As kids come back for screenings, dentists seeing more tooth decay

Pediatric dentist Leslee Huggins speaks with patient Claire Freemyers, 9, following her cleaning at Gentle Dental Catholic Community Services on Wednesday, Jan. 12, 2022. (Amanda Loman/Salem Reporter)

Claire Freemyers sat up from the chair in her dentist’s office and ran her tongue around her mouth.

“It feels weird,” the nine-year-old said, feeling the spot where Dr. Leslee Huggins had just filled a hole in a baby tooth with a soft, Play-Doh like substance.

Huggins, a children’s dentist who works at Gentle Dental in northeast Salem, said she’s spent much of the past year treating cavities in children under her care, using soft fillings that don’t require drilling. The goal is to stabilize the tooth and prevent further decay so it can fall out naturally as the child’s teeth grow.

In the clinic, most of her child patients are insured through Oregon Health Plan, which offers coverage to low-income Oregonians. She’s also the outreach dental director at Capitol Dental Care, helping coordinate screenings at local public schools.

When the Covid pandemic hit in the spring of 2020, dental offices were largely shut down, and school screening programs ground to a halt.

Now, almost two years later, Huggins said she’s seeing the consequences in the mouths of her patients. Some children are coming in with teeth that might have needed a simple filling had they been in earlier, but now require a crown.

“We’re seeing a lot more urgent needs for cavities that could have been prevented and kept under control,” she said. “Now we’re having to do more aggressive treatment.”

Pediatric dentist Leslee Huggins examines patient Claire Freemyers, 9, at Gentle Dental Catholic Community Services on Wednesday, Jan. 12, 2022. (Amanda Loman/Salem Reporter)

For more than 20 years, the Salem-Keizer School District has offered free dental health screenings and referrals to treatment for students, focused on elementary schools where a high share of students come from low-income families.

The effort started after a survey of school employees by child advocacy group Stand for Children revealed pain from problem teeth or other dental needs were a major reason students missed school or couldn’t focus in class.

Jessica Dusek, who worked at Richmond Elementary School at the time, now coordinates the dental program for the district, working with Capitol Dental Care to bring hygienists into schools for screenings.

The goal is to teach kids how to brush and about the importance of dental care and screen for early signs of decay so kids can get the care they need. Hygienists also apply sealants, a plastic coating painted over a tooth to help prevent decay.

Students with more serious needs are referred to a dentist who accepts the Oregon Health Plan, or to one who’s donated their time to help kids in need.

Dusek said last school year she did her best to coordinate dental appointments for students who needed fillings or other help. But she said it was harder to reach families.

“Even parents who appreciated the service being free and available, there was so much fear. A lot of families just kept their kids in quarantine and didn’t want to be taking them out for dental services,” she said.

Dental assistant Macy Toroni speaks with a patient’s family during a teledentistry appointment prior to an upcoming surgery at Gentle Dental Catholic Community Services on Wednesday, Jan. 12, 2022. (Amanda Loman/Salem Reporter)

Capitol Dental Care got a grant to offer some teledentistry appointments to kids instead, going over basics like brushing correctly, said Linda Mann, the dental provider’s community outreach coordinator.

Their mobile outreach team served 14 Salem-Keizer schools during the 2020-21 school year, but parents had to make appointments, and many were reluctant to have their kids miss online class or bring them anywhere in-person.

The result, Mann said, was they screened only 197 kids and applied sealants for 147.

During the 2018-19 school year, they screened almost 2,300 kids at those same 14 schools, Mann said.

Now, with kids back in school, screenings have resumed.

Dusek said in the fall of 2021, they screened 2,255 students at six schools. Before the pandemic, about 22% of students at those schools had tooth decay. Now, it’s 32%.

“That’s a big jump,” she said.

Huggins said routine shifts during online school likely play a role in the accelerated decay she’s seeing. Many students were left to set their own schedules and had junk food and sugary drinks more readily available at home.

With no need to get out of bed and dressed for school, many simply stopped brushing their teeth in the morning, she said.

Not all Salem dentists are seeing worsening decay, but the pandemic has still impacted operations and made getting kids in for appointments more challenging.

Dental hygienist Jessica Grapentine cleans the teeth of a patient at Gentle Dental Catholic Community Services on Wednesday, Jan. 12, 2022. (Amanda Loman/Salem Reporter)

The Boys & Girls Club of Salem runs a dental clinic where kids without dental insurance can get free care. They have about 1,100 patients.

Jodi Loper, who directs the program, said they haven’t seen a big shift in kids’ needs.

The clinic was shut down from March to October 2020 and was then able to resume regular appointments. Ideally, she said, they see patients every three months and focus on education to prevent problems.

They also stayed in touch with families during the closure.

“We definitely have our share of cavities, but no greater than before,” Loper said.

When the clinic reopened, local schools were still online.

“Kids wanted to come partly because it was someplace to go,” Loper said.

She said their main challenge is that appointments take longer.

Because of Covid protocols, they see four to six families a day. Pre-pandemic, they could see twice that.

Dusek said there are bright spots as the dental screenings at school have resumed this year. Capitol Dental is now providing staff for all the school dental screenings, freeing up her time to help kids who need follow-up dental care book appointments.

“We’re doing a better job closing that loop. It used to be we’d spend more time addressing the urgent needs and now we’re addressing early as well,” she said.

Correction: This article originally misspelled Dr. Leslee Huggins’ name. Salem Reporter apologizes for the error.

Contact reporter Rachel Alexander: [email protected] or 503-575-1241.

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