<span data-mce-type="bookmark" style="display: inline-block; width: 0px; overflow: hidden; line-height: 0;" class="mce_SELRES_start"></span> “A smile from a child is packaged sunshine and rainbows.” — Unknown Shy, goofy, sincere or laugh-out-loud big, there’s not much in life that beats a child’s smile. But kids in Michigan’s Upper Peninsula often have a harder time keeping that smile healthy. They’re at a much higher risk of dental disease and tooth decay due to limited access to fluoridated water and topical fluorides, widespread poverty, and a shortage of dentists in their area. In 2014, local public health departments started the U.P. Wide Smiles initiative, with initial funding from the Superior Health Foundation. After the first year, the Blue Cross Blue Shield of Michigan Foundation saw the program’s potential to reverse a track record of poor oral health and provided a $50,000 grant to sustain it for another two years. Program interventions focus on helping children access oral health care where they already are, eliminating potential barriers, explained Dr. Teresa Frankovich, local public health medical director for the U.P. Although the national standard is for a child to visit a dentist on or before his or her first birthday, many children in the U.P. don’t go until much later, if at all. In fact, there are only three practicing pediatric dentists in the U.P., which means that children with complicated dental needs often have to travel hundreds of miles for appointments. U.P. Wide Smiles focuses on training primary care provider offices to conduct oral health screenings and fluoride varnish applications for young children they routinely see at well-child and other doctor visits. School-based fluoride rinse programs for children in grades K-5, a group encompassing 13,000 children, help deliver an important preventive treatment on a weekly basis at 33 schools and counting. When the program first started, a targeted education campaign helped parents understand the importance of baby teeth, which are vital for chewing, speech development, spacing for adult teeth and overall health. “A lot of people don’t realize how important children’s baby teeth are,” said Rebecca Maino, a dental hygienist and the project coordinator for U.P. Wide Smiles. Frankovich said the program’s success will be measured by looking at the age children get their first cavity and their total number of cavities. The goal is to delay the appearance of those first cavities (or prevent them altogether) and to reduce the total number of cavities seen in young children. As these goals are met, there will also be a reduction in the number of children requiring hospital care for extensive decay. Anecdotally, there appears to be improvement in this measure already, but ongoing data collection and analysis will be necessary to determine effectiveness from a population health perspective. For Maino, the dignity that comes with U.P. families being able to access care that leads to healthier smiles is another measure of success. A woman whom Maino had treated as a dental hygienist years earlier recently brought her baby in to a local clinic for the fluoride varnish treatment. She’d struggled for years with her oral health and wanted to ensure her child wouldn’t. “She wanted her baby to receive the same care that she had when she was younger,” Maino said. “And that was when I knew that this work is really making a difference.” Photo credit: Pixabay
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