Weekly event at the Multnomah County Dental Clinic helps low-income babies get early oral care, teaches students how to care for very young patients
Tiny, pink-clad Jacqueline Hernandez of Gresham, Ore., lives in a low-income family, but she still gets excellent dental care from the Multnomah County Dental Clinic on Baby Day.
“Jacqueline has received fluoride varnishes and her mother has been counseled extensively about tooth decay prevention,” said Jean Custer, R.D.H., who coordinates Baby Day, held every Tuesday at the East County dental clinic. “She is a delightful little girl and shows every sign of being a wonderful dental patient —with good healthy teeth — in the future.”
Dental care on Baby Day is provided in part by third-year dental students in the Oregon Health & Science University School of Dentistry (www.ohsu.edu/sod). As part of their dental training, three students visit the Multnomah County dental clinic each Tuesday for Baby Day. Each student provides preventive care for five to 10 patients, ranging in age from 9 months to 36 months.
The American Academy of Pediatric Dentistry recommends that children see a dentist no later than their first birthday — ideally, within six months of the appearance of a child’s first tooth. Yet only three out of five children have seen a dentist by kindergarten. By then, more than half (52 percent) of 6- to 8-year-olds have tooth decay, according to the Healthy People 2000 oral health update.
“Early prevention is the key,” said Prashant Gagneja, D.D.S., chairman of the pediatric dentistry department at OHSU who started the collaboration in fall 2004 with the help of Sue Sanzi-Schaedel, R.D.H., M.P.H., director of the School/Community Dental Health Programs at the Multnomah County Health Department. “If we can give very young children good preventive dental care from the very start, they have an excellent chance of maintaining their dental health as they grow.”
Dental student Karen Richards, who did Baby Day last year, agrees: “Baby Day made me realize how important early intervention truly is,” said Richards, now a fourth-year dental student. “Educating the families and providing treatment to prevent or arrest tooth decay in these babies is the first step in creating a healthy oral environment. Baby Day gives us as students the opportunity to provide care in a public health setting to families that would otherwise not have access to dental care.”
Custer noted that many dental students get very limited hands-on experience working with young children. “Just gaining access to the mouth of such a young child can be intimidating,” she said. “We show the students how relatively easy it is to work with young children and how simple it is to intervene using preventive strategies that can prevent decay.”
Children younger than two who visit the dentist are often given what’s called “knee-to-knee” exams, with the parent holding the child in their lap, laying the child’s head on the provider’s knees, and holding his or her hands while oral care is conducted.
All of the children are on the Oregon Health Plan and enrolled in MultiCare Dental. “We see all eligible babies including Hispanic, Caucasian, Russian, Vietnamese and Somalian. The diversity is truly a wonderful mix. Many of the visits involve using an interpreter, which may also be a new experience for the students,” said Custer.
“Our goal is to use the Early Childhood Caries Program, which advocates fluoride application, parent education, and behavior changes, to prevent decay now in the primary teeth,” said Custer. “At all visits, the fluoride is applied to the teeth and the parents are asked about feeding issues, tooth brushing and fluoride usage. With the parents at the dental visit helping, it is a perfect time to teach them what they can do at home on a day-to-day basis to improve the oral health of their child, and the students can see firsthand some of the barriers that low-income families face in achieving good health care.”
Added Gagneja: “This is an excellent health care education model. Students get hands-on experience and learn a new technique while patients benefit greatly at the same time.”