Amanda Means, Rebecca Ebarb

DHYG 1315
March 23, 2015
Needs Assessment: Buckner Children and Family Services
A. General Data:
1. Description of Site: Buckner Children and Family Services (Buckner) is located in
Beaumont, Texas near Westbrook High School. The physical location is 9055 Manion Drive,
Beaumont, Texas 77706. Buckner is a private, Christian-based organization that was originally
opened as an orphanage in Dallas, Texas in 1879. It was founded by R.C. Buckner, a Baptist
preacher. [1] It has since evolved into an international foundation for abused and neglected
children, young adults, and seniors. There are numerous Buckner locations around the world
including Honduras, Ethiopia, the Dominican Republic, Russia, as well as many throughout the
United States. [1, 2] Buckner is funded by grants, donations, endowments, and also private
events that are held to raise funds for new construction and repairs to the site. [1] Primary
services provided by Buckner include: Residential childcare, orphan care, adoption and foster
care services, prevention programs, senior adult services, missionary opportunities, and a global
humanitarian aid program known as Shoes for Orphan Soles, which provides shoes to needy
children throughout the world. Buckner is an umbrella to several other organizations such as:
STAR (Services to At-Risk Youth, which provides free counseling to children and teens with a
history of juvenile delinquency), FYI (Fostering Youth Independence, a transition program for
former residents of Buckner into adult life), and Calder Woods (a senior living community for
those with limited to no financial resources). [2] The Buckner Childrens Village is the primary
focus of our oral health program and is a temporary home to approximately 50 children;
however, enrollment varies frequently. [1] Amenities of Buckner Childrens Village include: 3
group homes, which house approximately 12 kids each, a full kitchen, library, events center,
playground, emergency shelter/assessment center, and a storage facility that holds clothing, toys,
party supplies, etc. Activities that take place include: bible studies, crafts, outdoor activities,
holiday celebrations, summer activities, and back to school events. [1]
2. Target Group: Buckner Childrens Village accepts youth ages 5-17. The ethnicities
and genders of the children at Buckner vary each day. Buckner does not accept infants and
toddlers at this time due to the need for increased caretakers that is required for children of that
age. Buckner receives new children sporadically and, at present, enrollment is low. The average
amount of time for each child to remain in a group home and/or emergency shelter varies,
depending on availability of foster homes.
3. Description of Staff Population: There are approximately 45 employees at Buckner
in Beaumont, which include the program director who oversees all operations, case managers,
social workers, meal staff, transportation workers, and volunteers. There is also a licensed
therapist, ministry engagement coordinators, and home developers who perform home
inspections and are in charge of licensing the home to approve it as safe for the children.
Although there are many employees who hold college degrees in social work or other areas of
expertise, not all of the volunteers or administrative staff are trained or skilled in a specific area.
Several of the employees were trained on-the-job and have no formal academic credentials.

Amanda Means, Rebecca Ebarb

DHYG 1315
March 23, 2015
4. Description of Services Provided: Buckner has a ministry engagement coordinator
who organizes and plans community-related events for the children and works closely with
volunteers. Some activities are held at the Childrens Village while others are off-site. The day to
day routine for the children includes providing meals, transportation to and from school, therapy,
medical care, dental care, and also provides the children with entertainment, clothing, and all
other essential needs. In the past, Buckner has been presented with an oral health program;
however, no current plan exists or has been implemented in several years. [1]
5. Other Pertinent Data: Buckner children, as a whole, have a predominately low dental
health IQ. Buckners water supply comes from the city of Beaumont. It is a community water
system that flows at optimal fluoride concentration of 0.80 mg/L. The addition of fluoride to the
water system started on July 1, 1971. [3]
B. Information Related to Dental Health: Buckner children are insured through Medicaid and
see a private dentist in the Beaumont area for routine dental care. Through Medicaid they are
able to receive cleanings twice per year, along with fluoride and sealants as needed. The children
are taken to the dentist on staff by either the foster parents or the staff if emergency care is
needed. Dental visits are scheduled directly by the foster parents when needed and, if the child
has not been placed in foster care, the staff at Buckner arrange for routine dental exams. On-site
at the Buckner Childrens Village the storage room stores donated toothbrushes and toothpaste.
Foster parents are responsible for supplying these items if the child has been placed under their
care. The ministry engagement coordinator is intrigued and excited for the children, foster
parents, and staff to learn more about preventive oral hygiene care.
C. Dental Health Status:
1. Dental caries is the single most common chronic childhood disease. It is seven times
more common than hay fever and fourteen times more common than chronic bronchitis. Children
at high risk for dental disease are those from low income and/or underrepresented minority
family backgrounds, and children with special healthcare needs. Dental caries in children directly
affects their physical and mental health, as well as their quality of life, and is the number one
cause of school absences among young children. [4] According to Healthy Foster Care America,
approximately 35% of children and teens enter foster care with significant dental and oral health
problems. As children in foster care grow older, they are more susceptible to other oral health
related problems, such as diabetes, heart disease, oral cancer, etc. [5]
2. Periodontal Disease can be found in children and adolescents. Research indicates
chronic periodontitis is more common among adults while aggressive periodontitis may be more
common in children and adolescents. The onset of this type of oral disease is typically seen
during puberty. [6]
3. Research indicates children who are insured with Medicaid are covered for orthodontic
treatment solely as a result of severely handicapping malocclusion or special medical conditions,
such as cleft palate, head trauma involving the oral cavity, and/or skeletal anomalies involving
the oral cavity. [7]
4. Foster children are more at risk for certain oral pathologies and oral cancer due to
increased substance abuse and sexual promiscuity of their parents or guardians. [8]

