Child Care Health Project Provides Access to Care in their San Francisco Community

By Amber Kuo and Emily Moody, Community HealthCorps Members

1The Child Care Health Project at the San Francisco Department of Public Health (SF Health Network) conducts yearly dental screenings at low-income preschools around the city as part of a larger effort to ensure that children are the healthiest they can be leading up to kindergarten enrollment. The preschools that we target mainly serve minority children and those who come from families of low socioeconomic status.

The supplies generously donated by Henry Schein Cares Foundation are used in these dental screenings to help isolate cases of children with early signs of existing dental decay and to assist with case management: helping get these children into a “Dental Home.” Millions of California children (estimates are 50% of CA children) are covered by Medi-Cal/Denti-Cal insurance. Because the reimbursement rate of Denti-Cal is one of the lowest in the nation, many California dentists find it financially unsustainable to accept this low reimbursement and keep economically afloat. Parents often cannot get actual dental visits for their children, although on paper their child has dental coverage.

Since receiving the Henry Schein Oral Health kit, we have conducted dental screenings that specifically targeted eight preschools (two per week since October 22nd) and have screened over 300 children. Child care sites screened include preschools in underserved San Francisco neighborhoods. The screenings are conducted by a registered dental hygienist, a public health nurse, and two members of the San Francisco Community HealthCorps (under the general supervision of the SFDPH Dental Director and MCAH Medical Director). The oral hygiene of each child is checked by the dental hygienist and noted on a sheet later distributed to the parents to inform them of the results of the check2-up.  Fluoride varnish is then applied to those children with parental consent. Fluoride varnish has been proven to be a cheap, quick, and effective preventive measure against early childhood caries.

The most common conditions seen in the children of San Francisco are the formations of white lines, early signs of dental decay, or small brown spots, indicating cavitations in the enamel of the tooth. In the most extreme cases, we have seen children with completely rotted teeth, examples of a Class II severe dental problem, and a child with a dental abscess, an infected tooth causing swollen gums and pain. We have followed up with the parents of about 40 children so far, who should be seen by a dentist within 24 hours to 2-3 weeks of the initial screening. Our screenings are not meant to be a substitute for routine dental care, though we hope they assist in motivating parents to prioritize their children’s oral health, and often involve a “warm” hand-off to a “Dental Home.”

We ultimately hope that these children leave with a positive oral health experience and take away some of the important oral messages we try to instill through our educational circle time. Though it is upsetting to see children whose baby teeth are marred by brown spots, we are optimistic about the fact that by providing the screening and the fluoride varnish free of charge in a setting where parents do not experience the additional barrier of having to take off of work, we will act as the first line of defense against tooth decay in the future. A goal is to ensure that “All San Francisco Children are Free of Dental Caries” regardless of the economic situation into which they are born, or their special health care needs. We hope that with supporters such as the Henry Schein Cares Foundation we will continue to advance towards this goal. We do more good when we all work together!