The good news/ bad news of NC kids’ oral health

Author: Anne Bryce

State health officials made a dismal observation this month about the oral health of North Carolina children: Nearly one in five kindergartners has untreated cavities.

The mascot wearing an inflatable blue shark costume hugs a little boy.
A friendly blue shark mascot hugs a child during Give a Child a Smile Day event at the University of North Carolina Adams School of Dentistry.Photo credit: Anne Bryce

The rate is the highest in five years, in part because many dental offices scaled back their workloads early in the pandemic. Add to that longstanding barriers to health care that disadvantage children from low-income families and communities of color, and it’s not hard to reason why Susan Kansagra, assistant secretary for public health at the state Department of Health and Human Services Got it.

“We have a responsibility to address these disparities and ensure that all children have access to quality dental care, regardless of background,” Kasangra said.

The news isn't all bad, though.

Students at the University of North Carolina Adams School of Dentistry spent an entire day last week working on improving access to dental care for children under 17 years old. These aspiring dentists organized and participated in the 10th annual Give Kids Smiles Day.

“For me, coming from a public health background, I saw the critical need for dental care in our state,” said Niki LANKA, a third-year dental student at UNC who is involved in setting up and providing care. “A lot of the kids we see here, this may be their first time.”

Give Kids a Smile is a national program launched in 2003 by the American Dental Association Foundation to provide free exams, fillings, caps and other restorative care to underserved children.

Its roots lie in St. Louis, where two dentists used a dental office that was about to be demolished to open 15 dental chairs to provide care for nearly 400 children.

“The ADA recognizes that this grassroots effort has tremendous potential to increase national awareness of the importance of oral health to overall health and the impact of the millions of children who go without care,” the foundation's website reads. There was a huge need. “So in 2003, Give Kids a Smile grew into a national program with the goal of providing free oral health care to underserved children. “

Today, nearly 6,500 dentists nationwide participate in programs that care for more than 300,000 children each year.

At the Feb. 2 event in Chapel Hill, more than 50 UNC School of Dentistry faculty and staff saw nearly 200 children from Orange, Durham and Wake counties. They provided nearly $40,000 in care.

“This is a great opportunity to reach out to the community,” said Miguel Simancas-Pallares, of the school's pediatrics and public health department. “We know there’s a lot of unmet need around us.”

The day before the event, dental students spent five hours decorating the school's three floors with colorful streamers, balloons, toys and art projects to fit their “Under the Sea” theme.

“Favorite day”

Bree Smith, a third-year student, participated in every Give Kids Smiles Day event while in dental school. This came to mind as they entered the atrium of the building after completing their activities.

Students went from an outer space theme in 2023 to the depths of the ocean this year.

“I just love how excited everyone is about treating these kids,” Smith said.

There is an inflatable swimming pool filled with small toys instead of water. Small fishing poles are placed on the pool, and children can cast plastic hooks and reels for a special treat.

Artistically inclined kids can choose from a range of colorful crayons and markers to decorate kid-friendly handouts about good eating and dental care.

The kids also got an electric toothbrush and a Spider-Man toothbrush.

Young children also received well wishes from the Carolina Blue Shark, or the mascot wearing an inflatable costume, trying to convince worried and curious viewers that hugging didn't lead to bites. UNC mascot Ramses also made an appearance.

Grayson is a well-trained, compassionate golden retriever who knows when to snuggle a child in the dental chair to relieve anxiety about a screening, cleaning or filling, and he's right there.

Grayson, a golden retriever who snuggles up with pediatric patients and helps ease their anxiety at the University of North Carolina Adams School of Dentistry, is relaxing in his dog trainer's office.
Grayson, a golden retriever who snuggles with pediatric patients at the University of North Carolina Adams School of Dentistry to help ease their anxiety, relaxes in her breeder's office.Photo credit: Anne Bryce

Kanine Jucoski came to Chapel Hill from Wake County for the event with her children, Clara and Lucca Graciano, because she 's daughter had a “bad experience” visiting the dentist elsewhere. A friend told Jucoski about Give Kids a Smile Day, where 10-year-old Clara was all smiles after a visit to the UNC dentist. Girls reported they liked what they saw, too.

“This looks good,” she said they told her.

Esther Lee, a third-year student, said it was important for the event to be a “one-of-a-kind” dental visit that could lead to more regular care for the children and maybe even a new Parents and caregivers bring more regular care. The goal is to have them return to dental school or find a provider closer to home for routine cleanings and screenings.

As a child, Lee had to travel to another state to see a dentist.

Her parents were Korean immigrants who trusted the care of their uncle, who spoke Korean and lived in Atlanta, about a four-hour drive from their home in Charlotte. Giving back to the community through events such as Give Kids a Smile Day keeps her spirits up.

“This is my favorite day of the year,” Lee said.

Close the coverage gap

Dental students, faculty and state health officials point to the need to improve access to care for low-income children.

North Carolina Medicaid dental plans cover a wide range of care—from cleanings, screenings, and other preventive services to fillings, dental restorations, dentures, periodontal care, and some oral surgeries.

After years of resistance, the Republican-led General Assembly finally agreed to expand Medicaid benefits to more low-income workers, creating new ways for underserved children to get oral health care.

A girl and boy lean on their mother during the UNC Dental School's Give Kids a Smile Day
A girl and boy lean on their mother during the UNC School of Dental Medicine's Give Kids a Smile Day.Photo credit: Anne Bryce

“Our recent expansion of Medicaid has helped expand access to oral health care for thousands of fellow North Carolinians across the state,” Kansangra said.

However, a major sticking point is that only about 45% of dentists in North Carolina accept Medicaid patients. However, many of these providers do not accept new Medicaid beneficiaries.

Dentists say Medicaid reimbursement rates have remained flat for the past 15 years, causing access problems. A task force and other oral health advocates have been studying the issue and may recommend changes this year.

At the same time, oral health care providers continue to emphasize the importance of classifying dental and periodontal services as critical services.

“Good oral health in childhood is an important component of overall health and well-being,” Kelly Kimple, senior medical director of health promotion in the NCDHHS Division of Public Health, said in a statement declaring February National Children’s Dental Health Month. “By providing our young people with appropriate dental care, we can prevent lasting effects and help them live healthier lifestyles in the future.”

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