Upper Valley Program Teaches Children To ‘Be in Charge of Their Own Dental Health’

Published 4/11/2011

By Nicola Smith
Valley News Staff Writer

Dental Disease has been called a silent epidemic that affects up to 23 percent of the nation’s children and nearly half the adult population who fall below the federal poverty line.

Dental disease may not be a high-profile health issue, but it is shockingly widespread. According to data released last month by the Centers for Disease Control in Atlanta, between 2001 and 2004, 19 percent of American children ages 2 to 5, and nearly 23 percent of children and young adults ages 6 to 19, suffered from untreated tooth decay.

It particularly affects people in lower income brackets and those who do not have dental insurance, or have only minimal coverage.

As with many other diseases, an ounce of prevention is worth a pound of cure, and both dental and medical professionals are working to improve access to dental care for children and adults. In this region, Upper Valley Smiles, a program in Alice Peck Day Memorial Hospital’s Department of Community Health brings dental care and screening into the Lebanon, Canaan, Enfield and White River Junction school districts for uninsured or under-insured children in grades K through 3.

The Community Health Care program at Alice Peck Day involves more than its dental care component; it also holds community flu clinics and helps people with Medicaid applications and blood pressure screenings. But Upper Valley Smiles, said DuMont, is the “biggest piece of the community health pie.” It also holds quarterly clinics at Alice Peck Day Hospital for children staying at The Haven in White River Junction and refers children with emergency dental issues to area dentists.

The way Upper Valley Smiles works is this: a team of a dentist, hygienist and an assistant go into a school once a year to screen children, who have been given permission to attend by their parents, for such dental issues as cavities, injuries that have resulted in trauma to the mouth and teeth and poorly positioned teeth or abscesses.

“We determine which children are at risk and identify those teeth that need restorative attention or sealants, and everybody gets a fluoride varnish,” said Dr. Bob Keene, a Hanover resident and the dentist currently affiliated with Upper Valley Smiles.

The idea, Keene said, is to “teach people to be in charge of their own dental health.” Dentistry is “the art of behavior modification.” Children need constant reminders to brush at least twice daily and to floss. At the screenings, he and the hygienist try to “teach, encourage and help kids learn the skills they need to maintain a life of comfort and health.” Children are also given a handout for maintaining good dental practices at home.

Preventive education is key, said DuMont, because it has become more difficult for many parents to oversee their children’s dental health. If there are two parents, both may work fulltime. In a single-parent household, the parent may be unable to leave work to take a child to a dental appointment and may also be uninsured or underinsured. In either case, it could cost that parent money, through lost wages or the price of treatment, to provide regular dental care for a child or children.

“Lives are so complicated, and supports aren’t there for some families,” DuMont said. “I’ve really found over the years that parents want to do the right thing, and it’s hard.”

The recession is another factor. DuMont has seen an increase in families applying for screening and treatment because they have lost their dental coverage or can’t meet the insurance deductibles.

In addition, according to a paper released by the National Health Policy Forum on the state of oral health in the U.S. a decade after the Surgeon General’s report, the ability of lower-income families to gain access to dentists is made more difficult by the fact that there is a low participation rate by dentists in Medicaid and the Children’s Health Insurance Program (CHIP), and by the fact that dentists are limited in the number of Medicaid patients they can treat. In return, dentists cite low reimbursement rates and administrative barriers as some of the reasons they do not accept more patients with Medicaid.

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