Dentistry: Helping Kids Smile Brighter

from The Children's Hospital (TCH) News, March 2006

Dentist David Ramirez performs

a checkup on patient Denton

Vultaggio.

The Children's Hospital's department of Pediatric Dentistry is one of just a few programs in an eight-state region to provide dental treatment to children with special healthcare needs.

In fact, 25 percent to 30 percent of the patients treated in the dental clinic fall into this category, said Ulrich Klein , MD , the program's interim chair and residency program director. These patients have a variety of conditions, including cerebral palsy, epidermolysis bullosa (a rare skin disease), craniofacial abnormalities or less-severe conditions such as Attention Deficit Disorder (ADD) or behavioral abnormalities. Others are recovering from heart transplants or are in remission from cancer.

Because Children's is a multidisciplinary hospital that treats patients for all of these conditions, the caregivers in the dental clinic can specialize in treating these children.

"Our dentists and caregivers have special training so they are able to focus on children with these needs," Dr. Klein said.

Dentists are trained in pharmacological management of patients, pediatric medicine, emergency care, diagnostic and restorative skills and child growth and development.

Many of these patients have complex dental needs, and may need to be treated in the operating room under general anesthesia.

The mission of the program, with its state-of-the-art facilities, is to provide children with the best treatment for all of their dental needs. Pediatric dentists specialize in the treatment of all aspects of developing dentition; therefore, the majority of the patients seen in the clinic are 13 years old or younger. The most common condition treated is tooth decay, which also is the most prevalent childhood disease. Studies have shown that children miss more school from dental conditions than any other disease.

"I think a lot of kids come here because it's part of The Children's Hospital and it's a very kid-friendly place," said Office Supervisor Cristina Azzam.

The Dental program is so successful, in fact, that it expanded to the Fitzsimons campus with the Healthy Smiles Dental Clinic four years ago.

The Healthy Smiles Clinic, created in collaboration with the University of Colorado School of Dentistry, is a regional clinic that focuses on treating underprivileged children who cannot readily access basic dental care. The pediatric residents, undergraduate dental students and dental assistants at this clinic make sure that these patients receive dental exams, regular checkups, cleanings, restorative dental care, and cavity prevention education.

While approximately 50 percent to 60 percent of the patients treated at the Healthy Smiles Clinic and The Children's Hospital Dental Clinic are insured by Medicaid, a large portion of the remaining patients are uninsured. Fortunately, over the past few years, Healthy Smiles has negotiated arrangements with Aurora Public Schools , Rocky Mountain Youth and The Indian Health Clinic to provide care for these underserved children.

As an additional benefit, The Children's Hospital offers a 35 percent discount to the self-pay population.

Children's also is one of just a few healthcare organizations in the state to offer services under the Colorado Indigent Care Program. This program determines payment based on a rating system according to household income. In the program, the family pays a co-pay based on their rating.

"There is a need to make dental care accessible for families who don't have insurance," Azzam said. "We provide these discounts for uninsured children."

The Department of Pediatric Dentistry offers a two-year residency program. During the program, resident dentists participate in weekly lectures that cover the latest technology, pediatric anatomy and physiology, patient assessment, restorative care, orthodontics and trauma, to name a few. Part of the training involves working with the community to provide education and oral health screenings at schools and various other locations. After successful completion of the program, residents receive a certificate in pediatric dentistry. This title allows them to call themselves specialists and limit their practice to providing healthcare for this group of patients.

Both the pediatric dental program and the Healthy Smiles Clinic provide the best possible oral healthcare for patients, but staff members also understand how important it is to teach children and their parents the importance of good oral hygiene as the primary way to prevent dental disease.

"No child is ever turned away," Azzam said. "It's just one reason the pediatric dentistry department so unique."