Amanda Means, Rebecca Ebarb

DHYG 1315
March 23, 2015
5. Utilization of Dental Services by Buckner Childrens Village is done through a local,
private dentist in Beaumont, Texas. Dental visits are typically scheduled once a child has been
placed in a foster home, however, emergency visits can be arranged while the child is being
housed at Buckner Childrens Village, if needed. When it comes to routine dental prophylaxis, a
private dentist is contacted by the foster parent directly, who is responsible for transportation and
costs associated with treatment. Children who are in foster care are insured through Medicaid.
D. Goals and Objectives:
GOAL: The goal of this project is to increase the knowledge and skills of the children, young
adults, staff, and foster parents at Buckner Childrens Village to attain and maintain optimal oral
health through the development of an oral health program.
OBJECTIVES:
1.
Decrease dental plaque of the children and young adults of Buckner Childrens village by
5% through brushing modification instructions and plaque control techniques.
2.
Increase the dental health knowledge of the children and young adults of Buckner
Childrens Village by passing an oral health test at a 75% or higher level.
3.
Establish a daily routine of proper oral hygiene for the children and young adults of
Buckner Childrens Village.
4.
Increase the dental health knowledge of the employees of Buckner Childrens Village by
passing an oral health pre and post test at a 10% or higher level.
5.
Increase the dental health knowledge of the foster parents of Buckner Childrens Village
by passing an oral health pre and post test at a 10% or higher level.
6.
Incorporate an overall oral health education program into the children, young adults,
employees, and foster parents daily routine.
RATIONALE FOR PROGRAM:
Oral health at Buckner Childrens Village in Beaumont definitely has room for
improvement. At present, no oral health program currently exists due to various reasons. First of
all, the overall lack of oral health knowledge among the employees, foster parents, and children
is a factor. Secondly, as children enter into foster care, their oral health is typically not an
immediate cause for concern. The children often come from abused or neglected home
environments with limited access to resources needed to improve their oral health. Employees
and foster parents need to be made aware of how to properly teach tooth brushing to the children,
the importance of routine care, the benefits of fluoride, etc.
Low-income children, especially those in foster care, are less likely to receive regular
dental care, and, as a result, face a greater risk of tooth decay. These children, as they grow older,
are susceptible to a myriad of oral health related problems from heart disease, diabetes, and oral
cancer, to low self-esteem and depression. [5] Some barriers to health care for kids and teens in
foster care are due to delays in insurance enrollment, lack of follow through, and the
questionable guardianship as to who is in control of their health and dental needs. Inadequate
resources, lack of practitioners, lack of funding, and lack of dental knowledge in general also
contribute to the inevitable barriers to care. [9]

Amanda Means, Rebecca Ebarb

DHYG 1315
March 23, 2015
Ideally, at the conclusion of this oral health program that will be implemented at Buckner
Children's Village, the children, adolescents, parents, and staff will have a better understanding
of their oral health and how to maintain it. They will be properly educated regarding disease
prevention, benefits of sealants and fluoride, and plaque control. With this newly acquired
knowledge, optimal oral health will unavoidably be reached.
E. Program Design Activities: The program plan is aimed towards educating the children,
young adults, employees, and foster parents of Buckner Childrens Village. The education
sessions will consist of teaching general oral health topics, such as: The importance of good oral
health, proper brushing techniques, the benefits of fluoride, sealants, and routine care. The
sessions will be conducted in four different sessions and will be developed as follows:
1.

Session 1: (Tuesday, March 17, 2015)

Who will attend: Emergency Shelter children and adolescents

During this session we will conduct a pre-test to determine the overall oral health knowledge of
the participants. We will introduce general oral health information such as: plaque, calculus,
brushing, flossing, and a post-test.

Pre-test on basic oral health knowledge

Explain plaque and calculus

Demonstrate correct method of brushing and flossing

Measure plaque score by using disclosing solution tablets

Participants will then practice brushing and flossing techniques on a typodont as well as
on themselves

Re-disclose participants

Modify techniques if needed

Stress the importance of adequate oral hygiene care

Post-test
2.

