Inaugural program in Hawaii aims to bridge access to care gap
August 12, 2020
Remote learning: Kapiolani Community College faculty and students in the Community Dental Health Coordinator program meet up in a Zoom meeting during a student presentation in July. The course is entirely online.
—Hawaii’s children have the highest prevalence of tooth decay in the United States, according to the Hawaii State Department of Health
Nearly one of four third-graders in Hawaii have untreated tooth decay.
About 7% of Hawaii’s third-grade children are in need of urgent dental care because of pain or infection.
Stemming the prevalence of childhood caries in the Aloha State is a challenging task, but one new program has set its sights on helping the diverse population overcome barriers that prevent its residents from accessing and benefiting from dental care.
In August, Kapiolani Community College
, part of the University of Hawaii system, is finishing up its inaugural Community Dental Health Coordinator
course, the first of its kind in the state.
The ADA-supported program seeks to empower the students — seven dental hygienists and two dental assistants — so that they can proactively help community members, communities and dental health care systems in both Oahu and the neighboring islands achieve positive outcomes in overall health status for children and adults.
“The HDA congratulates the first class to graduate from Kapiolani Community College’s Community Dental Health Coordinator Program,” said Dr. Wayne Leong, Hawaii Dental Association president. “We look forward to having them work with dental teams to increase awareness of the importance of oral health among our patients and the public.”
The online CDHC program, which began in October, is a professional development apprenticeship program that focuses on case management, navigation, oral health education and promotion and community mapping, according to Janet Primiano, course instructor and past president of the Hawaii Dental Hygienists' Association. She has served on the Hawaii State Board of Dental Examiners for 12 years.
The goal for the nine students in the program is for them to utilize their new-found expertise to link patients, especially at-risk children, to available dental care, as well as educating and spreading awareness of the importance of oral health to caregivers.
“There’s been a high need for this for many, many years,” said Ms. Primiano.
ADA, HDA spurred program
“Based on the request for this program from the Hawaii Dental Association and dentists of the state, this program can and should be a game changer for Hawaii,” said Sally Pestana, coordinator of the CDHC program at Kapiolani Community College.
In 2004, the ADA set up a task force to determine how to best meet the needs of dentally underserved rural, urban and American Indian communities. Two years later, the ADA established the Community Dental Health Coordinator pilot program as one component in the effort to break through the barriers that prevent people from receiving regular dental care and enjoying optimal oral health.
In October 2010, the first class of 10 CDHC students completed training and began working in tribal clinics, urban and rural Federally Qualified Health Centers, Indian Health Service facilities and other settings.
The ADA is currently providing technical assistance to 18 educational institutions with more than 600 graduates over the years, and 43 states have either a CDHC school program, a graduate of the program or a student in the program.
The CDHC program at Kapiolani Community College is a welcome addition to Hawaii, a state with no dental school and without community water fluoridation, said Kim Nguyen, executive director of the Hawaii Dental Association.
With third-graders living in Kauai, Hawaii, and Maui counties more likely to have experienced tooth decay than children living in Honolulu County, the Kapiolani Community College students come from every island in the state except for Kauai, Ms. Primiano said.
"Oahu has about 80% of our stateʻs population, so even low rates of tooth decay point to the need for this program," Ms. Nguyen added.
Students dedicated to underserved
Aloha State: Kapiolani Community College sits at the foot of Diamond Head, looming past the skyline of Honolulu.
The nine graduates are Beatrice Joaquin (island of Hawaii), Jessica Oliveira (Hawaii), Melorie Yuen (Lanai), Alyson Hernandez-Ignacio (Maui), Hillary Vidinhar (Maui), Deborah Drummondo (Oahu), Jessica Lozano (Oahu), Heaven Tancayo (Molokai) and Leesa Omizo (Oahu).
Ms. Oliveira is a dental hygienist on the Big Island who is about to graduate from the program.
“I enrolled in the CDHC program through KCC because I saw the potential the program would have to help me bridge the gap between dentistry and the communities within my Hawaii island,” Ms. Oliveira said. “I’m optimistic of what this CDHC certificate will bring to my community's future. Having worked in community dental health as a dental assistant from 2003-2017 has proved to me the need for more CDHC and dental health education within our education system in Hawaii. Therefore, I feel this program is vital to Hawaii.”
The training was developed by the ADA and the Hawaii course has the benefits of more than a decade of refinements behind it.
“The program was well-formed,” Ms. Nguyen said. “It was a ready-made curriculum.”
“Having the ADA curriculum and the support of the ADA made this first cohort possible,” Ms. Pestana said. “The program simply would never have happened without them.”
Ms. Primiano said plans are in development for offering the program during the upcoming school year as the need continues.
“I believe that each of the students will be like a drop of water, and with their knowledge and experiences they will cause a ripple effect as they share this information with others who will in turn share this with their ohana and beyond,” Ms. Primiano said.
Ms. Drummondo, a dental assistant at Kalihi Palama Health Center in Oahu, said she enrolled in the course to create and become more innovative in broadening her skills in oral health education and promotion for the underserved.
“I have worked with community health workers in assisting various patients that are limited English speakers,” Ms. Drummondo said. “As an immigrant myself, I know the struggle in understanding the health information that is significant in the wellbeing of patients. Having [education] available in Mandarin, Cantonese, Tagalog, Vietnamese and Pacific Island languages will help integrate prevention, education and promotion programs in the community.”
Ms. Omizo, a dental hygienist in Kaneohe on the island of Oahu, is also enrolled and committed to reaching out to her fellow Hawaii residents.
“Someone needs to advocate for these children and help them and their families find dental resources,” Ms. Omizo said. “In Hawaii, we use the word kuleana to describe someone's personal sense of responsibility. In our culture it is our kuleana to take care of each other, so being a CDHC is a perfect way to do just that.”