Dental hygienist Quinesha Brewer lets Giovanni know what to expect.

Tooth decay is it most common chronic childhood disease and is responsible for 51 million missed school hours nationally every year. In Michigan, nearly half of Head Start children have tooth decay and close to one-third have untreated tooth decay. If left untreated, it can cause children pain, inability to eat certain foods and loss of sleep, all of which make it difficult to pay attention in school.

To address childhood caries, the Michigan Department of Human Health Services (MDHHS) launched Kindergartener’s Oral Health Assessment Program (KOHA).

“There is a law for children entering school, either kindergarten or first grade, which requires them to see a dentist or an adult hygienist to undergo a screening to look for cavities in the mouth, said Christine Farrell, MDHHS oral health director. “We’ve added this on top of the hearing and vision screening to make sure we’re looking at a child’s whole health and making sure they have a healthy mouth – and that will help them learn when they go to school.

Dental hygienist Quinesha Brewer shows Giovanni how to brush.

Increased access to dental care

While hearing and vision screening assessments were first legislated in 1949, the KOHA program was not introduced until 2020. Originally, dental screening was an optional service that children were not required to have before entering school. In December 2023, the policy changed, requiring children to have a dental exam before school starts for the 2024-25 school year. MDHHS is having all 45 health departments across the state implement the KOHA program in phases.

Christine Farrell“The state partners with local health departments to provide this program. We started with 18 health departments in the first phase,” Farrell said. For example, Ingham county has had it for the last three years while Wayne county has yet to implement it.”

Currently, 32 health departments have implemented the new assessment program. The goal is to have all 45 health departments on board before the start of the 2024-25 school year. The state-funded program was widely received by Michigan families with 10,441 children screened in FY 2023 by 20 health departments.

“We are actively recruiting the health departments now by talking to the health departments, their partners, health professionals and advocates,” says Farrell. “We hope that in the 2024-2024 school year we will have all 45 in place.”

Administered by local health departments, KOHA screens children getting ready to enter kindergarten at preschools, Head Start programs, school enrollment events and community screening events before the start of kindergarten or first grade. The brief assessment, carried out by a dental hygienist, looks for possible tooth decay. If available, a summary report informs parents of interventions needed based on urgency.

“A hygienist sits the child down, has a flashlight or a headlamp or some external lighting, asks them to open their mouth, has a disposable mirror and just looks in their mouth. It’s a basic observation for obvious signs of either pain, infection, decay or cavity ,” says Kimberly Singh, director of community and government affairs with My Community Dental Centers (MCDC). “If we see that reparative care may be needed, then your child should go to the dentist, or on the other hand, as urgent needs, the results will go home in a summary letter, as well as a list of dentists who accept children. We will then follow up.”

Dad lets Giovanni know that everything is cool.

Declining decay in Detroit

Singh is making the program available to Detroit schools. This will not only allow more children to be screened, but will make dental exams more convenient for Detroit families. The assessment is free for parents unless they prefer it to be carried out by their own dentist. Parents then have their dentist complete the KOHA form required to come to school.

Kimberly Singh“We know the best way is to bring these services into the schools for the kids to make it convenient. So we’re working on parental consent and logistics,” Singh said. “We want to make sure everything is ready before we 100% launch, and we’re connecting what’s required, how important it is, and what the value is to where these kids can get the services.”

For mass outreach in Detroit, MCDC will offer free assessments every Wednesday from July 31 to August 21 at Detroit Health Department on Mack Avenue. Flyers and social media posts will help spread the word about these assessment opportunities. MCDC also participates in various community events, block parties and other places where young children gather this summer to provide free assessments and raise awareness. .

“Ultimately, we want the program to be a link for children with ongoing dental care,” says Singh. “We want it to be simple, cost-effective and counter all barriers, but it’s not a substitute for a dental home where thorough, comprehensive examinations are done.”

The dentist, Dr. Gina Tischendorf, takes one last look at Giovanni’s teeth.

Rural families brush up on dental care

Sanilac County Health Department (SCHD) started the KOHA program in February 2023 and has continued to reach out to the community to inform families that the service is available. The county had seen a large number of children with emergency visits due to tooth decay.

“We didn’t have a community dental center here, so our health department, along with some other community partners, advocated to bring a dental center here,” said Katie O’Mara, SCHD nursing director. “From there, when we became aware of the new requirements for the KOHA program, we connected with MCDC.”

The collaboration not only helps with outreach and completion of assessments, but also eliminates the need for SCHD to hire a dental hygienist.

“We would have to hire our own dental hygienists and jump through a lot of hoops,” says O’Mara. “This is not our area of ​​expertise, so it only made sense to partner with MCDC to help us implement the program.”

As the health department has a larger presence in the community, O’Mara is responsible for helping MCDC get the program out to local families. SCHD also handles the financial responsibility. MCDC performs the dental assessments, reports documentation, provides a list of dentists in the area, and performs any follow-ups that may be needed.

“They have helped me connect with many of the schools and local programs like the Great Start partnership in Sanilac County,” said Carly Szyska, registered dental hygienist and MCDC KOHA program coordinator. “I can reach out to the public and make my face more familiar to everyone, especially the kids.”

Sanilac County has more than 400 children starting kindergarten this year. Szyska has made 125 assessments since April. To ensure families can access these services, Szyska also provides them with information about local transportation options.

– Just to start and get this program introduced in the county, 125 is a good number, says Szyska. “I think I’ll be able to deal with most of them by the beginning of the school year.”

For children, going to the dentist for the first time can be a scary experience. But if a child becomes comfortable with going to the dentist at an early age, Szyska says that fear begins to fade.

“I recommend, if they can, that the parent bring the child to their dental appointments so they’re familiar with the atmosphere,” says Szyska. “Make brushing a family event twice a day. And do anything that would get them used to the dentist’s chair and good dental hygiene.”

Monique Bedford is an aspiring journalist currently freelancing for Issue Media Group publications. She graduated from Oakland University in the fall
2022 with a bachelor’s degree in journalism and a minor in Spanish. Monique has experience in solution journalism, media design and hosting a radio show. When she is not writing, you can always find her studying different cultures and languages, reading her favorite magazine, The New York Timesand spend quality time with their friends and family.

Photos by Doug Coombe.
Photo by Katie O’Mara courtesy of the Sanilac County Health Department.

Yours, mine and ours – Public health series highlights how our state’s public health agencies keep us healthy, safe and informed about issues affecting physical and mental health in our communities, homes, workplaces and schools. The series is possible with funding from Michigan Association for Local Public Health.