Doc-in-the-box

Fletcher Parish was fairly reluctant about his first-ever trip to the dentist, said his mother, Tanya Parish. But when he found out the appointment was in a truck, the 2-year-old was all for it.

The 40-foot-long Mobile Dental Clinic (MDC)—founded in 2008 by Northern Valley Indian Health Inc., and funded by $375,000 in grant money from government-funded early-childhood program First 5 California—was parked in front of Enloe Children’s Health Center on Cohasset Road recently when Fletcher and his mother walked up and knocked on the door of what looked like a giant ice cream truck.

A staff member welcomed the family inside the colorfully painted, roving dental office housing two exam rooms and a waiting room. Dr. Cynthia Carter, the dentist on staff that day, introduced herself and sat down with Fletcher and his mom in one of the exam rooms, complete with all the necessary tools and a dentist’s chair.

Carter started with a checklist of questions ranging from how many times a day Fletcher brushes his teeth to what kind of foods he likes. Then she asked Fletcher to lie down on his mother’s lap. He did so calmly while Carter looked inside his mouth for cavities.

“Kids feel really comfortable here,” offered Carter, of the mobile clinic that offers its no-cost services to children younger than 6 and pregnant women with limited or no insurance who live in Butte, Glenn and Tehama counties. “Their parents are able to sit next to them and hold their hand, whereas often dental clinics don’t allow parents in the treatment rooms.”

Considering that dental disease is the most common chronic illness suffered by American children, according to the National Conference of State Legislatures, and that the dental health of California’s children ranked third from the bottom in the National Survey of Children’s Health, places like the MDC are a welcome breath of fresh air.

The existence of the MDC is especially welcome for parents such as Parish who participate in the state’s Healthy Families program. Healthy Families, as its website (www.healthyfamilies.ca.gov) states, is “low-cost insurance for children and teens [that] provides health, dental and vision coverage to children who do not have insurance and do not qualify for free Medi-Cal.”

Parish, who recently moved with her family from the San Francisco Bay Area back to her hometown of Chico, said she was relieved when she heard about the MDC from Fletcher’s pediatrician. She said it was easier to find a dentist in the Bay Area that would take her Healthy Families insurance.

“It was really hard for me to find a dentist [in Chico] that took our insurance,” she said. “I think I pretty much called everyone in the book.”

A 2009 study done by First 5 Butte County officials found that 44 percent of Butte County children younger than 6 had never visited a dentist. One of the main reasons for the dismal numbers was a lack of access to dental facilities due to a number of factors, including prohibitive cost and nonavailability of transportation, said First 5 Executive Director Jill Blake in a recent phone interview,

In fact, one in four California children younger than 12 has never seen a dentist, according to a brand-new Pew Center on the States report.

“There’s a lot of people on the outskirts of town who don’t have transportation that are in great need,” offered MDC coordinator Jolynn Delgado. For example, said Delgado, the migrant-worker camp in Gridley is “one of our busier spots. We see between 19 and 20 patients a day there.”

The two dentists who staff the MDC are not just filling kids’ cavities; they’re also trying to educate parents. Carter said a lot of people make the mistake of thinking baby teeth don’t need attention from a dentist because they eventually fall out.

“Baby teeth are really important because they maintain space for the adult teeth,” said Carter. “When the adult teeth come in, they’re guided by the roots of the baby teeth.”

About 90 percent to 95 percent of decay is preventable with daily flossing and brushing, she added. And the costs of neglect are serious. Left untreated, bacteria from a rotting tooth can cause infection in other parts of the body, swelling in the throat that can lead to suffocation, and expensive visits to the emergency room.

“Bacteria travel much faster in baby teeth because baby teeth are thinner,” said Carter. “It can take a year or two for an adult tooth to [develop a cavity], but it can take just a couple months for children. And then if it hits a nerve, they need a root canal, they need crowns, and it costs a lot of money.”

“Before we started, we were seeing severe dental problems with the kids,” said retired dentist Dr. Mel Sage, who spearheaded the MDC program. “Now, with many of the return patients, we’re seeing much less decay. We’re looking at approximately 2,000 kids with improved dental health. We’re saving the county and the state government a lot of money. It’s making a lifetime of difference.”

In addition to First 5 funding, the outreach program relies partly on reimbursements from both Medi-Cal and Healthy Families insurance and will help parents sign up for the appropriate program as needed.

The MDC is expected to continue offering crowns, exams, fluoride treatments, cleanings, sealants, extractions, fillings, and pediatric root canals until at least 2013, depending on funds.

As it turned out, Carter gave Fletcher’s teeth a clean bill of health. Parish said she credits the MDC for a pleasant experience she hopes will lead to a lifetime of good dental health for her son.

“He was not really interested in going, and then he saw the flier with the truck on it—that was a sure sell,” said Parish. “I want him to have a positive experience. I want him to have healthy habits.”