For Children, There's No Place like (a Dental) Home

BUFFALO, N.Y. -- Tooth decay is the most chronic disease among children. In one year, more than 51 million hours of school is missed because of tooth decay or other dental-related illness. And even when children with dental problems can attend school, research shows that these problems are distracting enough to impair classroom learning and behavior.

Yet, in all of Chautauqua County, there is only one pediatric dentist who accepts Medicaid. The children of Chautauqua County, however, have not gone without dental care -- in fact, the care comes to them.

Every year for the last 14 years, the University at Buffalo School of Dental Medicine has been serving the oral health needs of Chautauqua County's children through its school-based mobile dental unit (MDU), a van that is outfitted with two dental chairs and staffed by three UB dentists, a dental hygienist and a dental assistant.

UB's MDU dental staff has provided care during 38,000 patient visits since 1997.

Barbara Moore, DDS, UB MDU clinical director, who has been treating MDU patients since 1998, expresses how meaningful her work is: "We treat more than 1,700 kids a year who might not get dental care without our visits. I enjoy providing care to these children; they need us. I know that when I treat them, I'm helping their dental needs, which affects their overall health."

But the UB dental care provided to the Chautauqua county children is in jeopardy. While UB's MDU van is aging and needs to be replaced, state budgets have been cut and funds for this service are scarce. The initial cost of replacing the van is $500,000.

In addition, changes in Medicaid funding reimbursement have been modified making it difficult for UB to staff the MDU van with the requisite dentists and dental hygienists.

To understand why the UB MDU van treats the kids in Chautauqua County it's important to understand the county's dental demographics, says Moore, For example:

-- 12.7 percent of families live below the federal poverty level (children in families living below the federal poverty level are twice as likely to have untreated decay);

-- Children ages three to five years averaged 292.3 cavities. The New York State rate was only 87.7 (visit rate per 10,000 for dental caries or cavities from 2005 to 2007);

-- Only 14 percent of Medicaid-eligible individuals received services.

According to Moore, a dental van, like the MDU, that goes directly to schools solves a host of challenges for families in need. It gives them access to a dental provider without having to worry about transportation or proximity to a dental office. It means that a parent doesn't need to leave work or home to accompany their child to a dental provider.

The UB MDU van also got out in front of decay within the county and placed children on a preventive care track, establishing for each child a "dental home" and an opportunity to build an ongoing relationship with dental care. Eighty percent of the children seen by the UB MDU accept the van as their "dental home."

The ability to get individuals into dental and medical homes before a minor problem develops into a major in-patient problem, is a key objective in health care and also reduces health costs, Moore says.

Because Chautauqua County children are now seen by dentists regularly for teeth cleaning and other preventive measures, fewer treatment procedures like fillings and extractions are needed. These positive changes can be directly attributed to the work of the UB MDU van in the county over the years, Moore says.

One of the UB School of Dental Medicine's primary goal's has always been community outreach, and in 1997 the extreme need in Chautauqua County convinced the school to take action, using dental school funds to provide a mobile dental van, Moore explains.

Because the dental school's budget has been significantly reduced, it is applying for grant money and reaching out to philanthropic organizations to buy a new MDU van.

Daniel Kathman, superintendent of the Jamestown Public Schools, says, "We are aware of the hardships that have arisen with the van's age and condition and hope that they can be overcome for the sake of our kids. The dentists and the hygienists from UB have provided an essential service for our community's children."

The University at Buffalo is a premier research-intensive public university, a flagship institution in the State University of New York system and its largest and most comprehensive campus. UB's more than 28,000 students pursue their academic interests through more than 300 undergraduate, graduate and professional degree programs. Founded in 1846, the University at Buffalo is a member of the Association of American Universities.