Lockdowns force school dental services to adapt

Original article written by Sarah Eames for the Daily Star.

Amid the coronavirus pandemic, School-based health centers (SBHCs) have been essential for communities and local families but nearly one year after widespread shutdowns began in New York State, some school-based health services remain unavailable. While physical and mental health services have continued largely uninterrupted (albeit with some modifications) since the start of the pandemic, dental services have been suspended since April, according to Dr. Chris Kjolhede, co-director of Bassett’s SBHC program and board member for the New York School-Based Health Foundation. Dr. Leah Carpenter, Bassett’s chief of dental services, said many health officials at the start of the pandemic were concerned about the aerosolization — the spray of small, airborne particles — that can occur during dental work and possibly spread coronavirus. “There’s been a huge learning curve for dentists throughout the past year,” Dr. Carpenter said. “At this point, we’ve learned so much about how to offer safe dental care, but our hands are needlessly tied.”

With additional requirements for personal protective equipment, sanitation and social distancing, Gov. Andrew Cuomo allowed elective dental care to resume in June, but the guidance for SBHCs, limiting them to emergency and urgent care, remained unchanged, Dr. Carpenter said. Both Dr. Carpenter and Dr. Kjolhede emphasized that preventative dental care and regular check-ups are the most effective way to promote long-term dental health and avoid painful procedures down the line. Patients in rural areas are especially at risk for dental health problems, Dr. Carpenter said, due in part to the lack of fluoride in well water supplies, which works to prevent decay, and the inaccessibility, both physical and financial, of regular dental services. “We’re a safety-net program. We see all kids, regardless of their family’s insurance or their parents’ ability to pay,” she said. “Some of these kids have never seen a dentist. The problem was around long before COVID, and COVID obviously didn’t make it any better.”

While Bassett was able to work with school district leaders to reopen SBHCs and expand clinic hours during the summer, there have been challenges in convincing the state to allow SBHCs to resume their dental services. “It’s very frustrating that private practitioners are operating and we can’t,” Dr. Kjolhede said. “They modified their practices, and we’re willing to modify ours, too.” According to Dr. Kjolhede, Bassett officials drafted and submitted to the state a plan for reopening school-based dental services several months ago and are hoping to hear back in the coming months. In the meantime, school-based dental hygienists have checked in with hundreds of families and found that children were reporting pains and aches, Dr. Carpenter said. “We’re starting to see the effects of unmet needs that have been going on a year or more. Now, everything is urgent.” With this information, Dr. Carpenter and Dr. Kjolhede are preparing to see a huge amount of work to be done with students when dental services are able to resume, and are encouraging parents to call their elected representatives to restore full dental services in schools. “Doctors and health care professionals have been working on this for months, but if the patients and families get involved, that’s the one voice I’m not sure Albany is hearing right now,” Dr. Carpenter stated.

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