Table of Contents

Writer’s Preface

In recognition of National Children’s Dental Health Month, OPCA met with Community Health Centers providing pediatric dental services and programs to learn how they engage youth in our communities to protect their smiles.

In 1941, the American Dental Association observed the need to dedicate time and resources to raising awareness of the importance of pediatric dental care. The association organized a one-day event in Cleveland, OH, called Children’s Dental Health Day to promote good oral hygiene and guide parents on supporting healthy habits. Gradually, this day of recognition has become a national month of awareness advocating for children’s oral health.

In this post, dental teams from Neighborhood Health Center and the Native American Rehabilitation Association of the Northwest, Inc. (NARA NW) share the amazing work they’re doing that focuses on dental services and programs exemplifying the goals of National Children’s Dental Health Month.

Neighborhood Health Center

“SBHCs provide comprehensive care to students: physical health, mental health, dental care. We’re addressing public health goals like chronic disease management. And they’re so convenient, right? They really help with removing barriers to transportation, scheduling conflicts, and financial challenges. And I really appreciate how they address issues around equity, ensuring access for underserved or low-income communities.”

Carolyn Tziu, Community Dental Program Manager

“SBHCs are an important access point for families who are immigrating from other countries. This is often a first touch point to healthcare for a lot of these students. They’re in high school, and this is the first time they’ve ever seen anybody who’s looked in their mouth to do an assessment to address oral health issues. It’s an important access point for new families to the community.”

Alynn Vienot Hayes, Director of Dental Program Operations

School-based Health Centers (SBHCs) can see students and siblings of students within a district regardless of insurance status or ability to pay. Because these health centers are on campus, they reduce barriers to care while increasing access to integrated health services. Neighborhood Health Center (NHC) operates within three school districts, managing sites at Tualatin High School and Merlo Station High School as well as providing dental services at a third co-partnered health center at Milwaukie High School. Due to all the efforts in increasing awareness, improving dental education, and providing care, the team at NHC is extremely proud of the increase in the volume of patients served at these clinics.

NHC provides preventive care with weekly dental services at the SBHC sites by scheduling students with Hygienist Kristen Gallaway. These services include cleanings, screenings, fluoride, and Silver Diamine Fluoride (SDF). SDF is used for patients with cavities who cannot see a dentist immediately. SDF is put on their teeth to cover the cavity, preventing it from worsening until the patient can see a dentist for treatment.

“The other thing I want to mention is the early intervention piece. I think that’s really important. We’re not able to provide restorative treatment as far as dental goes, but we have a heavy focus on early intervention and preventative care to get students thinking about oral hygiene. [This] education includes nutrition and talking about how what you eat impacts your oral health. We’re talking about exercise, just overall health habits. We really try to tie it all together. So, that’s a really important piece that we’re able to provide at SBHCs, particularly at Milwaukie High School.”
Carolyn Tziu, Community Dental Program Manager

The Community Dental team also provides referral services, insurance assistance, and an event called Screen & Seal, a week-long event that provides screenings, sealants, and fluoride. The team also coordinates appointments for children identified with emergent needs at Screen & Seal with the Dental Foundation of Oregon, Tooth Taxi. The Tooth Taxi is a mobile dental clinic equipped with two operatories and staffed by a full-time dentist and assistant. This van goes throughout Oregon, serving kids needing restorative care.

Tele-dentistry is a service NHC is working to implement, hopefully, this year in 2025. The team is procuring equipment, like an intraoral camera, and will take X-rays and images—getting a full picture of the mouth—for a dentist to look at in the electronic dental record to make a diagnosis. The patient would be given this information along with the findings. Then, the team would coordinate by getting them to a clinic for follow-up services.

See a summary of SBHC sites and patient engagement below.

