The Dental HOME clinic is a dental office on wheels that allows children from lower incomes families to get dental care at school. Credit: Courtesy of OSU
When families with little disposable income prioritize their expenses, pediatric dental care often does not make the list. In fact, a report from the American Dental Association said more than half of children aged 12 to 15 suffered from tooth decay. The study said tooth decay is disproportionately common in lower-income populations.
Eighty percent of tooth decay and cavities is concentrated in 25 percent of the youth population, most of whom live in lower-income families. A group of faculty and students in the Ohio State College of Dentistry are working to combat these problems with the Dental Health Outreach Mobile Experience, a bus outfitted with dental equipment that visits schools in the Columbus area.
The project is led by Dr. Canise Bean, a professor of dentistry, and Rachel Whisler, the program coordinator for the college’s Office of Community Education. Students from a dentistry class staff the bus and provide children with dental treatments. Bean said there has been an emphasis on creating medical homes, or places that provide comprehensive care to patients. With this project, she hoped to create a home for dentistry, she said.
The clinic began in 2005, when the college was already working with several social service organizations around the city. Bean said at the time, she knew that access to dental care was the largest unmet pediatric health need in the state of Ohio. She said that this is because of the fact that working parents often do not have the time to take their kids to the dentist during the day. Additionally, dentists might not accept the family’s insurance or allow them to pay a reduced rate for services.
Putting a dentist office on wheels and visiting schools allows the OSU team to go to students directly and always have access to students who are in need of dental health care. Bean said the coach is state-of-the-art with technology, such as electronic medical records, available to the OSU team and TV monitors that allow children to watch educational videos as they undergo dental treatment.
“We felt we could really make an impact,” she said. “When we pull up and our staff enters the school, the kids run up and ask, ‘Is it my turn? Do I get to go out to the dental van today?’ So that’s pretty cool.”
Whisler said the program does not accept private insurance, which means that patients either use Medicaid or do not pay at all. This allows the Dental H.O.M.E. to help more families in need. Bean said her team looks for high-need elementary schools to provide services. In the past, she used the percentage of students on free and reduced lunches to measure the level of need. Now that the program is more established, she works with elementary school nurses to learn if the school is in need.
Whisler said the Dental H.O.M.E. works to provide complete care, but if they are unable to provide the treatment that is needed, they have a referral service where patients can get follow-up care.
“Most of the schools are really glad to have us and help us get the parental consent needed to treat the kids, and so we pull up and and get to work,” Bean said.
When children come on the coach, they receive dental X-rays and are given a treatment plan based on their dental needs. Once these needs are met, the Dental H.O.M.E. returns periodically for check-up exams. While the Dental H.O.M.E. project team works to return to the same kids every six months, children often move between schools, which presents a challenge. Bean said the condition of the children’s teeth can vary a lot.
“It leans more toward multiple cavities, and in many of the older children there is very extensive decay that may require extraction of teeth,” she said. “We’re seeing a lot more disease than we’d like to see, but at the same time we feel we are making a real effort to address the need.”
Bean said one of the biggest strengths of the program is that dental students who work on the bus get exposure to working with young kids. She said the children who visit the coach often have multiple dental needs, which allows the students to learn in the field.
“It’s a tremendous teaching and learning opportunity for them, and the ultimate goal is that they have enough experiences with children that they feel comfortable working with them when they graduate,” Bean said. “There’s just a shortage of pediatric dentists, and so if the general dentist feels comfortable accepting kids into their practice, that eases the burden for care.”
Bean said she feels that the opportunity to see a different method of dental care delivery from the traditional “four-walled” clinic is valuable. Whisler said some students might learn that pediatric care is not for them, which is also important.
“Sometimes I think that students will take that as a negative, but they don’t realize how much they really learn when they find something they don’t want to do,” Whisler said. “But we have other students who come back and say, ‘I love working with children, I think I’m going to go into pediatric dentistry.’ It can be a life-altering experience to work hands-on in these situations.”
Whisler added that many dentists never have the opportunity to work in a mobile unit, making the experience something other students can’t say they have had. Bean added that her team learns something new every school year, and Whisler said over the past 10 years of its existence, the program has become more streamlined.
“We say it a lot, but it really is a win-win. It’s a win for our dental students, and it’s a win for the kids in the community, and we are so thankful we can be visible in the community that way,” Bean said. “This is a vehicle that goes around the city, and it allows people to say, ‘Hey, Ohio State is doing great things.’”
The Engaged Scholars logo accompanies stories that feature and examine research and teaching partnerships formed between the Ohio State University and the community (local, state, national and global) for the mutually beneficial exchange of knowledge and resources. These stories spring from a partnership with OSU’s Office of Outreach and Engagement. The Lantern retains sole editorial control over the selection, writing and editing of these stories.
