MPCA News

Community Health Centers Provide Innovative Oral Health Care

Access to dental care is an issue of increasing concern in Montana. Two Montana Community Health Centers have recently initiated innovative programs that not only provide critical oral health services to those without access, but stress the importance of prevention of caries and early interventions.

MILES FOR HEALTHY SMILES

First grade MHS student plays dentist while explaining to Dr. Andy (referred to as Dr. Angel by students) what he learned about his teeth while reviewing his x-rays.

Partnership Health Center (PHC) of Missoula City County Health Department is excited about the community driven program, Miles for Healthy Smiles, MHS.  This is a traveling dental program that uses portable equipment to increase access to dental care and provide oral health education.  The program focuses on school aged children and their families, who lack a regular dentist and are Medicaid or CHIP beneficiaries or non-insured, living in Missoula and surrounding rural areas.  With the portable equipment, staff and volunteers are able to provide cleanings, fluoride varnishes, sealant placement, exams, x-rays, fillings, and even extractions on-site. 

MHS started with a grant from the local Chutney Foundation which supports projects enhancing the well-being of residents of the Blackfeet Valley.   The start up funds, given out over three years, gave time for this to develop into a program that is efficient, sustainable, and able to respond to the need for dental care and education in Missoula and surrounding rural areas.  MHS is also supported by Missoula County Health Department,  Missoula county and rural schools, the University of Montana MSU nursing program & Health and Human Performance Department, Missoula Hygienist Association, local dentists (Dr.’s Huckeby, Nelson, Seamons, & Tiede), Bitterroot Motors, and local Girl Scouts (donates floss, toothpaste and toothbrushes). 

All eligible children on Medicaid and CHIP, in grades Kindergarten through 8th, whose parents have given consent, received a complete dental check-up, including x-rays, a dental cleaning, a fluoride application for cavity prevention, and development of a treatment plan which may include other services as needed, such as fillings, and routine extractions.  Children who require more extensive work are referred either to Partnership Health Center’s on-site dental clinic, or to participating local dentists in private practice.  

Twin brother and sister smile proudly for a photo after learning how to properly brush their teeth and while waiting to get a visual screening by Dr. Althauser.

All 1st, 2nd, and 3rd graders receive classroom and one-on-one oral hygiene education.  All kindergartners and 4th graders also have the option to receive dental health education.  Children are taught about eating properly and good health, brushing and flossing, going to the dentist, and they take a field trip to Partnership Health Center’s dental clinic. While in the schools, MHS staff have been stopped, on several occasions, by older students pleading for dental care to relieve them from tooth pain.  In most cases, the students reported that their family had never been able to afford to take them to a dentist or could not take the time away from work.  MHS staff provided services to these children, as well.  Also contrary to staff expectations, when MHS staff called a child’s name for treatment, children often jumped up as if they had won a prize.  These children were excited to see the dentist because they viewed it as an opportunity to get relief from pain.

In addition to classroom education, MHS staff educated parents of elementary students on dental care through school newsletters, media stories, health fairs, and other opportunities.  School and neighborhood nurses, WIC, and Head Start staff received guidance and education on how to screen, identify, and refer children who are in need of dental care. 

Lisa Tims, MHS program coordinator, said, “At the end of the year, program evaluations indicated that the program was a resounding success with participating schools and parents.  We received several thank-yous from the schools and principals.”  She shared what Sally Johnson, district clerk at Seeley Lake Elementary School wrote, “This wonderful program introduced parents to affordable, manageable, and accessible dental care.  This program was immensely beneficial to students who would have struggled or put off treatment.  Many families who are not insured learned about sliding fee services at Partnership Health Center.  Thank you for this great service.”   For more information on Miles for Healthy Smiles, contact Lisa Tims at timsl@phc.missoula.mt.us or call 406-258-4115. 

PILOT ORAL HEALTH COLLABORATIVE

Community Health Partners Dental Practice, in Bozeman (a satellite of the Community Health Center in Livingston), is one of four clinics in the country to be recently accepted into the HRSA Pilot Oral Health Collaborative.  A collaborative is a focused, structured approach to change the way care is provided which encourages the use of the most current best clinical practices while promoting techniques to involve patients in their care.   This is the first collaborative to focus on oral health; others have focused on diabetes, cancer prevention, cardiovascular disease and other chronic diseases. 

The Dental Collaborative focuses on involving primary care providers to promote oral health care, treating cavities and gum disease in pregnant women to prevent transmission to their babies, and preventing and treating cavities in children ages 0-5.  Cavities, called caries by dental professionals, are an infectious disease that is also considered a chronic disease.   Research shows that there is a relationship between gum disease in pregnant women and pre-term and low birth weight babies.   It is also now known that the bacteria that cause cavities can be transmitted from a mother to her child.  A goal of the Collaborative is to assure that pregnant women are referred by their doctor for dental evaluation and treatment so that they are free of gum disease and cavities when their babies are born.  The Collaborative encourages medical providers to refer kids to a dentist prior to the time their first tooth arrives.  There are many things a mother and child can do to completely prevent early childhood caries or cavities.  Caries can be prevented by the setting of self-management goals, frequent fluoride varnish applications, prescription fluoride toothpastes, xylitol gum, sealants, restoration of caries, and nutritional counseling. 

This program started in October 2005 and has been well received by patients, local dentists and associated health center physicians.  The dental director of the Community Health Partners Dental Practice in Bozeman, Dr. Jane Gillette, said, “This is an amazing program.  There will never be a way to care for all of the pain and oral disease in our communities.  This program focuses on wiping out dental disease at its most basic level, before children are even born.  It does this through extensive and exciting partnerships with physicians.”    For more information on the oral health collaborative, contact Dr. Gillette at jgillette@chphealth.org or
406-585-8701. 

Contributors include Dr. Jane Gillette, Alisa Reich, and Lisa Tims.

Montana Primary Care Association 1805 Euclid Avenue Helena, MT 59601 Phone: (406) 442-2750 Fax: (406) 449-2460