Session 2: (Thursday, March 19, 2015)

Who will attend: STAR children and adolescents (Services to At-Risk Youth)

During this session we will conduct a pre-test to determine the overall oral health knowledge of
the participants. We will introduce general oral health information such as: plaque, calculus,
brushing, flossing, and a post-test.

Pre-test on basic oral health knowledge

Explain plaque and calculus

Demonstrate correct method of brushing and flossing

Measure plaque score by using disclosing solution tablets

Participants will then practice brushing and flossing techniques on a typodont as well as
on themselves

Re-disclose participants

Modify techniques if needed

Amanda Means, Rebecca Ebarb

DHYG 1315
March 23, 2015

Stress the importance of adequate oral hygiene care

Post-test

3.

Session 3: (Thursday, April 7, 2015)

Who will attend: Foster Parents and House Parents

During this session we will conduct a pre-test to determine the overall oral health knowledge of
the participants. We will discuss and review general oral health information including: plaque,
calculus, brushing, flossing, sealants, benefits of fluoride, the importance of routine care, and a
post-test.

Pre-test on basic oral health knowledge

Explain plaque, calculus, the formation of caries, sealants, fluoride, and routine care

Demonstrate correct method of brushing and flossing

Participants will then practice brushing and flossing techniques on a typodont

Modify techniques if needed

Stress the importance of adequate oral hygiene care

Post-test
4.

Session 4: (Tuesday, April 14, 2015)

Who will attend: Buckner Childrens Village Staff

During this session we will conduct a pre-test to determine the overall oral health knowledge of
the participants. We will discuss and review general oral health information including: plaque,
calculus, brushing, flossing, sealants, benefits of fluoride, the importance of routine care, and a
post-test.

Pre-test on basic oral health knowledge

Explain plaque, calculus, the formation of caries, sealants, fluoride, and routine care

Demonstrate correct method of brushing and flossing

Participants will then practice brushing and flossing techniques on a typodont

Modify techniques if needed

Stress the importance of adequate oral hygiene care

Post-test
F. Constraints and Alternative Strategies:
Constraints: There could be a lack of compliance from the participants in the class.
Alternatives: Keep each lesson interesting by encouraging the participants involvement
with hands-on demonstrations and age-appropriate games related to oral health.
Constraints: There could be a lack of interest in the information being presented.
Alternatives: Keep the participants interested by being interactive using props and
hands-on demonstrations while engaging them with open-ended questions related to their
oral health.
G. Resources:

Amanda Means, Rebecca Ebarb

DHYG 1315
March 23, 2015
Personnel: Engagement Ministries Coordinator, foster parents, and foster children.
Location: Commons Facility at Buckner Children's Village.
Equipment: PowerPoint presentation on projector provided by Buckner Children's
Village.
Supplies: Toothbrushes, toothpaste, floss, safety glasses, gloves, masks, cups, disclosing
tablets, mouth rinse, pamphlets, paper napkins, plastic hand mirrors, typodonts, pre and
post tests, hand mirrors, plaque score sheets, and patient education flip charts.
Audio/Visual Aids: PowerPoint presentation, pamphlets, handouts, typodonts, disclosing
tablets, and patient education flip charts.
Evaluation Supplies: Pre and Post-test, plaque score sheet, and Engagement Ministries
Coordinator evaluation.

Budget:
Toothbrushes Donated by Colgate
Toothpaste - Donated by Colgate
Floss - Donated by Colgate
Safety Glasses - Provided by presenters
Gloves - Provided by presenters
Masks - Provided by presenters
Cups Provided by presenters
Disclosing tablets Donated by Colgate
Paper Napkins - Provided by presenters
Plastic Hand Mirrors - Provided by presenters
Typodonts - Provided by presenters
Pre and Post-test - Provided by presenters
Plaque Score Sheet Provided by presenters
Patient education flip charts - Provided by presenters
Dental related activity color sheets and games Provided by presenters
Mouth rinse Provided by Crest

Estimated Total: $10.00

H. Timetable:
This oral hygiene program will last four weeks. The days we plan to implement will be
as followed:

Session 1 will be Tuesday, March 17th

Session 2 will be Thursday, March 19th

Session 3 will be Tuesday, April 7th

Session 4 will be Tuesday, April 14th

I. Evaluation:
Formative:

Amanda Means, Rebecca Ebarb

DHYG 1315
March 23, 2015

Plaque indices will be measured and recorded to evaluate progress.

Review at the end of each session with each group.

Meet with Engagement Ministries Coordinator weekly to discuss progress.

Pre-test of general oral health knowledge.

Summative:

The foster children and/or adolescents will be given a pre and post-test to
determine their dental IQ.

