The Oral Health Program in the Community


OHP in the Media

  • Collaborative Project with Southern Nevada Health District--Immunizations and Oral Health for the Halloween Season:
  • National Children's Dental Health Month with the Southern Nevada Health District's Dental Clinic-Part 1
  • National Children's Dental Health Month with the Southern Nevada Health District's Dental Clinic-Part 2
    • https://youtu.be/Jf0Q22UWoCQ
  • National Children's Dental Health Month with the Southern Nevada Health District's Dental Clinic-Part 3
    • https://youtu.be/PcqCjzitUwc
  • National Children's Dental Health Month with the Southern Nevada Health District's Dental Clinic-Part 4
    • https://youtu.be/-j96d0wNKuU
  • National Children's Dental Health Month with the Southern Nevada Health District's Dental Clinic-Part 5
    • https://youtu.be/8x4yH4XO2gc
  • National Children's Dental Health Month with the Southern Nevada Health District's Dental Clinic-Part 6

Medical Miles For Rural Smiles

 

What is the Medical Miles for Rural Smiles (MM4RS) project?

Geographically, Nevada is the 7th largest State in the nation; however, out of Nevada’s 17 counties, only 3 (Carson City, Clark and Washoe) are large enough in population to be considered urban (Nevada State Health Division, 2011). Health professional shortage areas (HPSA) reflect the level of provider shortage for a service area. There are 441,382 Nevadans who live in dental HPSAs with an estimated 16.5% without access to care (Pew Charitable Trusts, 2011).

Consistent issues in HPSAs include inadequate primary care resources, limited health professionals, fragmented service delivery, and inadequate transportation. Many people remain uninsured due to the barriers in enrolling in Medicaid or understanding how to maneuver the system. It is not enough, however, to simply enroll people in Medicaid; providers must be accessible for people to reap the full benefit of state funded dental services.

From April 9th to June 30th, the Southern Nevada Health District (SNHD) in partnership with the Nevada Department of Health and Human Services (DHHS), Division Public and Behavioral Health (DPBH) - Oral Health Program (OHP) launched the Medical Miles for Rural Smiles(MM4RS) pilot project to bring medical and dental services to rural counties in Nevada that have been identified as health professional shortage areas.

 

Funding:

Two small one time funding opportunities made the Medical Miles for Rural Smiles project possible. The first was a Department of Health and Human Services Grant and the second was a grant from the Division of Public and Behavioral Health, Maternal, Child, and Adolescent Health Section. 

 

Data:
The pilot project which spanned three months included 11 clinical sessions and traveled a total of 2,040 miles. The trip successfully delivered 221 preventive dental sealants, 117 fluoride varnishes, 120 dental screenings, 18 dental cleanings, oral cancer screenings, oral health and nutritional information, Medicaid enrollment paperwork, and oral hygiene supplies. In addition, 102 immunizations (42 Shingrix, 20 Tdap, and 40 others including HPV, Hep A, PCV13, MMR) were provided to 57 clients. Through this pilot project, over $30,000 of donated dental services were provided to patients of all ages in rural Nevada.

Additional services:  1 emergency parent consultation for Department of Child Family Services, nutrition and oral hygiene instruction to 131 children at McGill Elementary in McGill, Nevada, 1 emergency incision and drainage in Tonopah, Nevada, and nutrition and oral hygiene instruction to 50 seniors at the White Pine Senior Center

What is the Oral Health Status in these Counties?
Previous Information on the Oral Health Status of Adults across Nevada
Almost 40% did NOT visit a dentist in the last year (BRFSS 2016) 

2018 MM4RS, Adult OH Questionnaire:
1. “Overall, how would you rate the health of your teeth and gums”
28.13% Excellent/Good vs. 
68.75% Fair/Poor

2. “During the past 12 months, was there a time when you needed dental care but could not get it at that time” 64.06% Yes vs. 34.38% No

3. “Do you have any kind of insurance coverage that pays for some or all of your routine dental care?” 49.21% No vs. 34.92% Yes, (14.29% Don’t know)

2018 MM4RS, Adult Basic Screening Survey

           3% had a suspicious lesion

           15.38% had severe gingival inflammation 

           43.08% needed periodontal care (more profound in 65+)

 

What is the Oral Health Status in these Counties?
Previous Information on the Oral Health Status of Children across Nevada
*Children attending Head Start: 43% in rural counties had untreated decay  vs. 32% in Washoe and 28% in Clark Counties (2007 DPBH OHP)

*Third grade children: 24% in rural counties had untreated decay   vs. 25% in Washoe and 30% in Clark Counties (2009 DPBH OHP)

