Dentist on wheels treats low-income children

SPRINGFIELD, Mo. -- It's no trip to the candy store, but this dentist's office is sweet on kids.

The 40-foot-long, pearly-white "Tooth Truck" glides on wheels right to your school. Cavities are "black dots," nitrous oxide is "strawberry air," fillings are "silver stars" and numbing injections are "sleepy tooth bubbles" that don't hurt.

Well, maybe just a pinch. But 4-year-olds Kambria Twedell and Aliyah Hendricks took it in stride earlier this month with their strawberry air and hot-pink star-shaped sunglasses -- to shade the bright office light.

But the best part of all: Kids who can't get a dentist appointment anywhere else -- potentially 16,000 Medicaid-eligible youths in Greene County alone are welcome here. And once their smiles are restored, they learn how to prevent cavities and practice good oral hygiene.

That's the idea behind the new Ronald McDonald Care Mobile, which began serving children at Springfield public schools this month, starting at York Elementary School.

Each week the Tooth Truck will visit a different Caring Communities school. School nurses, with parents' consent, schedule appointments for children based on previous dental screenings. Children who qualify for Medicaid or the free or reduced school lunch program are eligible.

Can do most work

Dr. Craig Rechkemmer sees children in two fully equipped treatment rooms at either end of the 40-foot unit.

It's so high-tech, Rechkemmer can do any dental work there that doesn't require complete sedation.

Dr. Carrie Arquitt, a pediatric dentist working part time on the Tooth Truck, treats the special needs of children there or at a hospital.

The project targets second- and sixth-grade children for now -- critical years in tooth development, said Bonnie Keller, CEO of Ronald McDonald House Charities. But she adds, "We could see five times more children, just in Greene County."

Tooth Truck staff also will spend about 20 percent of each week at each site treating children referred from other schools and Head Start preschools -- to make sure a child doesn't suffer with a problem tooth until the truck comes to his or her school.

The unit visited Head Start schools and the Boys and Girls Clubs for eight weeks this summer, treating 440 patients. Many of them had never been to a dentist, and most required an average of four return visits just to correct all the cavities and apply preventive sealants, Rechkemmer said.

That's when he realized how area children have suffered from the lack of access to dental care, and why so many community groups have backed the project.

Hard to find dentist

Low-income children and Medicaid recipients across Missouri and especially in Greene County have difficulty finding a dentist who will treat them, Keller said.

One major barrier to access: Medicaid reimburses dentists about $38 on a $100 dental bill. Dentists say they can't treat too many of those patients because they lose money -- it costs them about $75 to provide the service due to clinic overhead. Other barriers: Parents don't have transportation, and some parents aren't good about keeping appointments or following up with good oral hygiene, dentists say.

The mobile dental unit, arriving each week at a neighborhood school, removes all of those barriers, Keller said.

Kambria's dad, Danny Twedell, said the Tooth Truck made it possible for him to get her to a dentist on his day off. His 8-year-old daughter had to wait about two months for an appointment with a dentist willing to take Medicaid.

"Kambria has never seen a dentist and she's 4, so I knew she needed to," he said.

Ideally, parents should take their child to the dentist by age 1 to identify any early problems, Arquitt said. But because of the barriers to access, parents often don't seek dental care for their children until a problem becomes unbearable and more complicated.

"A lot of times, we're the first dental experience they've ever had," Arquitt said.