The foster parents will be given a pre and post-test to determine their dental IQ.

The Buckner staff will be given a pre and post-test to determine their dental IQ.

A lesson plan will be provided to the Engagement Ministries Coordinator of the

program to allow implementation of the oral health program annually.

An evaluation/review will be submitted by the Engagement Ministries

Coordinator to determine the overall success of the program.

Amanda Means, Rebecca Ebarb

DHYG 1315
March 23, 2015
References:
1.

Rhodes, Jessica, Bucker Childrens Village, Beaumont, Texas (2015, February

10). (Personal Interview).

2.

Buckner (2015, February 17). Programs Overview. Retrieved from

http://www.buckner.org/our-work/beaumont/.

3.

Center for Disease Control (2008, February 6). My Waters Fluoride. Retrieved from
http://apps.nccd.cdc.gov/MWF/PWSDetailV.aspPWSID=1230001&State=TX&St
artPg=1&EndPg=20&County=Jefferson&PWSName=&Filter=0&PWS_ID=&Sta
te_ID=TX&SortBy=1&StateName=Texas.

4.

American Academy of Pediatric Dentistry (2003, April 6). Early Childhood Caries and
Quality of Life. Retrieved from http://www.aapd.org/assets/1/25/filstrup-25-05.pdf

5.

New York University (2013, January 7). College of Dentistry, Foster Care Agency
Partner to Improve Child Health. Retrieved from
http://www.nyu.edu/about/news-publications/news/2013/01/07/college-ofdentistry-foster-care-agency-partner-to-improve-child-health.html

6.

American Academy of Pediatric Dentistry (2004). Periodontal Disease of Children and

Adolescents. Retrieved from
http://www.aapd.org/media/policies_guidelines/e_periodontaldisease.pdf

7.

Children's Medicaid Dental Services Managed Care Orthodontia Review Policy and
Procedure (2012, January 30). Orthodontia Review Policy and Procedure.
Retrieved from http://www.dentaquest.com/getattachment/stateplans/regions/texas/dentists-page/texas-orthodontia-review-policy-1-30-12final.pdf/

8.

Medical Home Portal (2014, December). Foster Care. Retrieved from

http://www.medicalhomeportal.org/diagnoses-and-conditions/foster-care

9.

American Academy of Pediatrics (2015, March 3). Healthy Foster Care America.
Retrieved
from
https://www.aap.org/en-us/advocacy-and-policy/aap-healthinitiatives/healthy-foster-care-america/pages/Addressing-Barriers.aspx

Amanda Means, Rebecca Ebarb

DHYG 1315
March 23, 2015
Appendix:
Pre/Post Test Assessment (Ages 5-10)
1)

How often should you brush your teeth:

a) Whenever you feel like it
b) Once a day
c) Twice per day
d) Once every few days

2)

What is a cavity:
a) A piece of dirt on your tooth
b) A hole in your tooth
c) A bad tooth that has to be removed

3)

Plaque can only form on your teeth after you eat something:
a) True
b) False

4)

What type of snack is the best for keeping your teeth healthy:
a) A sugarless snack like string cheese
b) A cold snack like ice cream
c) A chewy snack like a candy bar
d) All of the above

5)

It is not necessary to brush your tongue:

a) True
b) False

Amanda Means, Rebecca Ebarb

DHYG 1315
March 23, 2015
Pre/Post Test Assessment (Ages 11-17)
1)

How often should you brush your teeth:

a) Whenever you feel like it
b) Once a day
c) Twice per day
d) Once every few days

2)

What is a cavity:
a) A piece of dirt on your tooth
b) A hole in your tooth
c) A bad tooth that has to be removed

3)

Plaque can only form on your teeth after you eat something:
a) True
b) False

4)

What type of snack is the best for keeping your teeth healthy:
a) A sugarless snack like string cheese
b) A cold snack like ice cream
c) A chewy snack like a candy bar
d) All of the above

5)

It is not necessary to brush your tongue:

a) True
b) False

6)

Energy drinks dont cause cavities:

a) True
b) False

7)

How long should you brush your teeth?

a) 30 seconds
b) 1 minute
c) 2 minutes

8)

It is important to always use a __________ bristle toothbrush when brushing your teeth and
gums:
a) soft
b) medium
c) hard

9)

___________ is a mineral that can be found in toothpastes, mouth rinses, and even tap water that
helps strengthen the enamel of your teeth and prevents cavities:
a) alcohol
b) zinc
c) fluoride

Amanda Means, Rebecca Ebarb

DHYG 1315
March 23, 2015
10)

Once plaque remains on the teeth for extended periods of time, it hardens and forms tartar. Tartar
can be removed from the teeth with proper brushing and flossing.
a) Both statements are true.
b) Both statements are false.
c) The first statement is false, but the second statement is true.
d) The first statement is true, but the second statement is false.