Dear Kristine,
I enjoyed your column last month about the concept of the "dental home" for children.
I can't share your kudos just yet. AAP may not realize it, but they are creating a lot of trouble and angst for those of us in public health. While their message to have a first dental visit by the first birthday (not to mention use of fluoride varnish) is reaching a lot of nurses, pediatricians, parents, teachers, and daycare providers, dental homes for poor and underserved one-year-olds are extremely scarce.
Public health clinics lack the resources and clinicians necessary to treat very small children with decay. We also lack the financial resources needed to pay for them to go to a private specialist, even if we could find one willing to see them and bill us. Yet the number of requests to us to see toddlers is growing rapidly. It would be very nice to think that every family in America can simply afford to pay out of pocket to take their children to a pediatric dentist. Sadly we all should know that isn't the case.
Dental hygienists can work great as you suggest, assuming they catch the toddler before decay has occurred. Unfortunately in public health, we frequently see 2 years olds — who have often just arrived from developing countries — with rampant caries. Our role then becomes much more difficult trying to find specialty care, funds to pay for it, and educating the family, all while overcoming language and cultural barriers.
Hygienists in associate degree programs can get the education they need to handle a dentally healthy two-year-old. But even those of us with master's degrees are challenged to handle the two-year-old with rampant decay in America's public health system. Can someone please write a column on that?
Thanks for reading.
Beth McKinney, RDH, MS
Montgomery County HHS
Maternal and Child Dental Program
Beth also included information on a Public Health ListServ which sponsored is by the University of Pittsburgh and is not affiliated with any other organization. Click here orhere to learn more.
Kristine's response: Thanks Meg, I respect your passion and dedication in your work advocating for children's oral health needs. Keep us posted about all successes, and I hope a reader takes you up on the challenge of writing an article. The continued dialogue is welcome and needed!
