Doing what it takes to provide dental care to children in Bennington County

Rebecca Bishop-Ware & Grace Winslow

According to the American Academy of Pediatric Dentistry, a dental home is “the ongoing relationship between the dentist and the patient, inclusive of all aspects of oral health care delivered in a comprehensive, continuously accessible, coordinated, and family-centered way. The dental home should be established no later than 12 months of age to help children and their families institute a lifetime of good oral health. A dental home addresses anticipatory guidance and preventive, acute, and comprehensive oral health care and includes referral to dental specialists when appropriate” (AAPD 2023). The following charts show Bennington County Head Start and Early Head Start enrolled children as compared to all Vermont Head Start- Early Head Start enrolled children, compared to national enrollment data for last school year.

A graph titled percent of head start children with a dental home: 2021-2022. End of year data shown by orange bars is higher than beginning of year data shown by blue bars.

Comparing the Head Start Program Information Report (PIR) data of 5 years ago, from the 2017-18 school year, by the end of that year, 88% of Head Start children had a dental home and 79% had had preventive care (cleaning and fluoride varnish) during the previous 12 months. This was a better rate of dental home and preventive care than much of the state at that time.

Five years later, during the 2021-22 school year last year, only 69% of Head Start children had a dental home by the end of the year and only 50% had had preventive care. This significant drop in both dental home acquisition and preventive care in an overwhelmed dental care system made program management re-examine how we can intervene to provide preventive care.

After using data to quantify a need for dental care in our community’s youngest, our own Health Manager, Grace Winslow, secured services for children attending Bennington County Head Start – Early Head Start Programs last month. Considering changes in the trajectory of dental care in the community, Grace knew that something needed to be done to increase dental preventive care to program children! She collaborated with her colleagues and contacts around the state and secured three days of support services by the Vermont Head Start Association Tooth Tutor, traveling from Northern Vermont, and providing services to program and partner programs in Bennington County. Head Start and Early Head Start children were able to be screened by dental hygienist Kim Hartling-Welles.

A yellow graph titled head start year-end dental care data (%). Dental home line shown in purple dips. Preventative care line in blue dips and then trends upwards.

As a result of Grace’s efforts:

A graph titled percent of early head start children with a dental home: 2021-2022. End of year data shown by orange bars that are higher than beginning of year data shown by blue bar

• 60 preschool children and 26 infants and toddlers received a dental screening (some for the first time!), plus application of Silver Diamine Fluoride (SDF) to stop decay, plus Fluoride varnish to protect teeth by hardening tooth enamel

• An additional 13 preschool children and 17 infants and toddlers received a dental screening and Fluoride varnish only
• An additional 5 children received a dental screening
• A total of 78 children were treated!

REFERENCES

American Academy of Pediatric Dentistry (2023). Oral Health Policies and Recommendations.

US Department of Health & Human Services, Administration for Children & Families. (October 6, 2022).

Data & Ongoing Monitoring. Program Information Report (PIR). https://eclkc.ohs.acf.hhs.gov/data-ongoing-monitoring/article/program-information-report-pir