School-based Health Center
Milwaukie High School Merlo Station High School Tualatin High School
School District North Clackamas School District 12 Beaverton School District Tigard-Tualatin School District 23J
Dental Set-up On-site Operatory Portable equipment to provide services. On-site Operatory
Patients Seen 50 – 60 students regularly throughout the school year

 

Close to 600 students screened at Screen & Seal events

Close to 100 students screened at the Fall and Spring Screen & Seal events Over 170 dental visits for students and siblings, January – June 2024

“The teamwork environment at the clinics is really strong. At Tualatin High School and Merlo Station Campus, Neighborhood Health Center provides medical and behavioral health services in addition to dental, emphasizing the importance of holistic care. So, even if you have a student coming in for medical or behavioral health, you know the provider is checking and talking about oral hygiene and referring these patients over to Kristen Gallaway on a regular basis.”

Kristen Weidner-Nguyen, SBHCs Clinic Manager

The Team at NHC
  • Kristen Gallaway is NHC’s Dental Hygienist, and Kristen Weidner-Nguyen describes her as, “. . . super warm and inviting. Getting oral hygiene done can be really scary for kids, and she is very good at making them feel as comfortable as possible.
  • Carolyn Tziu is NHC’s Community Dental Program Manager, and Alynn shared “Carolyn is expert in all things Community Dental!
  • Veronica Solorio is NHC’s Patient Engagement Specialist.

“She is the touch point for follow-up with students who have urgent healthcare or urgent oral health needs and helping students navigate to a dental home, even if it’s not urgent. She is our touch point for those students, and she follows up to help with insurance enrollment. There is somebody at the school-based health centers who does help with OHP, but Veronica is also able to assist students with navigating the system. From figuring out what their insurance is to where they can go if they wish to change to a clinic closer, whether at NHC or another dental home. She helps move them along in learning how to make an appointment for themselves, and how to understand their insurance.”

Alynn Vienot Hayes, Director of Dental Program Operations

 

Dental Champions

The team noted several advocates, from partnering FQHCs to district staff in the schools, who help promote dental services, encouraging students to schedule appointments for the services at the health center. Outside In, Trillium Family Services, and Neighborhood Health Center support the SBHC at Milwaukie High. Outside In does extensive outreach at the school, including tabling at events to educate students, staff, and faculty so they know where to refer them at Milwaukie if they notice something with a student. At Merlo Station, there’s a social worker who has been a huge supporter as well as the principal.

“We work really hard to make it a super welcoming space so that they feel comfortable being here, and they’re not intimidated by seeing a doctor or provider, in terms of dental.”
Kristen Weidner-Nguyen, SBHC Clinic Manager

At Tualatin High, NHC facilitates a Youth Advisory Council to engage with students at the school. Recently, the council managed a signage project to create and hang wayfinding posters throughout the campus leading to the health center. As a result, students understand where the clinic is located. Kristen Weidner-Nguyen commented, “It seems simple, but it’s significantly raised awareness and been super successful.

At Merlo Station High, NHC collaborates with the Leadership class. In 2024, the class managed a project involving the development of a podcast called Real Talk. This year, the students are writing a How to Adult Guide, including a section on what they’ve learned about oral health.

Parent Education: Caries (commonly known as cavities) are bacterial diseases that break down a tooth’s enamel and underlying layers over time by feeding on sugars and starches in the mouth. NHC’s Director of Dental Program Operations, Alynn Vienot Hayes, explained, “Those bacteria aren’t discerning, ‘Oh, I’m just going to stay on the baby teeth’. No, they’re going to jump onto the adult teeth as soon as they’re in the mouth. So just trying to set those kids up in terms of good oral health from the time they’re little helps translate into better oral health into their adult teeth.” Carolyn Tziu seconded this statement by recalling conversations with parents at Head Start. Understanding that putting your child to bed with a bottle of milk may have long term negative effects. Knowledge is power!

Academic Performance: Good dental hygiene in students improves academic outcomes. There is data presented by the National Institute of Health illustrating, Children’s Oral Health and Academic Performance: Evidence of Persisting Relationship over the Last Decade in the United States. NHC’s SBHC Clinic Manager, Kristen Weidner-Nguyen commented, “People aren’t as aware of how important oral health is to education and being able to learn. If you’re in pain, it’s really hard for a student to think, focus, and study in classes.”

