The tooth angel came to Whitefield School Monday morning.
Public health dental hygienist Susanne J. LaVallee, R.D.H., working from an RV parked in the school parking lot, told the six-year-old student in the examination chair, “You don’t know how much I love seeing teeth without decay!”
More commonly, as LaVallee travels among 34 schools in coastal and central Maine, she sees kids “with plaque three millimeters thick.” Some of the standouts? A seven-year-old with 14 cavities, and a high school junior who has had “multiple extractions and will lose the rest of her teeth,” the hygienist said.
Six years ago LaVallee, of Winthrop, started the Tooth Angel Program. She previously worked 20 years for a dentist in private practice. When he died suddenly, the loss of an employer who was also a good friend sent her life in a different direction.
Parents of MaineCare patients started calling the office, saying they couldn’t find a dentist for their children. Dr. Thomas Lee “was a really nice man,” LaVallee said. “He would see these kids, and if they missed an appointment, he would reschedule. ‘These kids need us,'” she remembers him saying.
That message of need continues to motivate the hygienist to this day.
In 2003 she embarked on her “Tooth Angel” career, screening public school students for decay, providing cleaning and fluoride applications, and eventually placing temporary fillings. Other hygienists work with her and in addition to treatment, they give advice about diet and oral hygiene. The program works because she goes to where the kids are, and to date 3500 individuals have been treated.
“For three years, I hauled equipment in and out of schools,” she said, a time-consuming and back-straining process. Some spaces – whether closet sized cubicles or sweaty locker rooms – were “just terrible.”
Then LaVallee purchased a recreational vehicle to serve as a mobile dental hygiene unit with two treatment rooms, and she incorporated as the nonprofit organization Maine Dental Health Out-Reach Inc. The status allows her to seek grants and other sources of funding (such as Northeast Delta Dental Foundation Inc.) besides receiving Medicaid reimbursement.
However, MaineCare, as the state’s program is called, doesn’t reimburse hygienists for screenings, resealing teeth or placing temporary fillings. Thousands of dollars of LaVallee’s time and supplies are not reimbursed.
For example, last week she and another hygienist were in School Union 133, which includes Somerville, Palermo and Windsor. They saw 19 students, placed 152 sealants and five temporary fillings. (Sealants protect against decay and temporary fillings buy time until patients can see a dentist for permanent fillings.) Eight students with 14 decayed teeth were referred to dentists.
As with every school district she serves, there were non-reimbursable services.
Throughout the area she covers, the cost of care that will go unpaid is nearly $27,000.
LaVallee is grateful for dentists that do pro bono work. Many dentists will not see MaineCare patients because it costs them money. “Business-wise, they can’t afford to take these kids,” LaVallee said. At the same time, she believes every dentist is in a position to treat at least a small percentage.
While LaVallee pays her staff well, she said she pays herself when money is available. She described herself as growing up in a family of two hard-working blue-collar parents, five siblings, “and no extras.” Referring to children lacking dental services, she said, “I could be in the position of any parent (struggling economically) and not know what to do.”
Providing some of those services, even at financial loss to herself, “is the right thing to do,” she said. Dental problems, especially infection, can affect the rest of the body. “It’s all one issue.”
The most important thing parents can do is limit their children’s intake of juice to once a day, serve “plain water the rest of the day, fruits, vegetables, milk at mealtime, and healthy snacks,” she said. Sugar that sneaks into kids’ diets in soda and flavored water should also be avoided.
Thirteen students, 10 from Whitefield and three transported from Jefferson, were screened between late last week and early Monday.
“Every school in the state of Maine should have this program,” LaVallee said. The savings over time to taxpayers would be tremendous, she added, including the fact that kids miss school because of dental infections and can have other related health problems over time.
The website for LaVallee’s Maine Dental Health Out-Reach program is www.mdho.org.
