition of at-risk children, signs of early dental disease and surprisingly that the main cause of dental decay in toddlers is not prolonged use of baby bottles but attack by a bacteria (mutans streptococci) transmitted from mother to child. Ways of preventing transmission of the bacteria and of preventing early dental decay was covered in detail, as was the application of fluoride varnish. For a cost of approximately 75 cents per application, the fluoride varnish can greatly decrease the incidence of dental decay.
The culmination of the program was a hands-on practical session where, under the supervision of Dr Tinanoff, the pediatricians, nurse practitioners, residents and medical students gained practice in applying fluoride to a group of volunteer patients. This included learning how to perform a dental exam using the "knee to knee" exam.
The same evening, at an enjoyable and well attended dinner meeting, dentists, dental hygienists. pediatricians. family practitioners, school nurses, residents and nurse practitioners from throughout the area gathered to hear Dr Tinanoff give a presentation on "Dental Care for
Early Childhood". |
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| Next Steps |
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Continue to educate Family Practice residents about the importance of early childhood oral health and fluoride varnish application. Apply for grants/donations to provide fluoride varnish to our vulnerable inner city pediatric population. Initiate oral health education and fluoride varnish in our well visits at clinic, with full staff support.
The entire staff, from the front desk to pediatrician, are now committed to the program. It is easy, safe, preventive, and necessary for good health, for many of our patients. Hopefully, additional money for fluoride varnish, and the assessment will soon be available from insurance companies. It is as important as the eye and ear exam. |
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