All Children Deserve a Healthy Smile

by Fern Ingber, MEd

Nathaniel, a child with special needs, was just five years old. This little boy was unable to eat and suffered severe headaches, fevers and pain due to three infected teeth. Night after night, his mother held her son as he cried, her heart breaking with each sob as she watched the little boy she loved so dearly suffer in agony. She was desperate to find help, but found only frustration in her search for dental care for Nathaniel. “We were turned away from several dentists and clinics due to his special needs, lack of finances and lack of insurance,” she lamented. “To sit and watch a child that we love so much, suffer in pain was heartbreaking. It is something a mother never wants to experience.”

Stories like these are all too common. For low-income families, obtaining dental care can be extremely challenging. For low-income families and those that have children with special needs, obtaining dental treatment can be nearly impossible. Studies reflect that increased degrees of poverty and limitations associated with disability present barriers to obtaining dental care. In fact, dental care is the most prevalent unmet health need for children with special health care needs (CSHCN).1 As a longtime partner of Special Olympics, National Children’s Oral Health Foundation believes that every child deserves a healthy smile, and as Canada’s Tooth­Fairy, we are here to help.

Formed in the U.S. in 2006, as a collaborative effort of clinicians, academicians and corporate leaders, National Children’s Oral Health Foundation® (NCOHF) is dedicated to eliminating children’s preventable suffering from pediatric dental disease by providing programs and comprehensive resources to deliver community-based critical, preventive, educational and treatment services. Recognizing the mouth is the gateway to the body, NCOHF, also known as America’s Tooth­Fairy® in the U.S., supports the delivery of oral health education and care beginning at the prenatal level. Now extending services in Canada as Canada’s Tooth­Fairy, National Children’s Oral Health Foundation is reaching children throughout North America.

With a growing Affiliate network of exemplary non-profit community programs, the Kids Club, professional and student service programs, NCOHF: America’s / Canada’s Tooth­Fairy is creating a powerful, united effort to eliminate tooth decay and protect the smiles of our most vulnerable children.

According to the Canadian Paediatric Society, early childhood caries is the most common infectious disease in Canadian children.3 Due to barriers associated with access to care, children with special needs are especially susceptible to the negative effects of rampant dental disease. With more frequent oral infections and periodontal disease, enamel irregularities, malocclusion and craniofacial birth defects, CSHCN are at an increased risk for poor oral health than children without special needs.2 Studies suggest that higher proportions of CSHCN suffer from dental problems and have untreated dental disease including cavities, crooked or broken teeth, grinding and pain.1,2

Cost for dental care is prohibitive. Families struggling to make ends meet find it difficult to procure funds for dental care. In a study conducted in the U.S., parents of both CSHCN and children without special needs reported lack of insurance and cost for dental care as the leading reasons for not obtaining care.2

In addition to increased risk and economic obstacles, finding a provider willing to treat a child with special needs can also prove challenging, especially for those with limited resources. Clinical instruction focused on treating patients with special needs is limited in dental schools in the U.S. and Canada. In addition to lack of training, physical inaccessibility issues such as ramps or widened doorways and inadequate equipment also present barriers to serving CSHCN.4

We know how devastating poor oral health can be to any child. The negative implications of early childhood caries extend beyond the oral cavity and impact overall childhood health and well-being.5 This is a humanitarian issue that demands an aggressive response.

By encouraging the implementation of good oral health practices, we can eliminate potential issues before they become a problem and result in the suffering of a child. NCOHF: Canada’s Tooth­Fairy (CT) community programs utilize the power of engaging preventive education to help break the cycle of disease. Educational materials focus on nutrition, biofilm control and germ transmission prevention–basic elements for preventing pediatric dental disease. The CT Kids Club is a free service that encourages healthy habits for all children. Dental professionals can provide instruction on good oral health practices for children and families in their communities through involvement in the Esther Wilkins International Education Program or Dentist of Distinction.

