March/April 2020 | Page 26

In-school Dentistry Career Path Rates an A+ By Cynthia Iseman, DMD Many of us entered the dental profession because we want to help people. That mindset is the same regardless of where we practice our profession. Helping people gain access to dental care in creative ways improves the quality of life for people of all ages within our communities. I have been fortunate in my career to find the perfect job fit: I work three days a week/roughly nine months a year providing dental care to children in a school-based setting. Over the course of my career I have worked in a variety of settings. I have been an independent contractor, a locum tenens dentist, a corporate employee and a practice owner. I am happy to say that I love everything about my mobile school-based dental job. Quite honestly, I am not someone who had much interest in treating children. What’s different about providing care at school? On the surface, it may seem like in-school dental programs and traditional practices compete for patients. The reality, however, is that school-based programs treat a subset of the population that rarely visits a dental practice. Mobile dental programs primarily serve underserved populations and are reimbursed by Medicaid and CHIP for the services they provide. According to the Centers for Medicare & Medicaid Services (CMS), only 21.3% of Medicaid-enrolled children in Pennsylvania are treated by a dentist. 24 MA R CH/A P R I L 2020 | P EN N S YLVA N IA D EN TA L J O UR N A L That means 78.7% of children on Medicaid/CHIP remain unseen and uncared for. Some parents of our young patients don’t understand the importance of dental health. Some parents simply do not have the means to get their children dental care. They may not be able to take time off work or they may not have the necessary transportation to get to a dental office. School-based care requires neither extra time nor transportation on the part of the parents. Dentists are not alone in providing health care in schools. Optometrists and physicians are also being invited into schools to help ensure children get the health care they need. Obviously a big difference between my chosen delivery model versus a traditional practice is location. I see children in the familiar surroundings of their school. Our dental team brings up to three full operatories of portable equipment into a classroom, auditorium or other available room, and we set up a temporary dental office. We bring dental chairs, a sterilizer, computers, electric handpieces, a variety of compressors, a digital X-ray unit and sterile instruments. We also bring free toothbrushes and stickers for the children. The children are more relaxed in a school setting, which makes treatment easier. We do not use any physical restraints or sedation, and care is never forced on a child. Other children are often milling about or coloring as they wait for their turn. Unlike most other in-school dental programs, we go beyond preventive care to provide restorative care as well. If a child requires treatment beyond the scope of what we can provide in school, they are referred to a traditional dental office in the community.