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Outreach targets oral health of S.C. youth by Cindy Abole Public Relations Lowcountry students last month carried home  new toothbrushes, toothpaste and a renewed knowledge for brushing, flossing and other good oral health habits. The effort was made possible by area dentists, College of Dental Medicine (CDM) faculty, staff and students in recognition of National Children's Dental Health Month throughout February. But many of these outreach activities within area schools and other locations are not only celebrated yearly. It is part of a continual effort that involves dental students in community outreach work to promote good oral health hygiene among children and adults.  A first-ever report on oral health by the Surgeon General in 2000 revealed that tooth decay (dental caries) is the number one unmet health care need of children in America making it the single most common chronic childhood disease of this day.  Studies have shown that oral disease at this stage of life can affect a child’s development, nutritional status and quality of life. CDM has recognized these disparities and responded by creating valuable outreach opportunities that have helped to meet the Lowcountry's dental needs. “The program has made a great impact on the school and our students, in particular,” said John J. Sanders, DDS, chairman, Department of Stomatology. "It has allowed them to get involved in public health and educational outreach. Their participation helps 'break the ice' in providing oral health education directly in the classroom and within schools.” The project was established five years ago as one of the 28 Healthy South Carolina Initiatives to reach underserved communities needing basic dental care. The grant provided a service needs assessment within the Charleston community and evaluated the college’s overall outreach activities. In 1997, the Department of Stomatology and Division of Dental Public Health and Oral Epidemiology opened the school’s own outreach office to handle community requests and create interactive programs involving students throughout their dental education. Managing the outreach is CDM's Community Academic Coordinator Stacy Nash. First and second-year dental students begin their outreach experience through rotations that involve school visits and classroom interaction among specific elementary grades. Outreach rotations are a non-graded, mandatory part of the dental school’s curriculum. At the beginning of each semester, Nash meets and prepares students by providing a rotation packet full of materials, lesson plans and other valuable teaching tips prior to their scheduled rotations.   Students are given a three-hour rotation period (includes travel and presentation time) within their schedule. Nash usually escorts groups of two/three students to conduct four classes during that time.   A valuable part of their preparation is the background information she provides which includes a complete review of patient populations including those socioeconomically disadvantaged areas identified in Charleston’s poverty rates, student comprehension levels, cultural competencies, school settings and basic do's and don’ts in the classroom.  “It’s important that students understand the reality of the Lowcountry and state’s diverse patient populations as dental health practitioners-in-training,” said Nash, Department of Stomatology, Division of Dental Public Health and Oral Epidemiology. “That understanding is critical as they begin to provide dental education to people throughout their career.”  During each session, students show a video, conduct a lesson, offer hands-on practice with dental puppets, field questions and concerns and provide “goodie bags.” Each bag contains a new toothbrush, toothpaste, floss, age-appropriate educational materials, activity sheets, educational materials for parents and MUSC dental clinic information or a list of local dentists.  Feedback is an important part of the program. Each presentation is evaluated by the teacher, school organizer (usually the school nurse), the student and Nash. The evaluations are helpful in providing needed improvements to the program. Nash feels the program is always evolving. She sees more interaction among the students and the children now than ever before and that makes her proud. “It’s important for our students to learn how to develop a certain level of trust and intimacy with the kids,” Nash said, regarding the helpful use of the brush puppet toys to demonstrate brushing basics and flossing. “Teaching is a gradual process that involves lots of adjustment. And the more they do it, the better the chances are that the children will get something out of the experience.” Second-year students do their outreach rotations in more varied environments. These students are able to use their skills to provide education to students in local middle and high schools, young mothers-to-be at the Florence Crittenton Residential Program, and to families in area Women, Infants and Children's classes.  Second-year dental student Jeanine Robinson visited students at Stiles Point Elementary, Ashley River Elementary, St. Andrew's Elementary and Toole Military Magnet Middle during rotations and also volunteered for health fairs at Promised Land Missionary Baptist Church and the City Gym's Health and Wellness Fair. The experiences helped her relate to the needs of most Lowcountry children regarding brushing and their general oral health.  “The experience was fun,” said Robinson, who is undecided about what tract she will specialize in. The visits helped to reinforce her choice of entering dentistry as a profession. “It left no doubts.” Robinson is currently involved in a dental public health class that is helping to contribute information for a CDM Web page about sealants. Sealants are a plastic material that is painted onto the chewing surfaces of a tooth that protects tooth enamel from plaque and decay.  The site will provide background information about sealants, Medicaid coverage, plus other general information for dental professionals, educators and the general public to access. Working in groups, students will also research and address specific oral health/dental public health competencies that they will contribute to the Web site. They will also participate in a statewide oral health assessment coordinated through DHEC that will involve check-ups with students from random grades in various Lowcountry schools.  School nurse Beverly O’Brian teaches both hygiene and basic health to her students at Ron McNair Elementary School in North Charleston.  “I’m glad to see their presence in the schools,” O’Brian said. She described the poor, disadvantaged students growing up in non-traditional family environments. “There’s not much reinforcement going on at home for many of these kids and a lot of them have bad teeth. What MUSC provides is a great service to this community.” For the past three years, certain schools have benefitted from visits by MUSC’s dental van  which provides a brief exam and assessment, cleaning, dental sealants and any needed dental work for children.  For Nash, perhaps the hardest part of the program is denying requests. The program coordinates with eight to ten area public schools per semester. But the number and coverage of requests keeps on growing.  “The need to prioritize  also means the need to turn people away,” Nash said. “It’s not because we want to turn down requests, it’s because we can’t meet everyone’s need.” Another challenge is educating the public about dentistry and the connection between oral health and overall health. Nash is always eyeing new opportunities for her dental students involving community education. Of all of the work and effort, she admits that the best part of her job is to be able to facilitate awareness and hopefully change.  “I’d like to hope that what we do helps to make a difference for people who need good dental care,” Nash said.  For more information, call Nash at 792-6614.