“She sparkled them!” showed off one proud Dwight School kindergartener, Kayla Jones (pictured at left), after slipping out of class to visit to the St. Raphael’s Mobile Dental Van. The van visits 15 city schools, serving kids who would otherwise have a tough time finding a dentist — mostly kids on HUSKY A.
HUSKY, the state’s insurance plan for low-income kids, offers such low reimbursement rates that most kids’ dentists won’t accept it. So most children on HUSKY simply don’t get cleanings. Most recent stats (from 2004) show only 1 in 3 New Haven kids on HUSKY had seen a dentist in the past year, according to Connecticut Voices for Children.
Before the dental van came around, the numbers looked a lot worse. When the van started out six years ago, only 1 in 5 kids in New Haven had seen a dentist in the past year.
Kids as young as six years old, many back for their second or third appointment, climbed into the van last week as it sat behind the Dwight Elementary School. Some had toothaches. Some came for cleanings. Others wriggled as a dentist filled cavities.
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When Shaniya Harris, 10, showed up at the van for her first visit, she had four cavities: “two up here and two down there.” This year, all she needed was flouride treatment — no cavities in sight.
“Have you been brushing?” asked Sharon McCreven (pictured), the dental hygienist in charge of the van. “Yes, twice a day.” Did you use that floss I gave you last time? “Yes, but I ran out.” McCreven gave her a new supply and some for her family, too.
By being so close to the schools, the van reaches kids whose parents may not be proactive in seeking dental care when their kids need it. “These kids are sitting in school with these big, swollen faces.”
Kids are screened by dental students from the University of New Haven, who come into the classrooms with flashlights and colorful stickers. Students are then referred to the van if need be. Emergency cases — a couple pop up every day — are sent to Yale New-Haven’s pediatric dental clinic, which has an operating room and accepts HUSKY. The service providers are linked through the New Haven Oral Health Collaborative, which includes the Hill Health Center.
McCreven says by the time students in New Haven schools are 5 years old, most have 50 to 70 percent tooth decay. That wouldn’t be true if the kids had had access to preventive care. Van staff are doing damage control for all the kids who didn’t get care through HUSKY (92 percent of the van’s patients are on HUSKY; the rest are uninsured).
Hartford’s Key to Success
Folks up in Hartford have figured out that bringing dentists to the schools makes a huge difference in getting underinsured kids care. With more than a dozen dental clinics in elementary schools, Hartford is out-sparkling the state in kids’ access to dental care. In 2004, 47 percent of Hartford’s kids on HUSKY got preventive dental care, compared to only 39 percent state-wide, according to Connecticut Voices.
New Haven was below the state average, with 35 percent. Could more school-based dental care be the ticket to helping New Haven’s kids catch up?
McCreven likes the idea. “There’s a lot of schools we’re missing. I bet you could put two more vans on the road” without ever letting the dentist chairs cool down. “We’re totally overwhelmed.” The van sees 15 kids a day, 1,600 a year — that’s just a slice of the kids in need.
McCreven sees recruiting dentists as the largest obstacle. “It’s a pay cut, it’s grueling work, the kids are tough.” HUSKY reimburses $68 per cleaning, whereas private dentists can get more than double that price.
In Hartford, medical staff are employed by the city. New Haven has a different setup — With so many small schools, the city “favors the mobile concept,” said Carlos Ceballos, the city’s school-based health coordinator. The city has only one school-based dental clinic, at the Katherine Brennan school. Setting up a clinic can cost $50,000, and with so many quality health facilities in the city, why not tap into their resources?
Existing school-based dental care has come because health professionals, not the city, stepped forward. That’s how the Katherine Brennan dental clinic got started — the Hill Health Center came forward with the idea and applied for a grant. “I’m really excited that they have this dental van,” but whether the city bolsters its school-based dental care would be up to the health clinics and the two hospitals, said Ceballos.