Students for Canada’s Tooth­Fairy engaging students in high school and pre-dental programs can take a leadership role in educating young children about the importance of maintaining a healthy smile. Students in dental professional programs can also provide preventive services such as fluoride varnish for children in need. Preventive services can have a significant impact in the reduction of dental caries. For example, a randomized controlled trial of fluoride varnish offered at least twice a year in Indigenous communities in northern Ontario, Canada, revealed an 18% reduction in the caries increment in participating Indigenous children.5

Improving access to care for vulnerable children and their families is imperative in addressing the growing need for dental services. NCOHF volunteer programs like Tomorrow’s SMILES® engage dental professionals in providing comprehensive care for at-risk youth. The NCOHF Affiliate network of non-profit community health programs includes university dental and dental hygiene programs, community healthcare facilities, partnerships, mobile units, stand-alone dental clinics, as well as school-based and hospital-based dental clinics. As members of this network, NCOHF Affiliates are eligible for product and financial support.

Engaging all community stakeholders in the fight against pediatric dental disease is also critical. The NCOHF Oral Health Zone Program®, the core of all of our education and service activities, brings together corporate and civic leaders, allied health professionals, educators and other caring individuals in a collaborative community-based approach, to effectively break the cycle of this disease. Through the compendium of oral health programs, NCOHF: America’s/Canada’s Tooth­Fairy delivers help to millions of underserved children and the promise of a happy, healthy future!

So, you may be wondering what happened to Nathaniel, the little boy who couldn’t eat or sleep due to pain in his mouth. This story has a happy ending. His mother reached out to us for help and this charming little boy received comprehensive, compassionate care from a NCOHF Affiliate. After receiving treatment, his mother saw a complete transformation in her little boy. Overwhelmed with gratitude, she said, “Your dedication, hard work and immediate response will never go unnoticed.”

A healthy smile contributes to a happy childhood. For Nathaniel, it meant being able to eat, play and enjoy his days without headaches and pain, as a child should. Unfortunately, children like Nathaniel are the children that need the most, have the least and are far too often overlooked.

We must work together to find solutions that ensure children from vulnerable populations have the building blocks they need for happy, healthy futures. Join Canada’s Tooth­Fairy and make a difference for Canada’s children. After all, every child deserves to have a healthy smile.

For more information about National Children’s Oral Healt
h Foundation of Canada: Canada’s Tooth­Fairy®, visit www.CanadasTooth­Fairy.org.OH

Fern K. Ingber, MEd, President and CEO, National Children’s Oral Health Foundation: America’s/Canada’s ToothFairy. Fern Ingber is founding President and CEO of the National Children’s Oral Health Foundation: America’s/Canada’s Toothfairy® (NCOHF). NCOHF was established in 2006 in the U.S. by a group of concerned dental professionals to address the nation’s most common chronic childhood illness–pediatric dental disease. Under Ms. Ingber’s leadership, NCOHF has delivered over $10 million in financial and product support to non-profit community oral health programs. Now extending services in Canada as Canada’s ToothFairy, National Children’s Oral Health Foundation is reaching children throughout North America.

Oral Health welcomes this original article.

REFERENCES

1 Lewis C, Robertson A, Phelps S. Unmet dental care needs among children with special health care needs: Implications for medical home. Pediatrics, 2005; 116;3

2 Kenney MK, Kogan M, Crall J. Parental perceptions of dental/oral health among children with and without special health care needs. Ambulatory Pediatrics; 2008;8:312-20.

3 Canadian Paediatric Society. 2012. http://www.cps.ca/sections/section/oral-health

4 Rouleau T, Harrington A, Brennan M, Hammond F, Hirsch M, Nussbaum M, Bockenek W. Receipt of dental care and barriers encountered by persons with disabilities. Spec Care Dentist 2011;31(2): 63-67

5 American Academy of Pediatrics, Committee on Native American Child Health, Canadian Pediatric Society, First Nations, Inuit and Metis Committee. Early childhood caries in indigenous communities. Pediatrics;2011;127(6):1190-1198

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