title: The Children's Oral Health Initiative: An intervention to address the challenges of dental caries in early childhood in Canada's First Nation and Inuit communities.
abstract: The objective of the Children's Oral Health Initiative (COHI) is to increase access to preventive oral health services provided to First Nations and Inuit (FN/I) children living on federal reserves and in remote communities.
  
  
  
  COHI targets preschool children; 5-7-year-olds; pregnant women; and parents/caregivers in FN/I communities.
  
  
  
  The program was piloted in 2004 by Health Canada and is potentially available to all FN/I communities. However, the community must consent to the program's implementation and agree to support a community member to be trained as a COHI aide.
  
  
  
  Dental therapists and hygienists screen eligible children, apply fluoride varnish and sealants to children's teeth, and stabilize active dental caries with glass ionomer. An innovation was the development of a community oral health worker, the COHI Aide. The COHI Aide is a community member who serves as an advocate for preventive oral health in the community and provides instruction to children, parent/caregivers and expectant mothers in preventing dental caries.
  
  
  
  COHI was piloted in 41 communities in 2004. By 2014, the program had expanded to 320 FN/I communities, which represents 55% of all eligible FN/I communities. In 2012, 23,085 children had received COHI preventive oral health services.
  
  
  
  The results demonstrate COHI's success as a preventive oral health care delivery model in remote communities. Implementation and delivery of preventive oral health services has been enhanced by the sustained presence of a community-based COHI Aide.
authors.affiliation: Division of Pediatric Dentistry, University of British Columbia, Vancouver, BC, 2199 Wesbrook Mall, V6T 1Z4, Canada. kmmuju@dentistry.ubc.ca.
authors.forename: Kavita R
authors.initials: KR
authors.lastname: Mathu-Muju
authors.affiliation: First Nations and Inuit Health Branch, Manitoba Region, Winnipeg, MB, Canada.
authors.forename: James
authors.initials: J
authors.lastname: McLeod
authors.affiliation: B.C. First Nations Health Authority, Vancouver, BC, Canada.
authors.forename: Mary Lou
authors.initials: ML
authors.lastname: Walker
authors.affiliation: Health Promotion and Chronic Diseases Prevention, Public Health Agency of Canada, Ottawa, ON, Canada.
authors.forename: Martin
authors.initials: M
authors.lastname: Chartier
authors.affiliation: Division of Pediatric Dentistry, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Rosamund L
authors.initials: RL
authors.lastname: Harrison
mesh_terms: D002170:Canada; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services; D019140:Dental Care for Children / Q000458:organization & administration*; D003731:Dental Caries / Q000208:ethnology* / Q000517:prevention & control*; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006297:Health Services Accessibility; D006303:Health Services, Indigenous; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D004930:Inuit / Q000706:statistics & numerical data*; D009909:Oral Health / Q000208:ethnology*; D010865:Pilot Projects; D011247:Pregnancy; D011314:Preventive Health Services