Mobile Dental Clinics Serve Austin Area
By Julie Chang
Luz Muñoz clasped her hands and shot her daughter a nervous glance. Seated just a few yards away under a beaming light, the 6-year-old, also named Luz, was having three teeth removed, two of which were infected. Dentists considered Luz’s procedure routine, but for Luz, her first visit to a dentist’s office was in a setting that might be considered unconventional to many—a mobile dental clinic.
“It’s kind of amazing that [children] do a whole lot better [in] a mobile setting than at a regular dentist office because they’re not as afraid,” said Dr. Falguni Patel, a dentist who was staffing the mobile dental unit parked outside of McBee Elementary in north Austin. “A lot of times they’ll ask you if you are a real dentist. It almost makes our job a lot easier.”
The St. David’s Foundation operates six mobile dental vans that provide free services to schools in low-income areas around Central Texas. Established in 1998, the program now served 12,430 children in 27 schools and 975 patients from local service agencies in 2008, according to St. David’s. Services include teeth cleaning and removal, fillings, root canals, stainless steel crowns, and sealants, which protect the teeth from cavities. The RV clinics, each outfitted with two dental chairs and the same state-of-the-art technology found at most dental offices, rotate from school to school.
“The philosophy is we take the service to where the children and patients are,” said Earl Maxwell, chief executive officer of St. David’s Foundation. “We don’t want any barriers to their getting dental care.”
Both dentists and professionals agree that dental care is underrepresented in health policy and in the medical community. Nationwide, 75 percent of adults with private health plans do not have dental coverage, and a child is three times more likely to have medical coverage but no dental insurance, according to the Centers for Disease Control and Prevention. Dentists attribute a lack of awareness for the poor safety net in dental care.
“[I]it’s been a long struggle of [understanding] the medical aspect of what’s going on in your mouth can affect the rest of your body,” said Dr. Patrice Coons, clinical director of St. David’s dental program. “I think people are still being educated about that. I’m sorry that it wasn’t considered in conjunction with health care reform.”
Unlike adult dentistry, federal health reform does improve access to pediatric dentistry. New legislation requires all insurance plans offer basic dental coverage. But dentists still worry it might not be enough.
To minimize the barriers to care, St. David’s mobile dental clinics offer free services regardless of insurance status, information for which the clinic will not even ask. The mobile units usually park for two months at at time at qualified schools like McBee, in which 98 percent of the student body comes from low-income families. Each of the two dentists on a mobile clinic sees about 20 students a day during school hours as well as emergency appointments after school.
Muñoz, who is uninsured, has been jumping from one dental office to another trying to find affordable dental services for her three children. After seeing her daughter receive quality treatment for free, she said she would like to send her other children to St. David’s mobile clinic, as well.
Yet some parents, including non-English-speaking immigrants to Central Texas from Mexico, are reluctant to have their children come on board, fearing fees will be charged or their personal information will be leaked to immigration officials, said Maxwell.
Maxwell said that the program’s Spanish-speaking dental assistants try to assuage these fears so that their children can access needed care.
And for many of the children who visit the mobile clinic, it is their first time having a dental check-up.
“Quite frankly, if you’re uninsured and you’re having hard times, preventive dentistry is going to be the first thing to go,” said Maxwell. “If they have a choice between taking their child to a dentist or a family physician, parents will go to a physician.” Pediatric dental care usually falls off the radar for low-income parents because some cannot get transportation to a clinic or are not aware of the importance of dental care, barriers the mobile clinic tries to eliminate.
A child living in poverty is twice as likely to develop tooth decay than their more affluent counterpart, according to the Centers for Disease Control. According to Dr. Ensy Atarod, many of her patients do not drink enough water, instead turning to sugary drinks. She said that education of both children and parents are important to eliminate unhealthy habits.
“It’s just the balance of what you put into your mouth and how you clean your mouth at night. It’s about incorporating it into a lifestyle,” said Atarod. “If they see their parents brushing every night then they’re more likely…to go ‘Oh I haven’t brushed my teeth. I’m going to go do that.’”
Education has been a priority for St. David’s. The program sends hygienists to schools to educate students on how to brush properly and to offer free toothbrushes and toothpaste. It also strongly encourages parents to find a fix-based dental clinic to visit because St. David’s returns to a school only after a two-year rotation.
The team at St. David’s hopes that health policy will increasingly highlight the need for adequate coverage of dental services so that patients like Muñoz can afford to see a dentist without unnecessary fees and fears. Even so, Muñoz is grateful for the mobile clinic. “I am thankful,” she said.