Self-Esteem: The managers shared several stories of students entering the clinic apprehensively. Kristen Gallaway was praised for talking to and reassuring them throughout the visit, causing kids to leave with a big smile on their face after the appointment. Then they’re happy to come back. Confidence in one’s smile and appearance supports social interaction at school, increasing self-esteem. Good dental hygiene allows children to interact without fear of what their teeth look like or whether they have bad breath.

Life Skills: By having a health center on campus, students learn key life skills such as understanding the effect of dental hygiene on the whole body, navigating the insurance system, and scheduling appointments because they can access care and advocate for themselves.

“It’s kind of a ripple effect. We’re making a change in the culture of oral health.”

Carolyn Tziu, Community Dental Program Manager

Carolyn, Kristen, and Alynn shared how this is an opportunity to work with young people, making a positive impact and setting them up for success. The team is building a foundation to equip students with healthy habits, improving their quality of life.

All three members of the team emphasized that holistic healthcare of a child is crucial to supporting their overall health. NHC has videos highlighting the success of engaging students in behavioral health services available at the health centers.

Also, Alynn mentioned resources for folks looking for networks involved in the oral health space:

NARA NW, Inc.

“[NARA] started as a rehabilitation for people to get sober that were battling with substance use.”

Sally Wiedeman, Expanded Practice Dental Hygienist

NARA NW is an Indian-owned, Indian-operated nonprofit agency that began as an outpatient substance abuse treatment center. Traditional Indian culture and spirituality are integral to the associations’ services. All services are centered on the family, as NARA NW’s philosophy is that there will be no future without the family circle.

NARA NW offers dental services for the whole family. The association provides preventative and restorative care, manages dental education programs, as well as works with family and child-friendly dentists.

“The outreach aspect of NARA started in 2018. We received a [three-year] grant from CareOregon, with myself, a dental assistant, and the dental director at that time [designing] and [implementing] this plan to use mobile equipment to provide services on-site at the adult facility, at our youth facility, and then it allowed for me to also go to the child development centers and other parts of the organization”.

Sally Wiedeman, Expanded Practice Dental Hygienist

The grant also allowed NARA NW’s dental team to develop a program for pregnant mothers, encouraging them to come in and get their dental needs taken care of with an incentive: if they completed their exam and cleanings, they would receive a diaper bag. This was an opportunity for Sally to say, “Hey, while you’re pregnant, you can do these things that are going to help your child. And then when your baby’s born, here are things that you can do to help keep their mouth healthy.

This program was inspired by the Baby Teeth Matters initiative sponsored by the Northwest Portland Area Indian Health Board (NPAIHB) and Arcora Foundation based out of Washington State.

NARA NW operates the only Native American dental clinic in the Portland metro area, located off of Stark Street. Youth receive comprehensive exams, X-rays, preventative, restorative, and periodontal care from child-friendly dentists at the Dental Clinic.

Dental services are also available at the child development center within the adult residential treatment facility. Sally Wiedeman, NARA NW Dental’s Expanded Practice Dental Hygienist, explained, “I also have dental chairs set up at our adult residential treatment facility, which is an in-house treatment facility for people going through recovery for substance use.” Families are allowed to bring kids under the age of five into the facility to be there with them while undergoing treatment. This allows the team to provide dental services to both the parents and their children.

NARA NW’s Youth Residential Treatment Center (YRTC) is a 24-bed co-ed facility in Gresham, providing treatment for youth between the ages of 12 – 17 with a primary diagnosis of substance use disorder. The center has a dental set-up, allowing the team to provide services on-site.

At the Children Development Center and NARA NW YRTC, youth are provided with preventive services like cleanings, fluoride, SDF, and sealants.

