Mobile Dental Clinics and Sealant

Clinic at Botts Elementary

Fayette County School Health Program

Seal Kentucky

Western Kentucky Mobile Dental Clinic

Statewide Dental Health Education Program

Dental Outreach Programs

      You Are Not Healthy Without Good Oral Health.
         C. Everett Koop, Surgeon General
         United States Public Health Service, 1993

Background

For several years the College of Dentistry at the University of Kentucky has conducted school-based dental outreach programs serving indigent children in the Commonwealth. Both mobile dental clinics and fixed dental clinics at participating schools have been used to provide oral health screening, prevention and treatment services. These programs started in Central and Eastern Kentucky, with encouragement and funding from the Kentucky Legislature, and in Eastern Kentucky with funding from the Robinson Trust at the University of Kentucky and have been expanded to Western Kentucky.

Current school dental outreach programs provided by the University of Kentucky College of Dentistry:

• Eastern and Central Kentucky Programs
     Mobile Dental Clinics and Sealant Outreach Program
     Fixed Dental Clinic at Botts Elementary School, Menifee County
     Fayette County School Health Program
     Seal Kentucky Program

• Western Kentucky Programs
     Western Kentucky Mobile Dental Clinic and Sealant Outreach

• Dental Health Education Program (Statewide)

Need

Kentucky has significantly high poverty levels. One in four Kentucky children live in poverty. Poor oral health is associated with poverty.

Tooth decay is a chronic, infectious disease that, if untreated, progresses steadily after teeth erupt into the mouth in both the primary (baby) and permanent dentitions. The lesions (cavities) start small and spread deeper into the tooth. Even with screening by a dentist, the full extent of these infections is not easy to determine without the use of dental radiographs or a detailed examination. Often, the initial infection (cavity) is not easily visible to untrained lay individuals (e.g., parents, teachers) or untrained health workers such as nurses. In populations that have difficulty accessing dental care, the need for dental treatment frequently becomes substantial before the need is identified.

Without proper care, children with these infections develop pain and other complications over time. These include the loss of baby and permanent teeth, and general health problems such as a lack of proper nutrition. Children with chronic tooth decay can also find it difficult, if not impossible, to regularly attend school and learn and perform at high levels. Thus the goals of the Kentucky Education Reform Act (KERA) and preparing a healthy workforce for future economic development in Kentucky are adversely affected.

Because of its dental outreach programs, the Public Service Program of the College of Dentistry routinely receives requests from teachers and Family Resource and Youth Service Center personnel for help with addressing the dental problems of children in their schools. Kentucky in contrast to many other states does not have an organized statewide program or system with which these personnel can routinely work. They frequently report great difficulty accessing dental services at the local level.

Information from a state and federal Medicaid report by the Office of the Inspector General¹ and screening programs conducted at the University of Kentucky² indicate that a major dental care access problem exists. This information indicates the majority of Kentucky children of the poor and working poor, even when they have dental insurance such as Medicaid, are not receiving needed screening evaluation, preventive dental interventions and follow-up dental care. As a result these populations have a major backlog of untreated tooth decay.

Goals for School Dental Outreach Programs

• To document the oral health status and treatment needs of target populations (children of the poor and working poor).

• To conduct school-based screening, prevention, education, and treatment programs to help address dental access problems for children in underserved areas of Kentucky.

• To provide community-based educational experiences for student dentists and dental residents in the disciplines of Pediatric Dentistry and Dental Public Health.

• To obtain funding and develop local models for improving dental access that can be shared with other Kentucky communities.

• To document children's access to dental services (screening, preventive education and treatment) in Kentucky and the associated dental personnel needs.

• To evaluate cost and quality of school-based dental programs.

• To be a public and legislative advocate for improved access to dental care for all Kentucky children.

• To obtain funding and develop a statewide, cooperative, private/public, Kentucky Children's Dental Health Improvement Program in support of Kentucky Education Reform and economic development in Kentucky.

References

¹ Brown, J.G. Children's Dental Services under Medicaid: Access and Utilization. Office of Inspector General, Department of Health and Human Services, USA. April 1996 OEI-09-93-00240
² Mullins, M.R. and Cecil, J.C. Seal Kentucky, 1997-98 Report to Robinson Trust, University of Kentucky, Lexington, KY. March 1, 1998