Give Kids a Smile

A Collaborative Partnership Approach to Improve
Access to Dental Care for Underserved Children

Every child deserves a healthy start in life, but when it comes to oral health, many children face significant challenges. The oral health of children is a major concern today in the United States. Dental disease in the primary dentition is currently the most common chronic disease in childhood.

Over 40% - 50% of children will be affected by tooth decay before age 5.
Oral health issues affect children in poverty and minorities far more than other groups.
According to the May 2000 Surgeon General’s report, Oral Health in America, more than 51 million school hours are lost each year to dental-related conditions and poor children suffer 10 times more restricted-activity days than children from higher-income families.
While 9 million children in this nation do not have medical insurance, more than twice that number — 23 million — do not have dental insurance.

Children with untreated dental decay can have difficulty sleeping, eating, and concentrating in school. Such discomfort may also impact their emotional well-being. Give Kids a Smile (GKAS) is an annual event created by the American Dental Association, held each year in conjunction with the national Children’s Dental Health Month. The objectives of GKAS are to enhance the oral health of large number of needy children and to highlight for policy makers the ongoing challenges that low-income families face in finding dental care. GKAS is administered locally through the oversight of constituent dental societies of the ADA.

The North Texas Give Kids a Smile Program

For the last six years the North Texas Dental Society (NTDS) has administered and overseen the GKAS program in Collin and Denton counties. Since the implementation of the program a collaborative partnership was developed between the NTDS and the Dental Hygiene program from the Collin County Community College (DHCC) to screen and treat children at the Dental Hygiene Clinic by volunteer dentists. In 2009, a grant from the ADA foundation was awarded to the program with the objectives to expand the program. The following additional partners joined the program; The North Texas Hispanic Dental Association (NTHDA), the Hispanic Student Dental Association of -Baylor College of Dentistry (HSDA), and the dental hygiene program from the Texas Women University (TWU).

The goals of this program are to: 1) Screen underserved children 5-12 years of age in North Texas communities. 2) Identify and recruit private dental practitioners to volunteer services to the program in order to provide free dental treatment for children in need and finding these kids a permanent ‘Dental Home’, and 3) Foster mentorship and leadership infrastructure between the professional dental associations, dental students and dental hygiene students.

Program Methodology

School nurses from 11 school districts were trained to identify underserved children. The selection criteria were: (1) Between 5-12 years of age; (2) Enrolled in a North Texas school district (3) Demonstrated inability to receive regular dental care due to financial limitations (such as parental unemployment; no dental insurance and/or parental income below poverty line; or qualification for government aid, such as Medicaid, Head Start, and school lunch programs). (4) Obvious dental problems which were not being addressed.

Children who met the criteria were assigned to one of the screening locations (DHCC and TWU). Parental consent was obtained. Every child received oral health education training, a radiographic exam with bitewings radiographs, and a clinical evaluation that identified the children in the following groups: (A) Need to be seen as soon as possible due to pain or infection, (B) More than 3 quadrants require treatment, (C) Two or less quadrants require treatment (D) No caries, and (E) Other. Children were assigned to receive free dental treatment provided by a private general or pediatric dentist who (1) agreed in advance to treat the program participant patients and (2) indicated what level of care the dentist is capable of providing. Spanish speaking parents were identified and a translator was assigned to coordinate the appointments.

Data from the 2010 and 2011
North Texas Give Kids a Smile

The table shows the number of children that were scheduled and the number children that showed to the screenings each year. Over 70 percent of the children had caries in both years. All the children that attended the program received information and education related to oral health, bitewing radiographs, an oral exam, and fluoride treatment. Each year over 100 volunteers participated in the program. Children caries free were placed in a six-month recall to be seen at the Dental Hygiene student clinics. From the children screened who were in need of treatment, more than two-thirds of the children referred were treated by a volunteer private practitioner member from the NTDS. As a pilot project, six children in need of orthodontic treatment are currently undergoing treatment with two NTDS members.

	2010	2011
Scheduled for screenings	156	227
Showed to screenings	101	164
Prevalence of Caries	74%	72%

Conclusions and Recommendations

The partnership between professional dental associations, dentists, dental students, dental hygiene students and faculty members demonstrated that the North Texas Give Kids a Smile Program can be expanded into more local communities to join other oral health initiatives designed to improve the oral health of underserved children. We are proud of what we have accomplished by helping children to get the dental care they so desperately need and raise awareness that our children deserve a better health care system that addresses their dental health. We want to make good oral health a priority for all children in North Texas. We seek to educate policymakers and parents that good oral health is integral to overall health and that preventive measures like fluoridation and sealants result in long-term savings.

Unfortunately, we will not be able to wipe out untreated dental disease until we focus on prevention at an early age. G.V Black, the father of restorative dentistry taught “extension for prevention” as a means to treat decay. Today, our motto is “prevention for extension” as an effort to spread awareness of the need to avoid unnecessary dental decay in children. In order to do this, our organization seeks to build public and private partnerships at the state and local level to help improve access to oral health.

For more information:
http://www.tda.org/displaycommon.cfm?an=1&subarticlenbr=1977
http://www.nthda.com/pages/events/gkas-collin-county-cc.htm