March 2012 Volume XLVIII Number 2
Spirit Lake Pediatric Dental Day
by Jan Silverman
As a project of the North Dakota Head Start Dental Home Initiative, a Pediatric Dental Day was held at Spirit Lake Reservation in Fort Totten, N.D., at the Four Winds School on Sept. 30, 2011. The origin of this project dates back to a Dental Home Initiative site visit in 2010 to the Spirit Lake Head Start Program where a meeting with Head Start staff and IHS dental staff took place. The large unmet dental needs as well as the severe disease burden of Head Start children was discussed and validated by this group. The difficulties in getting follow-up pediatric specialty care for Spirit Lake children was seen as a barrier for a number of reasons including travel distance and lack of parent follow-up. Through this meeting, the decision was made to attempt to bring the specialists to the children through infrastructure built on the Mission of Mercy model with equipment provided by America’s Dentists Care Foundation (ADCF) of Wichita, Kan.
The process began by soliciting North Dakota’s eight pediatric dentists for their participation. With their immediate and unqualified support, the process moved on to developing a budget, establishing a local Tribal steering committee, and working with ADCF to work out the logistics of equipment set-up and location. Co-chairs of the project were Dr. Brent Holman, state Dental Home Initiative leader, and Kimberlie Yineman, R.D.H., state oral health director. Early financial support from the Head Start Dental Home Initiative, ADCF, state dental organizations, and individual dentists helped provide momentum.
We determined that pre-screening of children, if possible, would help improve the efficiency and number of patients that could be helped in a one-day blitz. Children that could best be treated under general anesthesia by a pediatric dentist would be referred directly to a specialist. In addition to pre-screenings, walk-ins were also encouraged though a public information campaign at Spirit Lake in the months leading up the September 30 event.
On Sept. 30, nine pediatric dentists, five general dentists, two oral surgeons, and 35 dental staff volunteered their services. A network of 20-25 volunteers also was recruited to help as Family Guides. Spirit Lake children under the age of 12 were eligible to be seen either pre-screened or as walk-ins. Head Start children from nearby Devils Lake, N.D., were also eligible to receive care. On Pediatric Dental Day, the second-year dental hygiene students from the North Dakota State School of Science in Wahpeton, N.D., provided oral health education, hygiene services, sterilization duties, and helped as Family Guides. A total of 278 kids were pre-screened with the majority of those receiving fluoride varnish. Of those screened, 149 children were referred to Pediatric Dental Day. Following is a summary of treatment provided on September 30 at the Four Winds School Gym in Fort Totten, N.D.:
68 dental prophylaxes
105 fluoride varnish applications
254 fluoride varnish applications (including pre-screenings)
268 fillings (all types)
69 stainless steel crowns
27 general anesthesia referrals to pediatric dentists
35 general anesthesia referrals to pediatric dentists (including pre-screening)
2 referrals to oral surgeon
$107,701 total of free dental treatment (excludes pre-screening)
The Spirit Lake IHS Dental Clinic will provide follow-up and they are making the referrals of the 35 children determined to need general anesthesia in a hospital setting by a pediatric dentist.
The following groups were partners in this public health effort:
ND Association of Pediatric Dentists
North Dakota Dental Association
ND Head Start Dental Home Initiative
Office of Head Start
North Dakota Dental Foundation
Spirit Lake Tribe and Head Start
Spirit Lake IHS Dental Staff
Spirit Lake Early Childhood Tracking
ND State Oral Health Program
ND Department of Health
ND Head Start Association
Patterson Dental Fargo
America’s Dentists Care Foundation Missions of Mercy
ND Governor’s Indian Affairs Commission
State Head Start Collaboration Office
North Dakota State College of Science Allied Dental Education
Amber Neppl, RDH, at Spirit Lake Indian Health Service, said, "My feelings about the event are pure gratitude! The need for dental care on the Spirit Lake Reservation is great. The experience was awesome and something I will never forget. It was so amazing to see this event come to life and for the dentists to be able to help so many children in need in one day. The Spirit Lake Tribe really came through and was vital in making this day a success. It was great to see so many wonderful people come together for such a great cause!"
By every measure, the Spirit Lake Pediatric Dental Day was a success and the benefits go beyond the treatment statistics. The satisfaction of service in all who participated will foster further public health efforts by those volunteers. The excitement that was generated in the Spirit Lake Tribal community will help identify oral health as important value for their children and lead to preventive benefits for not only the children that were seen, but also the children that were not seen. Finally, the Spirit Lake Pediatric Dental Day will provide lessons in how to develop public/private partnerships to help American Indian children - children with high need for specialized treatment. These partnerships are not long-term solutions, but a way to shine the light of public policy on a public health problem that has been resistant to solutions.
Becky Larson, director of Spirit Lake Head Start, summed up her feelings: "For the children of this community to receive a contribution that offers a window to good overall health is a gift of unimaginable magnitude."
For questions or additional information on the program, please contact:
Brent L Holman D.D.S.
2538 S University Drive #A
Fargo, ND 58103