For every child without medical insurance, there are 2.6 without dental insurance. In parts of the Houston area, where many children have rarely been to a dentist and many go completely uninsured, Memorial Hermann Health System is bringing dental care to them.

The largest nonprofit health system in Southeast Texas created a Mobile Dental Program, partnering with five area school districts to provide dental care to uninsured children. Three 40-foot vans rotate year-round at 10 Memorial Hermann school-based health centers, providing an array of dental work from fixing cavities to performing restorative work.

Neglecting oral health has disastrous side effects, says Carol Paret, senior vice president and chief community officer at Memorial Hermann, who overseas the dental program. “As we learn more and more about oral health," Paret says, "we know that poor oral health leads to other chronic conditions. So it’s not this stand-alone issue that we used to believe it was.” Research has found links between dental health and chronic health issues such as diabetes, cardiopulmonary diseases, respiratory problems and, in some cases, low-birth weight babies.

The program, originally operating with one van, has expanded to three, and each is staffed by a dentist and one or two assistants. Patients are on a three- to six-month recall program after their initial visit. Not only does this program improve dental health, but it also affects the entire development of a child. "Our goal is to give children the tools so they can excel," Paret says. "You don’t care about your times tables if you have a toothache.”

Moreover, “dental issues create a lot of self-esteem issues," she explains. "If you’re afraid to smile because your front teeth are black, that affects a lot of pieces of your life and what you do."

The idea for a mobile health program started in 1996, when Memorial Hermann Health System took part in a citywide group that produced the Survey of School Medical Needs. Seventy-four percent of Houston school districts involved identified dental services as a need. And many uninsured individuals or those covered by Medicaid have problems finding transportation to a dental office. In 2000, the program kicked off with a solitary van and focused on its key partnerships with schools to provide oral care and educate children.

Each month, nearly 2,000 dental procedures are performed for 230 uninsured students. Fourteen percent of those students are seeing a dentist for the first time, and 61 percent of initial patients have cavities. Memorial Hermann collaborates closely with teachers, administrators and school nurses to identify children in need of care. Partner schools allow the vans to park in their lot even when not in session and provide electricity.

The program has produced significant positive results. Measuring itself against the Department of Health and Human Services’ Healthy People 2020 objectives, a national health promotion and disease prevention benchmark, Memorial Hermann is doing more than just meeting standards. Only 6.3 percent of children ages 6 to 9 have caries — tooth decay or cavities — when they return for visits. That's an impressive achievement considering the Healthy People 2020 goal is that 49 percent or fewer children in that age group have caries at recall.

“We see children who have a whole different chance at a new life,” says Paret. “How can you not feel great about that effort?”

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Pictured: Memorial Hermann Health System uses mobile dental vans to bring care to Houston's most underserved children.

About the award

Each year, the American Hospital Association honors up to five programs led by AHA member hospitals as “bright stars of the health care field” with the AHA NOVA Award. Winners are recognized for improving community health by looking beyond patients’ physical ailments, rooting out the economic and social barriers to care and collaborating with other community stakeholders. The AHA NOVA Award is directed and staffed by the AHA's Office of the Secretary. Visit www.aha.org/nova for more information.