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Nassau County GKAS highlights dental care access challenges for kids with special needs

March 19, 2018

By Kimber Solana

Photo of volunteer helping a child at GKAS event
Puppets: Students from The Viscardi Center brushes the teeth of a puppet during a puppet show at the Nassau County Dental Society Give Kids A Smile program. Photo provided by The Viscardi Center
Garden City, N.Y. — For children with special needs, access to dental care can be a struggle.

Patients with physical, medical, developmental or cognitive conditions require special consideration when receiving dental treatment, said Dr. Joseph Brofsky, pediatric dentistry section head at Cohen Children's Medical Center. Their options for dentists are often limited because of issues such as low insurance reimbursement rates or lack of training and proper equipment.

"Give Kids A Smile is about helping the underserved children," said Dr. Brofsky, who chairs the Nassau County Dental Society GKAS event. "Children with special needs are among the most underserved population."

For this reason, on its 15th year, the Nassau County GKAS extended an invitation to The Viscardi Center, a network of nonprofit organizations that provides services for children and adults with disabilities.

A dozen students from the center, many of whom use wheelchairs, were among the 1,100 children who roamed the Cradle of Aviation Museum during the March 9 dental screening event.

"The volunteers were just so thrilled when the students from The Viscardi Center showed up," Dr. Brofsky said. "You could feel the spark of electricity in the whole museum."

Of the 12 students from The Viscardi Center, four were found to have tooth decay, said Kim Brussell, vice president, public affairs and marketing at the Viscardi Center. The discovery allowed these children's parents to schedule follow-up visits with dentists.

"It was a really valuable experience for our kids," she said.

The invitation was also valuable in another way. It allowed volunteers, especially dental students and residents, to be exposed to patients with special needs in hopes some are inspired to treat this underserved population, Dr. Brofsky said.

Project Accessible Oral Health

The idea to bring in students from The Viscardi Center came about in 2017 when Dr. Brofsky attended a meeting of ADA Foundation Give Kids A Smile Ambassadors where GKAS organizers shared best practices and ideas. One idea that was raised at the meeting was treating children with special needs.

"I just thought that was a great idea," said Dr. Brofsky, who was a member of Project Accessible Oral Health, a global public-private partnership to raise awareness of the significant need to enhance oral health care for people with disabilities to improve overall health and quality of life. The project started in 2017 at The Viscardi Center.

"That's how I learned more about the extent of the oral health need for children with disabilities," Dr. Brofsky said.

Group photo of GKAS volunteers
Smiles: Students from Evergreen Charter School pose with volunteers during the Nassau County GKAS event at the Cradle of Aviation Museum. More than 400 volunteers screen about 1,100 children during the event's 15th year. Photo provided by Dr. Joseph Brofsky
When it comes to finding a dentist, people with special needs often see hurdles, said John Kemp, president and CEO of The Viscardi Center. These barriers range from difficulty in paying for treatment, to obtaining dental coverage, to the physical challenges of accessing a practitioner's office or being seated in a dental chair. For oral health care practitioners, lack of alignment within the reimbursement system creates an added challenge to serving this population, which requires ongoing professional development and training to address the unique needs of children and adults with diverse disabilities, according to the Viscardi Center.

"Now is the time to bring oral health into the conversation, as it plays a significant role in overall health," Mr. Kemp said. "Project Accessible Oral Health is an opportunity to explore challenges, collaboratively create solutions, and build a roadmap to a healthier future for individuals, while examining cost-effective coverage and reimbursement strategies."

From brushing teeth to moon landing

Along with dental screenings, the children enjoyed learning about the importance of brushing their teeth through a puppet show, watching movies at the IMAX theater and exploring the museum.

In all, about 25 percent of the 1,100 children screened would need follow-up dental visits, Dr. Brofsky said. A dental van from Stony Brook University School of Dental Medicine also provided dental services, including sealants, cleanings and fluoride treatments, to 30 children.

For kids from The Viscardi Center, transportation is often an issue, making the visit to Nassau County GKAS' venue, the Cradle of Aviation Museum, quite an experience.

"The event was done in a really fun way," said Angelo Zegarelli, head of school at Viscardi Center, adding that the kids enjoyed going to a lunar module area and learning about astronauts. They were most excited, he added, learning how to brush teeth on a puppet.

"I don't know who had more of a good time, the kids or the volunteers," Dr. Brofsky said. "The amount of excitement from all the dentists, residents and dental student was something I haven't seen before. And we already have 1,100 kids in a museum filled with music, games, shows and celebrities."

While volunteer dentists who were familiar with treating kids with disabilities screened the kids with special needs, dental students and residents were still just as thrilled to have them.

"They were so eager to help out in any way," Dr. Brofsky said.

An event of firsts

Having the students from The Viscardi Center was not the only "first" to occur in the event's 15th year.

Dr. Brofsky said he was excited to see volunteers use the DEXIS CariVu, a device that can shine a powerful light to the teeth to detect carious lesions and cracks. This tool was particularly helpful when screening the students from The Viscardi Center. Dental X-rays would have been difficult or inappropriate to use on many of the kids, Dr. Brofsky said. KaVo Kerr, one of GKAS' national sponsors, donated the equipment and sent a representative to assist with its use. Support for the GKAS program also comes from generous donations from national sponsors Henry Schein and Colgate.

Another first is the idea to visit students at The Viscardi Center.

Because of transportation, only 12 students could come to the GKAS event. To address this issue, Dr. Brofsky said, Nassau County Dental Society and The Viscardi Center are working on scheduling a visit to the center to screen more students.

The collaboration is definitely something worth expanding on, especially during next year's GKAS, Dr. Brofsky said. Other dentists and GKAS organizers in the country, he said, should consider reaching out to kids with special needs for their events next year.

"If we can get the word out that kids with special needs are not that different from other patients, it would be one small step to getting more dentists to treat them," he said.