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Dental hygienist Amy Maier conducts a screening on a third grader as part of the 802 Smiles Network program.

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MANCHESTER — The American Dental Association recommends a visit to the dentist for a checkup and cleaning every six months from the day your first baby tooth appears.

Unfortunately, that can be a challenge for families to accomplish in Southern Vermont these days.

The problem is only exacerbated for families that are struggling to get by financially. A cursory search within the area for a dental care provider is likely to yield one of two undesirable answers from the dental office: They are accepting new patients but don’t accept Medicaid, or they do accept Medicaid but are booked until late next year or aren’t accepting new patients at all.

Some families are resorting to traveling several states away just for dental care, according to Stratton Foundation Executive Director Tammy Mosher.

“We surveyed one of the schools around here, and they are driving as far as New Jersey, Massachusetts and New Hampshire to find a dentist,” she said.

This is all particularly troubling, since it is economically disadvantaged families, and particularly the children in those families, that need the dental care the most. Tooth decay or cavities are significantly more common in children at or near poverty levels, according to several benchmarks gathered by the Vermont Department of Health.

The 802 Smiles Network has been doing its part to help improve childhood dental care in Vermont since 2017, by getting to the kids while they’re right in school. The network connects school dental health programs across the state and puts them under one umbrella, providing funding for hygienists’ equipment and supplies in participating schools.

Amy Maier has been a dental hygienist in Vermont for the past 17 years. She serves two schools in Bennington County through 802 Smiles two days a week, while working at a private dental health practice the other three days of the work week.

“My aunt was a dental hygienist. I remember going into her office where she worked for a pediatric dentist,” she said. “Some of the things I remember seeing there really stuck out to me. I knew then that I really wanted to get into dentistry and just be as helpful and proactive as she was.”

One of the primary challenges before dental professionals like Maier, is that there simply aren’t enough of them to go around. Like so many vocations across the country, dentistry is still feeling the effects of COVID-19 in terms of labor shortage.

“Dental hygienists are not coming back to the field because of COVID,” Maier said. “If you think about it, the dental hygienists are the most vulnerable to get COVID. We’re like six inches from [patients], working in their mouths.”

While there is limited data on the topic specific to Vermont, Maier’s anecdotal evidence is backed by a study published in November 2021 by the American Dental Hygienists Association that investigated the correlation between licensed hygienists leaving the field because of the pandemic.

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Their survey, conducted monthly between September 2020 and August 2021 concluded with 4.9 percent of respondents saying they were no longer employed as dental hygienists. About 74 percent of those said that was voluntary, and the primary reason was fear for the safety of themselves or others because of the pandemic.

As demand for dental services recovers, and the industry tries to draw workers back to the field to keep up, 802 Smiles is also trying to bring Vermont schools back into the fold that have left for the same reason.

“We had 147 schools [in the 802 Smiles Network] pre-pandemic. That’s now down to 111,” Maier said. “We’re hoping these schools will gradually come back to the program so services can be rendered.”

While the program is limited in its scope and doesn’t replace everything a dentist can do in a checkup, the services hygienists like Maier provide can go a long way to identifying, preventing and arresting tooth decay.

That’s largely thanks to a relatively new fast-acting, non-invasive treatment called silver diamine fluoride. The compound kills germs that cause cavities and turns the spot where it’s actively working black (which can later be covered with a white filling).

“This way, if a child can’t get in to see a dentist, at least the decay isn’t going to get bigger, which is going to cause pain.”

Maier wants to get the word out to as many people as possible about 802 Smiles and new treatment to prevent any more needless suffering for children.

“Just about every day that I’m here at school, which is two days a week, I get one or two kids coming in and complaining of a toothache. It’s kind of heartbreaking,” she said.

Maier said that besides the fear of COVID, one of the main factors contributing to dental health problems is simply complacence or lack of education.

“A lot of parents unfortunately think that, ‘Oh, they’re just baby teeth, they’ll fall out,’” she said. “But what they don’t realize is that the baby teeth guide the permanent teeth into eruption … and this child may have that tooth until they’re 12 years old.”

Kids miss school because of toothaches, she noted.

“I’ve heard of kids waking up in the middle of the night because their tooth is throbbing.”


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