Contagious Smiles

Peering into the mouth of a little girl, Sarah Payne, a dental student at the UT Health Science Center at San Antonio, was surprised to find something rather alarming.

“I was painting the little girl’s teeth with fluoride varnish and as she looked toward the ceiling I noticed what looked like an abscess or sinus tract.” She called over her supervising faculty member. The abnormality was a small tumor known as a fibroma. Fortunately it was benign.

“I was so relieved to find out that it wasn’t something more serious,” Payne said. The child was referred for follow-up care and would be fine.

Payne was among a group of UT Health Science Center dental and dental hygiene students who were spending the morning at a Head Start Center in San Antonio, a day care for preschoolers who come from low-income families. Supervised by faculty members, they provided basic oral health assessments, applied a fluoride varnish and taught the youngsters how to care for their teeth.

Dental hygiene student Martha Rayas teaches Head Start preschoolers how to properly brush their teeth.

The community oral health project is a joint effort involving the Health Science Center’s Department of Dental Hygiene, the San Antonio Metropolitan Health District and Parent/Child Incorporated, which operates 20 Head Start Centers. Although the project is helping the preschoolers learn how to take better care of their teeth, it also provides a hands-on learning experience for the Health Science Center students while they offer a valuable public service.

“This is a collaborative effort all around,” explained Kathy Geurink, M.A., associate clinical professor of dental hygiene and coordinator of the oral health community project. “Not only are the students learning from their supervising faculty members, they also are getting advice from the public health dentists and dental hygienists there who may see some of these children later for urgent-care issues.”

The students are also learning from each other. Geurink and David Cappelli, D.M.D., Ph.D., M.P.H., associate professor in the Department of Community Dentistry, have worked together on community health projects for years. They also combine a few sessions of their classes each semester. “We want to help our students learn how dentists and dental hygienists work together in complementary roles and how both professions have a shared responsibility to provide oral health care for the underserved in our community,” Dr. Cappelli said.

Funded by a $300,000 grant from the Administration of Children and Families Office of Head Start, the underlying purpose of the initiative is to address the critical oral health care needs of families who live below the poverty level. The grant provides money for education, prevention and access to care. It also provides supplies for the weekly rotation of dental and dental hygiene students to the Head Start Centers.

According to the Department of Health and Human Services’ “Oral Health in America: a Report of the Surgeon General”:

• Dental caries (tooth decay) is the single most common chronic childhood disease — five times more common than asthma and seven times more common than hay fever.

• More than half of 5- to 9-year-old children have at least one cavity or filling, and that proportion increases to 78 percent among 17-year-olds.

• There are striking disparities in dental disease according to income. Children from low-income families suffer twice as many dental caries as their more-affluent peers, and their disease is more likely to be untreated.

In a February 2008 article Geurink wrote for Access, a publication of the American Dental Hygiene Association, she explained the difficulties low-income families experience with dental care:

“This population has numerous challenges and barriers to receiving these dental examinations and needed dental care. While the majority of Head Start families are enrolled in Medicaid, many dentists do not accept Medicaid patients. There is a shortage of dentists who are willing to see young children, and often there isn’t even one dentist located in the geographic region near the Head Start Center,” Geurink wrote. “There is also the barrier of a lack of oral health education for Head Start parents, staff and children. The preventive procedures necessary to reduce oral disease in this population are often not available or even known.”

While all of these problems cannot be easily solved through the Health Science Center’s community oral health project, it is a start. “We still see many children in classrooms with pain and infections in their mouths because they don’t have access to care,” Geurink said. “Our hope is that when our students graduate, they will know about the needs in this segment of the community so that they will agree to see some of these patients in their offices and will consider volunteering some of their time to help them in the future.”

Dental hygiene student Megan Bridges believes the program is accomplishing this goal. “The rotations at Head Start Centers have given me an open perspective in regard to considering working in a public health setting because there is a true need for dental health care workers in this area.”