Putting good teeth in young smiles

An island nonprofit group promotes oral hygiene for kids.

Kate Mills has cleaned children’s teeth on stages, in classrooms, and even hallways.

This summer, the registered dental hygienist is moving into a dental office to clean adult teeth.

Mills and hygienist Nan Hawkes, make up Washington State Smile Partners, providing school-based preventive dental care and education to underserved, low-income children in Kitsap and King counties.

The seeds for WSSP were planted when Mills worked in a school-based dental program in Sacramento, Calif., and saw a huge number of people in dental need: children, parents and grandparents.

“It was the first time I felt such passion in what I do, because it makes a difference,” Mills said. “A lot of kids need (dental care) desperately.”

She and Hawkes, who grew up together on Bainbridge Island, founded WSSP in March 2003 as a business partnership. Responding to the overwhelming need for dental care for all ages, they have reorganized as a nonprofit organization. As such, WSSP can apply for grants and funding to support their new Kitsap County Dental Disease Prevention Program for adults, which starts June 21.

Both Mills and Hawkes worked in private practice for more than 30 years before they founded WSSP, which addresses what a 2000 Surgeon General’s report calls a “silent epidemic of dental and oral health diseases.”

For over a year, they have visited schools to offer education and preventive dental care to all children on sliding scale rates – sometimes free – based on what the family can afford.

Many families without dental insurance or living close to the poverty line cannot afford paying for basic dental care out-of-pocket. Yet untreated, a minor dental problem can become an expensive emergency.

“We want to get down from the ‘big fires’ to ‘manageable,’” said Ellen Robinson, executive director of WSSP.

“Disease in the mouth can affect the rest of the body,” she said. “Dental (care) still is considered an option or frill, but it’s not.”

Robinson says some schools are very happy when WSSP calls up, having had kids see the school nurse because of tooth pain or feel self-conscious about their mouth.

Mills recalls one 5-year-old student who refused to open her mouth at first, but who she was able to cajole by offering to brush her teeth to make them pretty. The child’s front teeth had rotted to the soft, center pulp.

She saw one student whose teeth had rotted to the gum line, and another with a painful abscess that kept the child from chewing on one side of her mouth.

In every class, she sees at least one child who has either a toothache or has never been to a dentist; some do not own their own toothbrush.

At any school, Mills estimates that 15 to 20 percent of screened students need urgent or emergent care.

Since last March, they have treated more than 2,500 children at 12 schools in Bremerton, North Kitsap, Seattle and Federal Way. They target schools where more than 30 percent of students are eligible for lunch subsidies.

“Income is the single biggest predictor of cavities,” Mills said.

Each school visit of one to two weeks begins with a video that teaches students about maintaining oral health and modern techniques that make cavities preventable. Children are sent home with a permission slip for parental consent to a screening and cleaning.

Mills sets up shop in whatever space is available. During screening, classmates will mingle sociably, chatting, watching and waiting for their turn.

Mills was moved to see in schools with a high immigrant population, such as Federal Way, that for a newcomer with limited English, fellow students would interpret her entire explanation.

“No one was self-conscious, because everyone did it,” Mills said. “There’s something to be said about providing services in a familiar and safe environment.”

On day two, Mills gives an oral hygiene lesson and shows kids how to brush properly. For students who need extra attention, Mills forms an informal “brushing club,” meeting each day during the visit to brush their teeth together.

Students needing treatment are pulled out of class singly to get a cleaning and a fluoride varnish.

A tooth-colored resin sealant may also be applied to fill in the tiny grooves in molars which are hard to brush and prone to decay.

For students needing a dentist, WSSP and the school nurse will facilitate finding one.

When WSSP returns each year, it is an opportunity to check on everyone’s progress and confirm that last year’s urgent cases received needed care.

“It’s amazing, the difference,” Mills said. “There are usually more screenings and fewer treatments needed.”

Senior citizens are also an underserved group. The national advocacy group “Oral Health America” reports only 15 percent of seniors have dental coverage, which is not included in Medicare. Thus over 79 percent of seniors pay for dental care out-of-pocket.

“Most seniors don’t have dental services at a time when they need them more,” Robinson said.

The Kitsap County Dental Disease Prevention Program will help adults and seniors by offering preventive dental care appointments three days a week, with fees on a sliding scale during the summer and school vacations from a Poulsbo dental office.

With their portable equipment, WSSP will also visit area senior centers. They also hope to work with social services programs like Helpline House and welcoming area dentists to join in.

“We need to work on a networking of referrals and education for the public, in schools and among doctors, who may see a patient much more often than a dentist but may not discuss oral health with their patients,” Mills said.

Said Mills, “Helping kids to feel good about themselves and seeing them excited about their smiles and their dental experience is very satisfying.”

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