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'Give Kids A Smile!' As dental needs persist, program becomes a fixture

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A child holds a twisted balloon as volunteer dentists clean his teeth during Give Kids A Smile Day at Eastern Orthodontics and Pediatric Dentistry Friday, Feb. 2, 2018. (Juliette Cooke/The Daily Reflector)

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By Kim Grizzard
The Daily Reflector

Saturday, February 3, 2018

In 2003, when local dentists joined a nationwide effort to provide a day of free services to children in need, no one envisioned that it would be permanent.

But 15 years later, Give Kids A Smile! Day has become a fixture in eastern North Carolina, providing oral health care to more than 1,200 local children who might otherwise not see a dentist.

“When we started I had no idea (how far the program would extend),” said Dr. Lee Lewis, who was president of the East Central Dental Society when the local program was launched and continues as co-chair of the event today. “We didn't know much about what the program would be down the road.”

Give Kids A Smile! Day, which began in 2002 when two Missouri dentists gave free dental care to about 400 children, has grown into a nationwide effort that has served more than 5.5 million youth. About 1,300 programs are held across the country each year, most of them on the first Friday in February to kick off National Children’s Dental Health Month.

Friday's event was a first for Ryan Le, a third-year student at ECU's School of Dental Medicine, which sent more than a dozen students and a handful of residents and staff to Give Kids A Smile! Day in Greenville. Le, a native of Charlotte, previously had volunteered at Missions of Mercy dental clinics for adults but welcomed the chance to help children.

“There is definitely a need,” he said. “This is nice to give back and live the mission of ECU.”

Friday was also a first for Mason Ward, a 5-year-old who had never been to a dentist before. His mother, Rolanda Ward, said that before she learned about Give Kids A Smile! Day three years ago, Mason's brothers, Markevion, 13, Marxavier, 11 and My-khazhiyu, 7, had never visited a dentist either. Their parents' income does not meet the requirements for Medicaid, and the family does not have dental insurance.

“Some of us don't have the money or the opportunity to come to the dentist,” Rolanda Ward said. “It helps out a whole lot.”

That scenario is all too familiar to Lewis, who on Friday treated several children who had never been in a dentist's chair. One of those children, a 10-year-old, needed two extractions and two fillings because of untreated dental decay.

“A lot of the children we see each year don't qualify for Medicaid; they don't qualify for Health Choice. They're in that in between; there's just kind of a void. They (the parents) are not making enough to cover it,” Lewis said.

“If all they had to have was preventive services, it's not that much,’ he said. “The problem is it's not just preventive services. That's where it becomes really expensive.”

Friday's 16th annual Give Kids A Smile! Day provided more than $40,000 in free care for 85 children. In addition to routine dental cleaning and flouride treatment, patients required three crowns, 24 extractions, 53 fillings, 112 X-rays and 119 sealants.

Not all of Give Kids A Smile! Day events provide the same level of treatment. Some only offer screenings, education and preventive care.

N.C. Dental Society Executive Director Alec Parker called the eastern North Carolina event “the crown jewel” of the state's estimated 87 Give Kids A Smile! Day events.

There was a time when more North Carolina dentists participated. Several events were discontinued after 2010, when state budget cuts eliminated several public health hygienists positions. A number of Give Kids A Smile! Day events had relied on those hygienists to refer children for care.

“That was really something that kind of set us back for a few years,” Parker said, adding that Give Kids A Smile! Day is beginning to rebound. “We used to be close to 100 consistently.”

Programs that remained had to find creative solutions to try to identify children most in need of the service. The East Central Dental Society began partnering with other area health agencies that also had an interest in children's care.

Today, in addition to the dental society and dental school, Give Kids A Smile! Day involves the Pitt County Health Department, the James and Connie Maynard Children's Hospital at Vidant Medical Center, ECU's Brody School of Medicine and College of Nursing.

With the partnership, Give Kids A Smile! Day grew to include measurements of height, weight and body mass index and a review of children's vaccination history.

“What we've done with our program here is worked it into an overall health program,” Lewis said. “For us, that's the best evolution that we could have expected.”

Rocky Mount's Give Kids A Smile! Day also made adaptations. With fewer public health hygienists available to screen children in schools, volunteers spent Give Kids A Smile! Day doing their own screening at Coker-Wilberly Elementary School in Edgecombe County. About 50 who have the most urgent needs will receive free treatment another day.

“The kids that have the worst problems are the ones we try to see,” said Dr. Frank Courts, a Rocky Mount pediatric dentist and fomer chairman of the department of pediatric dentistry at the University of Florida College of Dentistry. “We're seeing more and more disease that's not treated.”

According to the North Carolina Oral Health Section's Kindergarten Oral Health Status report for 2015-16, an estimated 21 percent of Pitt County kindergarten students had untreated dental decay. The report indicated that more than 20 percent of kindergarten students had untreated dental decay in a region that included Pitt, Lenoir, Wayne and Beaufort counties. That was the highest level of untreated decay reported among the 10 regions surveyed.

Besides the loss of public health hygienists, Court attributes the increase in untreated dental decay to the fact that Medicaid reimbursements for dentists have not increased in more than a decade.

“We're still at the fee level that we were in 2006,” he said. “Dentists who provide Medicaid services actually end up losing money.”

North Carolina Dental Society President Mark Scheiderich said access to care for many needy patients becomes an increasing problem as more dentists are reluctant to accept Medicaid patients.

“Especially now with younger dentists coming out (of school) with so much debt, it's hard to take on patients that you're losing a little bit every time you see them,” he said. “It's hard to sustain a practice.”

Courts said events like Give Kids A Smile! Day call attention to the need for lawmakers to make changes in Medicaid to keep the program viable.

“There's a huge level of unmet need,” he said. “We want to try to fix that. We can't do it all just in a day.”

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