Oral Health Zone project coming to Nobles County

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WORTHINGTON — A medical doctor practicing with the University of Minnesota’s Department of Pediatrics is hoping to make a statewide impact with an initiative to improve the oral health of poor children on medical assistance programs.

With grant funding from the Dental Trade Alliance, 3M and the National Children’s Oral Health Foundation, Dr. Amos Deinard has laid the groundwork for a project with the Minnesota Department of Health’s oral disease prevention unit and the National Children’s Oral Health Foundation to train medical doctors to provide basic dental care to disadvantaged children.

Deinard has contacted health care providers in the area to offer training on identification of, and treatment for, dental caries, which is the process of the enamel getting etched and ultimately leading to erosion and tooth decay.

As a doctor who received his medical education in the 1960s, Deinard said he wasn’t taught dental care in the classroom because people are supposed to see their dentist when they have a tooth ache.

In today’s environment, however, children on government-funded medical programs like Medicaid or Minnesota Care rarely have access to an actual dentist.

“In about the mid-’90s, dentists across the country took a hard stand that if you’re on Medicaid, we really don’t have any interest in taking care of you,” Deinard said.

As a result, there’s a growing problem of untreated dental problems in young children.

Nobles County was one of nine Minnesota counties initially identified by Deinard for the Oral Health Zone project. It was chosen primarily because of the high rate of Medicaid-eligible children living here. Now, he’s hoping to establish zones in 32 counties.

With vocal support already from Sanford, Avera, Affiliated Community Medical Centers and most recently the Mayo Health System, Deinard’s next step is to organize times and locations to meet with health care providers to conduct the trainings. He’d like to meet with staff from the area, particularly Rock, Nobles, Murray, Pipestone and Lyon counties.

The meetings would include distribution of photographic images of dental caries to give health professionals a better idea of what to look for, as well as a demonstration of applying a fluoride varnish to help protect the teeth from decay.

“The act of putting the varnish on and educating the caregiver should be delegated to the lowest-paid member of the medical staff,” Deinard said. “If you can put polish on your nails, I can train you to put varnish on in probably 30 seconds — it takes less than 3 minutes to do all 20 primary teeth of a young child.

“Nobles County public health should be putting varnish on now because they were trained,” he added. Agencies are reimbursed $14 for each fluoride varnish completed.

In addition to applying the fluoride varnish approximately four times per year, Deinard encourages health professionals to also educate the parents so their children exercise proper brushing habits. At the same time, parents have to learn not to give their children sugary drinks at bedtime, from milk to juice. Plain water is the only thing they should be given in a bottle or a sippy cup.

“The goal here is prevention,” Deinard said. “Caries is an infectious disease, and it is thus preventable.”

Without training medical professionals to perform oral health care during well-child visits, Deinard fears dental caries will continue to be a major problem.

Children who suffer from tooth decay and abscesses end up in emergency rooms all too often, which leads to high medical costs and usually just a temporary fix to the underlying problem, he said.

Deinard spoke of one instance where a child was taken to the ER for the same tooth problem 11 times in a one-year period, and the problem was never fixed because ER docs don’t pull teeth.

“Dental care in an emergency room isn’t complete care — you’re paying $400 to $500 for incomplete care in an ER — because they didn’t have dental care to fix the problem,” he said. “There’s huge dollars being spent by health plans paying for kids who have no dental care, have abscessed teeth and end up in the ER.”

By establishing an Oral Health Zone in Nobles County, Deinard wants the community to take ownership of the caries problem affecting its children.

“The docs can do prevention and the dentists can agree, under the watchful eye of the citizens of the county, to take any referral that comes their way,” he said.

Deinard’s grant funding to lead the trainings will run out by the end of this year, but it’s a project he feels so strongly about that he’s willing to see it through.

“It’s a project I want to see come to fruition and actually accomplish something,” he said.

Daily Globe Reporter Julie Buntjer may be reached at 376-7330.

Tags: nobles county, news, healthy