By David M. Brown, GSN Contributor
Two years ago, Dr. Chantay Banikarim knew she needed to call a dentist.
As medical director for 14 years at the Durango and Southeast County juvenile detention centers, she ensures that each child receives a seven-day physical examination, including teeth.
What she saw alarmed her.
“We noticed widespread dental decay, and many of the juveniles had never seen a dentist in their lives,” said Banikarim, an adolescent medicine physician who can have as many as 200 juveniles ages 8 to 17 under her care at any given time.
“We found that those with an extensive drug history had more severe dental decay and greater need for preventive and acute dental care,” she added.
That’s all changed in the last two years.
And not only are faculty and students from A.T. Still University’s Arizona School of Dentistry & Oral Health in Mesa saving the youngsters’ teeth – they’re also saving taxpayers money.
As a result of the support she got from Deputy Chief Michaella Heslin and Chief Eric Meaux of Juvenile Probation, Banikarim two years ago called Dr. Jack Dillenberg, the inaugural dean at A.T. Still University’s Arizona School of Dentistry & Oral Health in Mesa.
At first, the school provided basic services, but because of the often intense needs of the young people, more was needed.
Dr. Scott Howell, an assistant professor, and his colleague, dental hygienist Colleen Trombly, had developed a teledentistry program with a $1.7-million federal grant that also helped the school expand its interprofessional education curriculum.
The university added approximately $30,000 for portable dental and x-ray equipment. And the Delta Dental Foundation of Arizona has just donated $40,000 for a new teledentistry van.
Now, the young detainees are finding the care they never got.
“We are one of a few dental schools in the country to teach teledentistry and how it can be used to reach underserved populations,” said Howell, a metro-Detroit native who graduated from A.T. Still in 2014 in both dentistry and public health. “We are also one of the only dental schools to expose our students to concepts in public health beyond the basics.”
Howell, Trombly, another hygienist and 76 students – many from the East Valley – provide preventive and maintenance care, exams, cleanings, fluoride varnish applications and prompt treatment for dental emergencies at the two juvenile facilities.
The A.T. Still team also works with the Arizona Recreation Center for the Handicapped in Phoenix, and will be working with East Valley Adult Resources in Mesa.
“Prior to this program, their only option was to complain of dental pain and go to a local hospital to get a tooth pulled,” said Howell. “What we’ve done is give them more options than just an extraction.”
On-site services at both sites are provided by A.T. Still dental students, guided by faculty dental hygienists.
When an acute dental problem occurs, Howell and his team can determine its urgency through teledentistry and devise a treatment.
Juveniles with acute needs, such as pain and infection, are quickly brought to the school’s advanced care clinic on the Mesa campus.
Teledentistry also enables Howell to work with students to review records, photos and X-rays collected at the centers to develop treatment plans for maintenance care.
“In about five minutes, I or another dentist can then review that data and plan the next steps for that patient,” he said. “At the same time, the hygienist will complete a dental cleaning and provide additional preventive services for the patient.”
One program, Axium Ascend, is a dental electronic records system that facilitates schedules, logs dental conditions and clinical notes, and takes x-rays and clinical photos through a secure, cloud-based website.
“With it, hygienists and students in the field connect with me and a different set of dental students back at the dental school,” he explained.
Banikarim or a nurse practitioner can take a photo of the tooth on a tablet with the MouthWatch camera, ask the juvenile some questions and forward that information through another program, Teledent.
The cost savings for the county are significant. For one, sending a hygienist to collect the clinical data is less expensive than sending a higher-paid dentist. For routine care, the program eliminates transporting the juvenile to a dental clinic for an exam, eliminating staff and vehicle time.
In addition, identifying acute conditions, such as a broken tooth, a toothache or a dental infection, allows staff to efficiently plan and schedule for the youth’s appointment at the school.
“By helping identify oral health problems before they get really bad, we can give the youth information about their current oral health and encourage them to follow up with a dentist once they are released before any problems get worse and are more expensive to fix,” Howell said.
The program is changing the lives of those who give, as well as those who receive.
“Dr. Howell has a great deal of compassion for these kids and their health. On many occasions, late in the evening on his way home Dr. Howell has stopped by the detention center to directly evaluate a juvenile when he felt he needed more information than what he received by teledentistry,” Banikarim said.
“When you find out you are doing a rotation in a juvenile detention center, you have no idea what to expect,” said third-year dental student Shima Ghattan. “My experience was eye-opening, humbling and overall very positive.
“The youth we worked with were incredibly cooperative and open to sharing their stories with us,” added Ghattan, explaining:
“We were surprised by how inquisitive they were about learning proper oral hygiene. At the end of the cleanings, many of the boys we worked with wouldn’t stop smiling and thanking us. Some even asked permission to hug us.”