Two professors at the University of Colorado School of Dental Medicine will spend the next year consulting with the Colorado Association of School-Based Health Centers (CASBHC) to reintegrate existing preventive dental practices that were suspended during the COVID-19 pandemic and offer guidance on the next level of preventive care.
The need for school-based care is as prevalent as ever, the professors said, as dental caries remains the most common chronic childhood disease in Colorado, disproportionately affecting children from low-income and minority households. Though 67 school-based health centers (SBHCs) in the state provide preventive healthcare for these populations, the pandemic left many of them closed or in various stages of reopening for the 2020-2021 school year.
“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 one of the professors, Dr. Tamanna Tiwari.
Tiwari heard about a request for proposals from CASBHC, which received funding through a Delta Dental Foundation grant, and reached out to her colleague Dr. Deidre 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,” said Callanan.
The project will begin by identifying 10 SBHCs and then conducting needs assessments with them. The professors then 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,” 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,” Callanan said.
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 Tiwari, who also is the DDS-MPH program director.
The professors also will develop 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 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,” Tiwari said.
Similarly, Callanan first encountered the negative impact of tooth decay on underserved children when she began her career as a dental hygienist and volunteered at a local health department. One boy she treated had rampant tooth decay but a buoyant spirit, she said.
“He wrote me a note about how much fun he’d had and put it in my pocket,” said Callanan. “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.”
These past experiences and others drive Callanan and Tiwari to do anything possible to prevent dental disease from spreading in susceptible populations, the school said. They learned the importance of always being in step with what each community desires. For both 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,” Callanan said. “We both have that passion. For us, there’s no choice. We have to do something.”
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