New Mexico`s Healthy Smile Program focuses on an interdisciplinary scramble to provide care for the `other children.`
Christine Nathe, RDH, MS,
Demetra Logothetis, RDH, MS, and
Ruth Nichols, RN, MSN
The delivery of dental care has been receiving much publicity recently due to the fact that more than 50 percent of the population does not receive adequate dental care. In addition, only 7 percent of children covered by Medicaid receive dental care. Consequently, many issues such as the unavailability of dental providers to see the government-funded (Medicaid-insured) populations and patients with special needs have been on the forefront of much political activity.
In many states, little, if anything, has been done to reach out to these populations. Dental hygienists need to assert their skills and knowledge to alleviate the barriers that these populations encoun-ter. One positive and effective step is to approach care in an interdisciplinary fashion as many other countries do. Interdisciplinary care is more comprehensive for the patient, thus improving the chances that the patients` entire health care needs are met. An added benefit of this comprehensive care is that it places dental hygiene strategically within the health-care delivery system. Extending dental hygiene into these systems increases the visibility of the dental hygiene science to other health care workers. It also places dental hygiene somewhat out from under the control of dentistry.
At the moment, dental hygienists working in private practice are not treating the entire population, only the population that makes the trip to the private dental practice. Remember, many dental practices throughout the country do not accept government-funded insurance. Although inevitable change may be gradually influencing dentistry, dental hygienists can take many positive steps at the present time to increase access to dental care. In the pediatric population, 20 percent of the children have 80 percent of the dental caries. This is the exact population that dental hygienists are prevented from treating because of restrictive supervision laws. One change involves bringing dental care to these children through public health models of interdisciplinary care.
A pilot program developed between the Albuquerque Public Schools and the University of New Mexico, Divison of Dental Hygiene, uses an interdisciplinary approach to providing dental services and education to a segment of the population currently in need of care. The Healthy Smile Program was developed to provide urgent treatment to children and prevent dental diseases through education, screenings, referrals, and follow-up. The screenings include dental caries and plaque indices before and after the educational and treatment interventions are provided, so that the program can be evaluated effectively. More importantly, the program enlists the help of parents and teachers to emphasize the importance of dental health to the child`s overall health.
The Healthy Smile Program differs from other dental health programs because it is interdisciplinary in nature. Dental hygienists, school nurses, teachers, social workers, and parents collaborate to develop, implement, and evaluate the program. Dental hygienists educate the students; parents and teachers provide screenings and referrals; the school nurses coordinate the health care needs of the students; the teachers educate their students; and the social workers assist the parents in accessing care by helping to meet the transportation, social, and funding needs for students. Most importantly, the parents become involved in obtaining dental care for their children.
The involvement of a social worker in this dental health program increased the children`s chances of actually obtaining dental care.
Another helpful addition to the program is the involvement of dental hygiene students from the University of New Mexico. They assist in providing screenings and presenting dental health education to the school children involved in this program. Dental hygiene students experience hands-on learning in the interdisciplinary approach to care. Hopefully, this simulated working experience in interdisciplinary health care will broaden the scope of care currently available to the public, as well as increase the likelihood that graduating dental hygiene students will seek employment in interdisciplinary settings as opposed to working primarily in private dental practices. If students experience "real life" situations in interdisciplinary care, society is more likely to benefit from practicing dental hygienists who have the skills and desire necessary to provide care in the public health setting.
The New Mexico Dental Hygienists` Association has become a collaborating participant in the Healthy Smile Program. The association developed free cleaning and sealant clinics on the weekends for students in these schools. The best benefit from this was the number of families that were linked up with Medicaid insurance and the New Mexico Healthy Kids Funds by the program`s social worker. The clinics provided yet another opportunity to provide needed services and help enroll more of the population in the government-funded programs.
The time to provide dental hygiene care in an interdisciplinary setting is now. Practicing dental hygiene and dental care without the involvement of the health care system further segments the population. Collaborating with all health care workers is the best way to provide quality dental hygiene care to the entire population. Dental hygiene must strive to position the profession strategically within the health care system for the betterment of society.
Christine Nathe, RDH, MS, is an assistant professor and community health coordinator for the University of New Mexico, Division of Dental Hygiene. She can be reached at (505) 272-8147. Demetra Logothetis, RDH, MS, is an associate professor and director at the dental hygiene school. Ruth Nichols, RN, MSN, is the nurse coordinator of the Healthy Smile Program at the Albuquerque Public Schools.