By Gregg Fishman.
The best county programs address an intractable problem with an innovative, sustainable, and collaborative solution that gets to the heart of the matter—or in the case of Amador County—to the “root” of the matter. They take oral health care seriously in Amador County because the water isn’t fluoridated. Now, maybe that doesn’t sound like a huge problem, but tooth decay and cavities are nothing to smile about, and fluoride protects teeth—especially children’s teeth—from those preventable problems.
As Doctor David Stone from the Sutter-Amador Pediatric clinic told us, “Having a cavity is just like having any other infection in your body. You don’t eat as well, you can’t sleep well, and you can’t concentrate in school.” So, there is good reason to take oral health seriously, especially for children. Amador County developed a program to protect children’s teeth with a fluoride application when they come in for their well-child checkups and vaccinations.
The Amador County Oral Health Task Force already had a program to apply a fluoride varnish, literally painted on the teeth. Numerous studies show the varnish helps prevent cavities just as effectively as fluoridated water. It’s simple, painless, and inexpensive compared to the cost of cavities down the line. However, there are not enough dentists in Amador County, especially those who accept Denti-Cal payments, to offer this type of oral health prevention services to everyone who needs it. The task force, part of the county’s First 5 program, had to get creative.
The fact that the Oral Health Task Force already existed made things a little easier. They had a framework to explore options. Task force members learned that Medi-Cal would reimburse the cost of applying fluoride varnish if it was done as part of a well-child visit to the doctor’s office. They applied for a small grant from the Sutter Medical Foundation and began working with the local Sutter Pediatric clinic to develop a protocol and billing system.
As it turns out, the protocol was easy. The Jackson Creek Dental Group trained the staff at the Sutter Pediatric clinic how to apply the varnish during well-child visits. It takes just a couple of minutes. The billing was only a little more difficult to figure out, but once they had a system in place, it all just flowed together. When we visited Amador County to learn more about this program, that’s what we kept hearing, how everyone collaborated to make it work, with no thought about territory or who would get the credit.
The results are impressive. In the first eight months of the program, they more than tripled the number of children receiving the fluoride varnish. The program is simple, sustainable, and it leverages existing resources. Best of all, it can be replicated in other counties that may be facing similar hurdles to preventative oral health care. That alone is worth smiling about—and thanks to the program, the children of Amador County have just the pearly whites for the job.