NARA NW Dental works closely with guardians and insurance providers to refer patients to a specialist for emergent needs. The team has started making impressions for orthodontic treatment to get clients approved through the Oregon Health Plan (OHP).

Before COVID, NARA NW partnered with the Native American Youth Association (NAYA) to conduct screenings, apply fluoride and sealants, and provide dental education throughout the year. The team would visit Native American-based schools quarterly to do oral assessments and preventive care. Sally is looking into revitalizing these partnerships and integrating dental into more of NARA NW’s sites to broaden outreach to reduce patient access barriers.

See a summary of sites and patient engagement below.

Treatment Centers
Dental Clinic Child Development Center Youth Residential Treatment Center
Dental Set-up On-site Operatory On-site Operatory and portable equipment to
provide services.
On-site Operatory and portable equipment to provide services.
Patients Seen 397 patients seen
between the ages of
1-17 in 2024.
6 patients seen in 2024 (Patient engagement
affected by COVID)
Approximately 83 youth clients (between ages
12 – 17) seen in 2024.

“So, I’m an expanded practice dental hygienist, and then [there’s] an expanded functions dental assistant, and then a dentist.”

Sally Wiedeman, Expanded Practice Dental Hygienist

  • Sally Wiedeman, Expanded Practice Dental Hygienist
  • Dr. Lisa Anderson, Interim Dental Director
  • Jennifer Myers, Dental Assistant
  • Audrey Devan, Dental Assistant

Parent Education: Sally shared, “The Native American culture has this saying, ‘Two is too late,’ because usually by age 2, they’ll already have cavities.” This statement emphasizes the significance of the diaper bag initiative and its goal to set parents and babies up for success. These dental education programs also allow the team to develop relationships with clients, allowing them to encourage patients to bring their children with them for appointments.

Trauma-informed care (TIC): This framework is used in healthcare to recognize how the impact of trauma can influence how an individual interacts with others. Sally, explained how the dental team collaborates to create a safe environment:

“The patients that I work with as adults . . . a lot of their fears for dental stem from trauma that they had as a child. So, a collaborative goal with our entire team is to reduce those fears in kids. We want to make it a safe place for them, where they feel comfortable coming in for treatment, [and] where they aren’t afraid to come in and sit in the chair. We’re really trying to break down those barriers and reduce those fears for them.”

“You can make it a positive experience for them, and [a positive] learning environment for them as well, in hope that your encouragement gets them to want to do things that are good for themselves. We’re trying to build these foundations that help reduce the anxiety by letting them feel heard and valued as a patient, even if they are . . . a kid.”

“When it comes to the youth, most of the time it comes down to the educational part of it, and explaining to them this is why this is important. And then seeing them a few months later at a community event, and they’ll come up and be like, ‘Hey, you’re the dental person. I’ve been brushing every day, and I’ve been flossing.’ Or when they sit in the chair and say, ‘It’s really hard to floss between this tooth.’ And I’m like, I’m sorry that it’s hard to floss there, but I love to hear that you’re flossing.”

Sally Wiedeman, NARA NW’s Expanded Practice Dental Hygienist

Health centers are important providers of healthcare as they offer physical, behavioral, and dental health services regardless of a patient insurance status or ability to pay. Sally shared how this is one of the most motivating factors of working with youth and all clients. Being in community health is where her passion lies, as she can give back to the group.

“I would just say to anyone is if you have an idea, don’t be afraid to put it out there. Don’t be afraid to try and pursue it [or] talk to people and see how can you maybe break down this barrier. What can we do to change this, to increase access? Or hey, think outside the box!”

“When it comes to working with youth and kids, we have to be patient some days. [It] might not be a good day. So don’t [force] things. That could either traumatize or lead them to not wanting to come back. If the biggest thing you can do today is come in and sit in the dental chair, and we just talk, and we don’t do any treatment to make you comfortable so that you do come back, that’s a big win!”

Sally Wiedeman, NARA NW’s Expanded Practice Dental Hygienist