Kids with cavities are not getting the dental care they need.
The problem has been whispered around the central Kenai Peninsula for a long time, with horror stories of frantic parents being turned away from dental offices and forced to take children in pain to Anchorage or Homer for relief.
But a solution may be coming soon.
This spring, the new Commun-ity Dental Health Project is being set up to tackle the problem.
"I have a feeling there is a lot of frustration in the community right now," said Cindy Sawyer, the project's coordinator.
Service groups report that low-income families cannot get the dental care they need. But dentists complain that charity cases fail to show up for appointments, decline to follow through on the doctors' advice and make for billing problems, she said.
"It is frustrating for both sides," Sawyer said. "We are just stuck right now."
One group caught in the middle of the issue is school nurses.
"I see students with dental needs -- toothaches, dental decay -- several times a week," said Bekkie Jackson, school nurse at Sears Elementary School in Kenai.
She heard of one case from another school where a student's mouth infection got so bad the child ended up hospitalized in intensive care in Anchorage.
Jackson can do little for the dental problems that come to her but apply topical anesthetic. When she talks to parents, they usually know about the problem but cannot afford to get treatment, she said.
She knows of central peninsula dentists who have charged half price or made other accommodations and of benefactors such as the Christian charity Love INC that have paid families' dental bills.
But the needs loom larger than the resources.
"Most of the time, there just isn't anything out there," Jackson said. "I think the real problem is money. These are needy families. Even transportation to Anchorage is a problem."
Difficulty in getting dental care for low-income children is more than a peninsula problem. The project here ties in with a statewide and national movement tackling dental health shortcomings.
Sawyer cited a 1996 federal report that found that only about one-fifth of children eligible for Medicaid were receiving recommended dental preventive services. On a state level, the dental health effort ties in with the Denali Kid Care project.
"Everyone is sort of working on it at the same time," she said.
On the central peninsula, 1998 figures found the same 80 percent of Medicaid children missing out on dental care. Of the small group treated, more than half went to Anchorage, some went to Homer and 39 percent reported seeing a dentist in the Kenai-Soldotna area.
Community and service groups working together through Healthy Communities-Healthy People identified the gap in dental care as a top priority. Working with the umbrella organization Bridges, the concerned citizens won a $36,000 grant from the Alaska Division of Public Health to work on the dental issue.
At the end of February, the project started off by hiring Sawyer, a former public health nurse with a background in family and community services health work. She has been working to build the project from the ground up.
Sawyer said its purpose is to build bridges between the dentists and the families and to seek constructive solutions to the difficulties obstructing dental health care delivery.
Modern health care can make cavities obsolete, she said, so the fact that dental decay remains the chief chronic disease of childhood reflects a major public health problem.
The solution lies with communities, Sawyer said.
"The solution is not going to be for me or the project to say, 'This is what is going to happen,'" she said. "Really, only the community can decide what works."
She is beginning her work by visiting with agencies and talking to dentists to gauge the scope of the current resources, needs and problems, she said.
Later, Sawyer plans to interview families about their experiences. The outreach effort may include surveys, parent meetings, information exchange at shot clinics and public round-table discussions, she said.
After documenting the situation, the dental health project will develop ways to overcome barriers to adequate care, promote preventive care and increase awareness of dental health issues.
The ultimate goal is to improve the dental health of all central peninsula residents.
"We are focusing on children from families with low incomes," Sawyer said. "But the final outcome will help all of our kids -- and maybe even some adults."
She said she looks forward to a challenging process.
"This is ... a change in the system," she said. "I think it will be a good model for other parts of the country. My belief is we will have a healthier community when we get finished."
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