On Monday, Feb. 22, seventeen children came to the TMCC Dental Clinic to receive free dental care as a part of the annual Give Kids a Smile (GKaS) Event. Give Kids a Smile is a national campaign in which dental professionals open their doors to children in need of dental care, providing those services for free. This is the fourteenth year in which TMCC has participated in the event. Given that this is also the year of COVID-19, the event looked somewhat different than it has in the past. What did not change: children from our community in desperate need of care received it, free of charge.
“I really couldn’t advertise for the event on campus, because there is no one here,” said GKaS Event Organizer and TMCC Dental Hygiene Professor Julie Stage-Rosenberg. “So I reached out to the Children’s Cabinet who work with children of at-risk families. Most of the children in the organization have access to Medicaid or Nevada Check-up so they are not uninsured, but some of them are.” Rosenberg coordinated for months to work to accommodate children from that organization. Weeks before the event, however, they encountered unforeseen challenges, and only seven children were able to participate.
Rosenberg reached out to another community partner, Healthy Smile Healthy Child, which is a collaboration between the Northern Nevada Dental Society and Renown Hospital. Fortunately, Monica Vasquez, who runs that program, had several children she still needed to place. So, within a day of reaching out to her, Rosenberg was able to fill the remaining spots.
Students in the Dental Hygiene program are required to work with different age populations in order to gain the necessary practical experience for their degree program and professional license. Rosenberg explained that finding those practice patients can be a difficult task, and the GKaS event offers a unique opportunity for students to work with populations they don’t typically see as often in the TMCC Dental Clinic. This year was no exception.
“Interestingly enough, we usually cater to younger children, but this year we had a larger number of teenagers participate than younger children,” said Rosenberg. “That was actually really wonderful because that’s the population that falls through the cracks. Parents tend to be more motivated to bring their younger children in and then somewhere in middle school or high school, they’re still eligible for treatment, but they just don’t utilize it.”
GKaS By the Numbers
In prior years, the GKaS event provided an opportunity for students in the Dental Hygiene and Dental Assisting programs to work together, as they would in a professional setting. However, due to social distancing and other safety protocols, only the 11 second-year dental hygiene students participated in GKaS this year. The students wore KN95 masks and face shields and practiced sterilization protocols that are a part of the safety protocols the profession requires in this “new normal.”
Indeed, the guidelines to participate were strict. Prospective participants were issued questions regarding COVID-19 when they registered, three days before and the day before their appointment. Safety, sterilization, and cleanliness are longtime cornerstones of the dental hygiene profession. “We’re working in a safe environment and we’ve done absolutely everything mandated by the CDC and the American Dental Association in terms of mitigating transmissions,” said Rosenberg. “Honestly you’re safer coming to the dentist than you are going to a restaurant or a grocery store.”
In fact, the program assembled a 13-page protocol last semester that outlines safety practices that keep students, faculty, staff and patients in the clinic safe. These are the protocols students will encounter as working professionals in dental offices.
Of the seventeen children who participated in this year’s GKaS event, the youngest patient of the day was four years old, and the oldest was eighteen; eleven of the seventeen were over 13 years old. Twenty-eight sealants were placed on seven of the children, and many of the children who came had decay or previous fillings in their molars that made them ineligible for sealants.
The event resulted in an $825 donation of dental hygiene services, based on TMCC Dental Hygiene Clinic fees, plus an additional amount for the $140 sealants. In terms of Medicaid, these services would amount to nearly $5,000, which includes the 6% reduction that the State recently cut from Medicaid reimbursement rates. Because the children that participated in this year’s GKaS event are eligible for Medicaid, in addition to helping their dental health and holistic wellbeing, TMCC’s Dental Hygiene program saved taxpayers a considerable amount of money.
According to Rosenberg, had these children sought dental services from private practice, they would have cost a lot more. “Private practice fees are estimated to be approximately 62% more than Medicaid fees... so the cost of private practice would have been closer to over $8,000,” she said.
However, giving back to the community is something that TMCC’s Dental Hygiene program has done since its inception. In addition to participating in the GKaS Event, dental hygiene students have participated in Holiday with a Hero, food drives for the Food Bank of Northern Nevada and fundraisers for Safe Embrace, a local shelter for those who have been the victims of domestic violence to name a few recent examples.
Giving Back Smiles in the Time of COVID-19
Even in the times of COVID-19, students in the program also provide pro bono services for Head Start, a federal program that promotes the school readiness of infants, toddlers and pre-school-aged children from low-income families. In addition to early learning and development, the program connects youth to medical and dental services. After all, health and physical development are crucial to early learning.
“I’ve been offering our services to the Head Start program for ten years now,” said Rosenberg. “Normally, we would see hundreds of children in the program, but this year we only saw about fifty.” The drop was due, in part, to a decreased enrollment in the program. COVID-19 also complicated the process of providing the children access to dental care.
“They wouldn’t allow us in the classroom, so we actually did the dental screening and put fluoride varnish on their little baby teeth while sitting on a blanket from my car on the playground at the different schools,” Rosenberg explained. “Honestly… you just have to adapt. We were grateful to provide that service. It really benefits the children.”
Dental hygiene students will offer services to children in the Head Start program beginning at the end of March this year. “It’s a partnership that works really well,” Rosenberg said. “And the kids are sweet. They are zero to three years old, and sometimes they don’t even have teeth yet. The students gain so much experience working with a much younger group than they will ever see in our clinic. They also see how hygienists can impact the community through public health.”
That focus has long been a part of the dental hygiene curriculum thanks to Rosenberg, who created a class called “Community Dental Health” that asks students to identify a population in need of dental care, and develop an educational curriculum and outreach programs to improve their dental hygiene. Although the majority of the students who graduate from the Dental Hygiene program will find their careers in private practices, some are inspired by the work they complete in that class, and with the larger mission of public health.
“Two weeks ago I came home to a giant box of chocolates in the mail from a former student who has since gone on to a physician’s assistant school in New York. Apparently because of that assignment I made her do [in the Community Dental Health class] where they have to pick a target population and plan lessons—kind of like writing a grant—she said she got a grant to teach nurse practitioners and physicians assistants in New York. She has over 100 participants,” said Rosenberg.
The grant will enable this former student to teach licensed nurse practitioners and physician assistants to apply fluoride varnish. “She wrote this whole curriculum [while she was in the program at TMCC],” Rosenberg said. “She said she just pulled out the binder that she had created in my class and followed it exactly and was granted the money to do this.”
Now that it’s funded, the program is projected to impact one hundred providers, which will exponentially impact the young children who are a part of the community there. But, this is one example among many students taking the mission to improve public health to heart.
Another student who was impacted by that class practices portable dental care as the “Traveling Toothfairy,” offering care to assisted living facilities and homebound patients.
“[These students] just touch my heart so much,” said Rosenberg. “We provide our students with real-world experience that they actually use.”
Lasting Legacy
In addition to producing graduates who will continue to give back to their communities either through charitable acts of their own, by encouraging the private offices at which they work to participate in the annual GKaS event, or by following through with their own public health work, Rosenberg has been integral in the creation of the four-year Bachelor of Applied Science program in Dental Hygiene that will witness its first graduates cross the stage this spring.
Rosenberg, who is retiring at the end of the semester, feels as though she’s come full-circle in what has been, inarguably, a very challenging year. “I’m amazed at what our students have done, in a year when it’s been a struggle to get commitments from long-term care facilities, from schools—and when it’s been so hard to communicate and connect. But, we did it. Their hearts are in this work, and they really want to do it,” she said.
For more information about the Dental Hygiene Program at TMCC, contact the program at 775-673-8247.