DOING BUSINESS


of kindergarteners and 70 percent of third-graders have experienced den- tal caries (tooth decay), and nearly one-third of children have untreated tooth decay. Latino children and low-income children experience more tooth decay and untreated tooth decay than other children. Many dentists are unwilling to treat patients on MediCal because of low reimbursement rates and sporadic payments. For example, a PDI sur- vey found that, in Sonoma County, there are only 1.5 pediatric den- tists—or three part-time positions— providing treatment for more than 46,000 children on MediCal. Many


undocumented families


resist signing up for health care for fear of being deported. They seek dental treatment for one of their children only when they are desper- ate because the child is in pain, and they are often unable to pay for ser- vices. Recognizing these challenges, PDI provides treatment pro bono for such cases as well as support for travel to and from the surgery cen- ter, which can cost as much as $300 when patients come to the ASC from rural areas by taxi. PDI also works to strengthen oral


health awareness with a comprehen- sive prevention education program that begins with an in-house oral health educator working one-on-one with parents while their child under- goes surgery. Educators explain the causes and dangers of tooth decay and the importance of a healthy diet and good oral health habits. Next, they warn the parents about the dan- ger of sugary beverages. The edu- cators explain that putting a child to bed with a baby bottle filled with juice or milk will rot their teeth and advises parents to encourage chil- dren to drink water and make juice, milk or soda a special treat.


mascot—to use on the refrigerator. All families also get an oral health kit that contains a toothbrush, tooth- paste, floss, a brushing chart and health guidelines.


The in-house oral health edu- cation program was effective for a


while and, over the first two


years, there was a decline in return patients. The number of children requiring oral surgery under anes- thesia, however, remained at 144 or about a three months’ wait period. This prompted the development of PDI’s Promotores Dentales Pro- gram designed to reach underserved people who slip between the cracks of the health care system before they receive treatment for severe tooth decay.


The PDI promotors (lay health PHOTO CREDIT: PDI SURGERY CENTER


PDI Surgery Center in Windsor, California, is the only nonprofit agency in Northern California that provides critical dental surgery under general anesthesia for children from underserved families.”


— Hazel Whiteoak PDI Surgery Center


PDI asks all families to sign a pledge to their child’s health, keeps a copy on file, sends a second copy to the agency that referred the family to PDI, and gives the final copy to the family to take home and put on the refrigerator as a reminder of the importance of good oral hab- its and a healthy diet. When the families leave, PDI gives them a Snappy Chompers magnet—PDI’s


26 ASC FOCUS JANUARY 2019 | ascfocus.org


workers) provide culturally and lin- guistically appropriate oral health prevention education to families in their communities and teach them how to maintain overall health through good dietary choices. The health workers explain that dental disease is associated with diabetes, respiratory and heart disease, and therefore, the oral health of each family member is of vital importance to the overall health of the whole family. They stress that dental dis- ease is communicable. For example, if parents have dental decay, they are likely to pass the bacteria in their mouths on to their children when they kiss them or taste food before feeding a baby. They also help fami- lies access health insurance and find a permanent dental home. This inter- generational approach teaches the whole family to develop a healthy attitude toward the importance of proper nutrition, oral hygiene and regular check-ups. Most recently, PDI’s promotores


have begun making home visits to families whose child or a sibling


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