When pediatric dentist Brian Martin fills teeth at a low-income clinic in the Terrace Village public housing complex, he also is filling a growing community need: treatment for children with mounting tooth decay who have no means to pay for dental care.
Martin, who is based at Children’s Hospital, works one day a week at UPMC’s Mathilda H. Theiss Health and Child Development Center in the complex straddling West Oakland and the Hill District, reaching children who might otherwise not get care. Cavities are common in toddlers as young as 14 months, he said. If left untreated, they can lose “baby teeth” that need to last another five to 10 years.
While cavities are, by far, the biggest problem, gingivitis, or mild gum disease, also is rampant among children who fail to eat properly, brush and floss regularly and see a dentist at least twice a year.
Some parents don’t take proper care of their own mouths and so the problem is passed from one generation to the next. Others know their children need treatment, but are reluctant to leave their communities to seek care, Martin said.
And so, a state Health Department challenge grant of $114,000 has brought dental care to the Theiss Center, an established family health care facility. The grass-roots Oakland Health Partnership is working with Children’s Hospital in this venture.
“We did a series of focus groups last year, asking residents of the neighborhood how we could better serve them,” said Theiss center director Vaughan Stagg. The residents in Terrace Village, Crawford-Roberts and West Oakland “identified dental care as the greatest unmet need.”
The state grant, which is being matched with money and in-kind services by UPMC, is paying for Martin, a hygienist and a general dentist. It also brought dental equipment up to code.
The dental clinic operates three days a week, though children are seen only on Tuesdays. Poor children suffer more dental disease, and their parents often pay more for treatment than middle-income families because they don’t to go to free Medicaid providers, said a study recently released by the American Academy of Pediatric Dentistry. And they often wait until there is a painful emergency rather than seeking regular, preventive care.
Inadequate Medicaid reimbursements have always limited the number of practitioners who see welfare recipients, though strides have been made in Pennsylvania over the past three years to improve access, Martin said.
“But there still needs to be a paradigm shift in the way the American culture perceives oral care, not as separate from a person’s general health, but as part of it. This change in philosophy would be applied to all levels–from parents to insurance companies.”
Regardless of insurance or ability to pay, children and their families can visit the Theiss Center for exams, cleanings, fluoride treatments, fillings and simple extractions, plus education about oral hygiene at home. More complicated dental problems get referred to Children’s Hospital, Martin said.
“Kids who have bad mouths often have parents who put off their own dental visits,” he said. “It may be a school nurse or the Head Start [health screening] program that forces the parents’ hand. Yet, it’s the parents’ responsibility to control their children’s eating habits and to see that they practice good oral hygiene.”
Poor diet is the single biggest culprit in cavities and gum disease, Martin said. “The biggest enemies to healthy teeth are chocolate milk and juices, juices, juices. They can be loaded with sugar. Kids get addicted and the sugar [sticks] on their teeth.
“Our mantra,” he said, “is white milk and water.”
Children should have their first dental visit at age 1, Martin said.
“That’s as much to educate parents about their kids’ development and about the importance of regular dental visits as to screen kids for decay.”