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HomeMy WebLinkAbout164-dental-services-in-shc-in-focus1© 2020 Center for Healthy Schools and Communities | achealthyschools.org School Health Centers in Alameda County School health centers (SHCs) are both health clinics and also places for students to experience positive youth development opportunities. Successful SHCs go beyond co-locating services on a school site; they have trusting and collaborative relationships with youth, families, schools, health providers, and the community. Our network of 28 SHCs approach young people holistically, offering inte- grated health and wellness services that include medical, dental, behavioral health, health education, and youth development. In the SHCs, youth expe- rience authentic relationships with health providers and develop agency over their own health and lifestyle decisions. IN FOCUS Dental Care in School Health Centers Why Dental Care in School Health Centers? Dental care in school health centers (SHCs) ensures that every child can have a pain-free, confident smile. Regular dental care and good dental hygiene are healthy habits with a life- long payoff. Having access to a dental home is an important part of universal access to care. The problems related to children’s oral health are widespread and affect students’ ability to learn. Poor dental health has been identified as one of the most common childhood chronic diseases linked to emergency room visits and hospitalizations. 1 According to the Center for Disease Control and Prevention, 11% of 13- to 15-year-olds have untreated cavities.2 Dental health also impacts academic indicators, as well as cognitive and psychosocial development.3 African American, Asian, and Latino youth are disproportion- ately affected and more likely to have poor dental health.4 Most dental disease and associated pain is prevent- able, thus, increasing children’s access to preventive dental care is critical. Our Approach Across Alameda County, SHCs are strategically located to address the dental needs of students through a combination of education, screenings, a range of direct dental services, and referrals. Our SHCs provide dental care through the following services: School-Wide Education SHC staff do classroom presentations, distribute toothbrush and toothpaste, and staff health fair tables to promote oral health. Mass Screening Most SHCs organize school-wide dental screenings, where they screen as many students as possible over the course of a few days and connect those students to appropriate follow-up care. Some SHCs even screen neighboring feeder schools. Dental Care in School Health Centers 2 Preventive Care Some dental work is provided onsite, including applying sealants or varnishes; this does not require specialized training and can be done outside a dental operatory. Dental Treatment Sites with an operatory can do fillings and restorations. Our newer SHCs include complete dental offices with all the specialized equipment necessary to do x-rays, fillings, and extractions. Referrals All sites refer students who come in with tooth pain or urgent issues to a dentist as soon as possible. SHC dentists refer patients for advanced care, such as orthodontics or root canals that cannot be done onsite. Case Management A key piece of oral health for youth is case management. Once students have been identified through screenings or referrals, it is often difficult to connect with parents and get consent to move forward with necessary dental care, even if the dentist is free and located at the school. SHCs work on building relationships with parents, teachers, school staff, and the entire school community to improve case manage- ment and follow-through. Also, dental care is a financially sustain- able component of a health center. The Federally Qualified Health Clinics (FQHCs) that run our SHCs can bill for all Denti-Cal patients. Highlights In 2018-19, twelve Alameda County SHCs provided full dental services. Nearly one in five (19%) of all visits to these SHCs were for dental services; and more than 1,800 clients received dental care. About a third (35%) of these visits were for restorative services, such as crowns; 34% were for preventive services, such as cleanings; and 35% were for diagnostic screenings and exams. Nearly every dental client (99%) had a baseline dental assessment conducted; and 84% were found to have some decay at baseline. Demonstrating the effectiveness of the services, the decay improved or did not worsen over time in 85% of the 1,281 clients screened at both baseline and follow-up. The Native American Health Center has integrated healthcare workforce development into dental screenings at the SHC at United for Success and Life Academy in Oakland. High school students interested in a health career were trained to apply dental varnish, and the students worked alongside paid health professionals to help provide preventive dental care to over 400 students. 1 Oral Health in America: A Report Of The Surgeon General. U.S. DHHS, National Institute of Dental and Craniofacial Research, National Institutes of Health (Rockville, MD, 2000). 2 Centers for Disease Control and Prevention/Na-tional Center for Health Statistics, National Health and Nutrition Examination Survey, 2009–2010. Accessed on February 25, 2013 at: http://www.cdc.gov/nchs/ data/databriefs/db104.htm#untreated. 3 C.C. Guarnizo-Herreño G.L. & Wehby, “Children’s Dental Health, School Performance, and Psychosocial Well-being” J Pediatrics, 161, no. 6 (2012), 1153-1159. 4 G. Flores, H. Lin, “Trends in Racial/Ethnic Disparities in Medical and Oral Health, Access to Care, and Use of Services in U.S. Children: Has Anything Changed Over the Years?” International Journal for Equity in Health,12, no. 10 (2013).