2018 MM4RS Children OH Questionnaire:

1.      “How would you rate the condition of your child’s teeth” 67.44% Excellent/Good vs.  27.9% Fair/Poor

2.     “During the past 12 months, was there a time when your child needed dental care but didn’t get it because you couldn’t afford it?” 93.02% No and 6.98% Yes

3.     “Do you have any kind of insurance coverage that pays for some or all of your child’s dental care?” 60.47% Yes, 23.26% No, 16.28% Unknown

MM4RS Team:
 
The team consists of Antonina Capurro, DMD,MPH,MBA, Nevada State Dental Health Officer, Jessica Woods, RDH,MPH, Public Health Dental Hygienist, Sarah Lugo, MSN, RN, Senior Community Health Nurse, Judith Flores, RN, Community Health Nurse II, Lizette Enzenauer, Senior Administrative Assistant II, and Lester Rossi-Boudreaux-Thibodeaux, Administrative Assistant.

How do dentistry and medicine collaborate in this program?
Oral health is essential and integral to overall health and is much more than healthy teeth. Oral health not only means being free of tooth decay and gum disease but it also means being free of chronic oral pain, oral cancer, and other conditions that affect the mouth and throat.

To address the needs of underserved and rural populations, innovative methods such as tele-health, mobile units, and portable dental equipment are needed. The MM4RS project combined a mobile hybrid system merging both a self-contained motorized unit and portable dental equipment which offered greater flexibility that address geographic barriers to health care utilization.  An additional focus of the project was disease prevention through immunization and fluoride varnish application as well as data collection and patient assessments.

Through MM4RS medical and dental services were brought together to eliminate access-to-care issues, educate patients, provide case management, and disease prevention treatments. For this pilot project, the team focused on
Esmeralda, Nye, and White Pine Counties but envision expanding the number and types of services and intend to broaden established service areas in the future.

What are the consequences of not receiving care in the rural communities of Nevada?
Oral health is intimately related to the health of the rest of the body. Changes in the mouth are often the first signs of problems elsewhere in the body such as infectious disease, nutritional deficiencies, cancers, and immune disorders. Poor oral health and untreated oral disease also have a significant impact on a number of systemic diseases such as cardiovascular disease, bacterial pneumonia, diabetes, and low birth weight.  In rural Nevada, many residents travel over a hundred miles for medical and dental care. Early treatment and routine examinations are needed to avoid emergency situations that can be not only costly to treat but life threatening when access to care is remote and burdensome to reach. 

Where can we go to find more information on this program?
More information can be found at: https://www.lasvegasheals.org/southern-nevada-health-district-increases-access-to-care-through-expansion-of-services-2/   

Future Plans: 
It is the program’s hope that this charter trip will be used as proof of concept to establish funding sources for permanent continuation as well as recruitment of additional licensed dental and medical staff. A year of trips is planned to launch in the fall of 2019. Nevada needs reliable high quality medical and dental services. If you would like to volunteer for to the Medical Miles for Rural Smiles(MM4RS) program, please contact Dr. Capurro, State Dental Health Officer, in the Nevada Oral Health Program at:  acapurro@health.nv.gov

We need your help to bring quality medical and dental services to rural Nevada. $160,000 is needed to continue the MM4RS program over the next year.

You can make the difference in the lives of rural residents in Nevada by donating to the Southern Nevada Health District. To donate contact:Southern Nevada Health District • Ernest Blazzard, Financial Services Manager: MM4RS@snhd.org


The team was asked to participate in the Tonopah Social Services Fair in Tonopah, NV during which Cleanings, exams, dental sealants, fluoride varnishes, immunizations, blood pressure checks, vision screenings and social services were provided.

 

Dr. Capurro and Jessica Woods shared the success of their trips during the Nevada Health Conference in Reno, NV

 

Medical Miles for Rural Smiles

    Project Homeless Connect

    Project Homeless Connect

     

    Since its establishment, the Nevada Homeless Alliance has convened community partners in the planning and execution of 26 Project Homeless Connects.  In the last five years alone, these events have assisted more than 15,000 participants in accessing vital resources.

     

    October, 2018, the Oral Health Program was proud to be able to participate in the Project Homeless Connect event along with the Southern Nevada Health District.  We are able to see 105 participants, offering dental screenings, oral cancer screenings, fluoride varnish, and a referral to the Southern Nevada Health District for dental cleanings.  

     

    Thank you to Jessica Woods RDH, MPH from the SNHD, Dr. Eve Chung from UNLV School of Dental Medicine, and Liz Metz RDH from Future Smiles for your invaluable contributions.

    Project Homeless Event