Beneath a purple poster for the Diary of a Wimpy Kid, and between shelves of books, a third grader slides into the vinyl dentist’s chair.
For most of the year, this space is the library at Congress Elementary in Grand Rapids. But since school began last week, this corner of the library has been a dentist’s office.
"Okay, open up big, I want to see those new teeth," says dental hygienist Julie Hilton.
She starts this visit by putting a sealant on a back molar. The American Dental Association recommends sealants for children around the second or third grade as a way to prevent tooth decay and cavities. But research from the Centers for Disease Control shows that kids in poverty are less likely to receive sealants, and more likely to develop cavities later on.
Congress Elementary has a high percentage of kids in poverty.
Kids in poverty are nearly twice as likely to develop a cavity as other kids.
And oral health problems can lead to all kinds of other problems. Not just health problems. A toothache can keep a kid from learning.
One way to ensure kids have healthy teeth is to bring dentistry services into schools.
The program that brings Hilton to schools like this one has been operating in Kent County since 1992. Some of the kids she sees are preschool age.
So, we start young, and hopefully by the time we get to this age, everything is taken care of.
But if it weren’t for this program, if there weren’t dental visits inside the schools, many of these kids wouldn’t have dental care at all.
"The majority of them are not getting services anywhere [else], " says Peggy Bettzinger, who runs the School Linked Health Services program at Cherry Street Health Services in Grand Rapids. "There just isn’t any place to take them."
Bettzinger says, last year, the school dental program served about 13,000 students in Kent County at 75 different schools. For many kids, it was the only dental visit of the year.
Bettzinger says the program is designed to serve families who otherwise wouldn’t be able to set up an appointment.
"We bring the services to them," Bettzinger says. "The parents don’t have to leave work. They don’t have to drive them to the dentist’s office."
This school-based model for dental care has been expanding for this very reason.
The Michigan Primary Care Association says there are now more than 80 school based Health Centers in Michigan, many of which include dental services.
And it’s not just convenience that’s driving the trend.
"A lot of the patients are having difficulty in accessing care because a lot of dentists do not take Medicaid, says Bill Piskorowski, Assistant Dean for Community-Based Dental Education at the University of Michigan. He’s in charge of a program that sends dental students out to clinics across the state. Those clinics mostly serve low-income patients, because most private dental practices don’t accept the insurance that covers those patients.
"Only 10 percent of the population in our state of dentists actually are involved with Medicaid," he says.
Piskorowski says that’s because the reimbursement rate for Medicaid eligible patients doesn’t cover costs. So dentists who accept low-income patients on Medicaid lose money.
There is a state program to help them not lose money on children who receive Medicaid.
The program currently exists in all but eight Michigan counties. Another three will get the program soon.
But Kent County still doesn’t have it.
So, for many parents who want to send their child to a dentist, the best bet may just be to send them to school.