Marcus’s mouth was a mess.
It was many years ago, but Deidre Callanan, MPH, DC, who started her career as a dental hygienist, distinctly remembers the day she volunteered at a local health department. The boy had rampant tooth decay but a buoyant spirit.
“He wrote me a note about how much fun he’d had, and put it in my pocket,” said Dr. Callanan, of the University of Colorado School of Dental Medicine. “I worked in this affluent area where care was easily accessible. I had no idea that children went without dental care for so many reasons – all of the social determinants of health.”
The need is as prevalent as ever, as dental caries, or tooth decay, remains the most common chronic disease of childhood in Colorado, with children from low-income and minority households disproportionately affected. On the front lines of providing preventive healthcare for these populations are 67 school-based health centers, but the COVID-19 pandemic left many of them closed or in various stages of reopening for the 2020-21 school year.
Drs. Callanan and Tamanna Tiwari, MPH, MDS, BDS, both assistant professors in the Department of Community Dentistry and Population Health at the CU School of Dental Medicine, are working on a year-long Colorado Association of School-Based Health Centers (CASBHC) project. They will consult on reintegrating existing dental preventive practices that were suspended during the pandemic, as well as offer guidance on the next level of preventive dental care.
“Our work will have a statewide impact on helping SBHCs to reintroduce oral health preventive services for the most vulnerable children and their families,” said Dr. Tiwari.
Dr. Tiwari heard about the request-for-proposals from CASBHC, which received funding through a Delta Dental Foundation grant, and reached out to Dr. Callanan. “I immediately called her and said, ‘We should apply for this ($25,000 grant) because she has the background knowledge and expertise (in SBHCs), and I have the background in conducting needs assessments and resource development with large entities.”
Their project will begin by identifying 10 SBHCs, and then conduct needs assessments with them. They will listen to the community needs of each center and tailor reintegration of preventive dental care to specific sites.
“So, let’s say that prior to the pandemic, a medical provider was offering the dental screening and a fluoride varnish. Maybe that was the top of what they did,” Dr. Callanan said. “And perhaps now they would like to offer more preventive care and more dental treatments – maybe even teledentistry. So, we’ll include that in the plan – how we will help them do these things in the midst of COVID.”
The project will also benefit students in the dental school’s new dual-degree DDS-MPH program, offering opportunities for practicums and capstones. “They can get hands-on experience about the public health activities and public health agencies in Colorado, and learn how they directly affect preventive oral health,” said Dr. Tiwari, who is the DDS-MPH program director.
Drs. Tiwari and Callanan’s work will also include developing a learning cohort for the SBHCs and a few videos that the CASBHC can make available to school-based centers statewide.
Community dentistry and population health became Dr. Tiwari’s passion after she served in the Center for Native Oral Health Research through the Centers for American Indian & Alaska Native Health at CU Anschutz. “We worked on reservations with Native American tribes,” she said. “The amount of disease and disease burden that I saw triggered the idea that we should definitely not just work with the community, but train the people who are going to be the future dentists to understand the importance of working in the community and understanding their needs.”
Past experiences drive Drs. Callanan and Tiwari to do anything possible to prevent dental disease from spreading in susceptible populations. They learned the importance of always being in step with what each community desires.
For both dental professionals, it simply no longer became a question of whether to intervene.
“Once we saw what the need was, once that becomes so real, you can’t pretend it’s not there,” Dr. Callanan said. “We both have that passion. For us, there’s no choice. We have to do something.”