Cracking down on cavities

WILLIAMSBURG, Ky.

Twelve-year-old Jordan Rickett nervously waited his turn in the Whitley County Central Elementary School gym, watching as a classmate seated in a dental chair got his teeth examined.

"He's sure been there a long time," Jordan said, fidgeting. "I hope it doesn't take that long for me."

For children in parts of rural Kentucky where dentists are in short supply, the dentists come to them. A specially equipped truck packed with portable chairs, lights, tables and instruments rolls into school gyms as part of Seal Kentucky, a program aimed at improving access to dental care for underserved children.

Jordan had four teeth sealed that day; the boy ahead of him, 11-year-old Larry Angel, had 15 that needed sealing.

"Oral disease is reaching a crisis level for children across the country and here in Kentucky," said Jim Cecil, administrator of Oral Health Programs for the Kentucky Department of Public Health. "There are a lot of places, Appalachia being one, where kids do not always get the dental care that they need, which can cause health, social and financial problems as they get older."

Seven-chair clinics

Dr. Raynor Mullins and as many as a dozen student dentists from the University of Kentucky hit the road with everything they need to support a seven-chair dental clinic.

Two students work at each of six stations, with the seventh normally set up for a volunteer dentist. They apply sealants to help children prevent cavities. They do basic screenings to provide reports to parents about any serious dental problems.

"It's a lot of fun to get out and actually see patients after weeks of work in a classroom," said Heather Erbe, 23, of Lexington. "For most of us, this is our first experience with patients and the first chance to see and do some of the things we've been taught."

Once the work is completed, Mullins or another faculty member examines each child to make sure the work has been done correctly or to consult on more serious problems -- such as cavities or gum disease.

"It's really great working with the kids -- never boring," said 22-year-old Regina Liford of Laurel County, who started working as a dental assistant in high school before deciding to pursue dental school at the university.

"A lot of times, kids have a bad experience with the dentist when they are young and become afraid to go back. I think it is easier for them in this situation because it is noninvasive work being done by people who are closer to their own age."

Cincinnati program a model

Seal Kentucky was modeled after the Cincinnati health department's dental sealant program. It targets second- and sixth-graders to seal molars when they have fully developed.

Depending on the number of students to be served in a given school, students from other grades also are eligible to receive screenings and sealants, which normally cost between $40 and $60 each.

Schools are recommended to the program based on the numbers of children eligible for reduced or free school lunches or the Medicaid and Kentucky Children's Health Insurance programs.

The goals of the dental program include increasing access to preventive services and increasing public awareness of the value of dental sealants, which prevent plaque from getting down into the natural grooves of teeth and growing into cavities.

Mullins, chief of the College of Dentistry's Division of Dental Public Health, said the program also teaches youngsters the importance of oral health and frequent trips to the dentist.

"It's a mindset, really," Mullins said. "I mean, if you had a finger that was rotting, you'd get it taken care of, right? As stereotypical as it sounds, there's a lot of people who just do not take oral health as seriously as they should.

"If we can plant positives about oral health in the minds of these children at a young age, they'll be more comfortable with trips to the dentist and continue to take care of their teeth as they get older."