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As COVID Limits Options, School-Based Dentists Fear Impact On Kids

Original article written by Jillian Forstadt for WSKG.

Most dentists in New York were able to fully reopen their practices last June, but those who work in school-based health centers are still waiting on state clearance to do the same. Bassett Healthcare Network’s school-based health centers (SBHCs) aim to make care more accessible for rural families by placing physicians’ and dentists’ offices directly in school buildings. Costs to families for services in these offices are covered by insurance providers and New York State. Bassett’s school-based health centers serve more than 7,100 students across 21 schools in rural counties, making it the largest rural program of its kind in the state. Physicians and behavioral health workers have since returned to schools with a combination of in-person and telehealth visits, but New York State Department of Health guidance still in place from April prevents dentists from getting students back in their clinic.

Leah Carpenter, Bassett’s Chief of Dental Services, said the students she serves are among the least likely to be able to seek care elsewhere, and many lack dental insurance entirely. “Pre-COVID, there just weren’t a lot of dentists in the area accepting Medicaid and state insurances,” Dr. Carpenter said. “That’s only decreased with the COVID pandemic.” With the suspension of the program’s in-school dental care, convenient access to free services has become even more scarce. According to a national poll by the C.S. Mott Children’s Hospital, one-third of parents say the pandemic has made it harder for them to get their child dental care. Roughly 40% have avoided seeking dental care at all since the pandemic began, citing fear of COVID-19 exposure, office closures and cost.

Bassett’s staff adapted to the pandemic’s restrictions by helping families find dental care locally at one of the hospital network’s clinics and through video and phone calls, but that limits who’s seen and what dentists can do. “It’s through those outreach calls and those tele-dental visits that we are finding a lot of kids that are having acute issues because they’ve gone without regular preventative care for so long,” Dr. Carpenter said. Many of the students Dr. Carpenter has seen over telehealth in recent months are experiencing the familiar progression of tooth decay: pain and swelling that can lead to permanent tooth loss. Once the pain begins, Dr. Carpenter said it’s likely the tooth can no longer be saved.

The state’s guidance for school-based health centers, issued on April 2, 2020, asked staff to postpone all non-urgent dental care until further notice. As of Monday, Dr. Carpenter said no changes have been made since. “The school-based health centers, by and large, have remained open throughout the pandemic for medical care and mental health care,” Dr. Carpenter said. “Dental’s really been excluded because of this DOH guidance.” The NYS Department of Health did not return a request for comment.

Last week, Dr. Carpenter began setting up her site at Laurens Central School in Otsego County to resume urgent care. It’s a step in the right direction, but she fears that won’t address the root of the problem the way regular preventive care can. “Integrating oral health care with overall healthcare has been my charge,” Dr. Carpenter said. “I hate to see us sliding backward during this pandemic with our school-based population.”

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