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A Reason to Smile

Central Minnesota boosts the diversity of its dental professionals. 

By Elizabeth Foy Larsen | Photography by John Linn

Last year, when she was a senior at Pine River-Backus High School, Taina Williams was on a field trip to research college options when she learned about the Dental Assistant Diploma program at Central Lakes College (CLC) in Brainerd. The one-year course prepares students to be dental assistants, a career that involves anything from taking and developing X-rays to teaching patients about oral hygiene to assisting dentists during treatment procedures. It’s fast-paced work that requires empathy and a good-natured temperament, which Williams has in abundance. 

In fact, the idea of a being part of a team and doing a variety of tasks appealed to Williams, who was born in Haiti and adopted by a family in Pequot Lakes when she was a teenager. "I'm a people person and I like staying active and not being in one spot," she said. So last fall, she enrolled in the program and is happy to report that "I've loved it from the first day." 

That enthusiasm has been buyoed by the fact that Williams received a scholarship to help with tuition and the state licensure and national certification examination fees. Sponsored by the Initiative Foundation through a $200,000 grant from the Delta Dental of Minnesota Foundation, the Diversity of the Dental Workforce in Central Minnesota project was created to increase the gender, racial and cultural diversity of a field that is so overwhelmingly white and English speaking. The program is for students at CLC, which hopes to boost the ranks of Latino and American Indian students to better serve those communities, and St. Cloud Technical & Community College (SCTCC), which aims to train more students of East African descent. 

These students can become dental assistants, dental hygienists, and even dental therapists—mid-level licensed practitioners who provide many of the routine preventative and restorative procedures that dentists do, including fluoride treatments, tooth sealing, and filling cavities, but at a lower cost. Similar to a nurse practitioner, dental therapy is a growing field. Although it’s a common career in other parts of the world, Minnesota currently is one of only a handful of states to enact legislation to allow dental therapy. 

The Dental Diversity program is part of a multipronged effort by the Foundation to improve dental health in children ages 0-5 across the region. “As our communities get more diverse and welcomes more New Americans, it’s crucial that we are able to provide this vital component of health care in a way that is welcoming to everyone,” said Don Hickman, vice president for community and workforce development at the Initiative Foundation. In addition to providing assistance for tuition, exams and supplies—which can cost thousands of dollars for students studying dental hygiene—the grant helps students cover the costs of common barriers to attending class, including gas and child care. Colleges can also use funds to develop programs that help retain students of color and to provide training to faculty to support inclusion of students from diverse communities.

Root Cause

For the past three years, the Initiative Foundation has focused on reducing the challenges to obtaining dental care for young children in the 14 Central Minnesota counties it serves. That’s no small task when you consider that 65 percent of the dentists in the state work in the seven-county metro area. That leaves only 35 percent for the remaining 80 Minnesota counties. “Access to dental care is more of a challenge in outstate Minnesota,” said Joseph Lally,  the executive director of Delta Dental of Minnesota Foundation. In some towns, the dentist-to-patient ratio is 5,000 to 1. 

That challenge is compounded by the fact that no nonprofit dental clinics, which provide subsidized treatments, are based in Central Minnesota. Minnesota also has the lowest Medicaid dental benefits in the country, making it financially challenging for many dentists to treat patients who are receiving medical assistance. In fact, Just one-third of children and young adults who are eligible for Medical Assistance receive some kind of dental care, according to a report by the Department of Human Services (DHS). That’s compared to the 85 percent of children on Medical Assistance who see a physician each year. 

“We have effectively bifurcated the head from the body,” said Sarah Wovcha, the executive director of Children’s Dental Services, a Minneapolis-based nonprofit that provides dental care for children from income-eligible families across the state. It’s a serious issue given how important oral health is to a person’s well-being. According to the Mayo Clinic, people with poor oral hygiene can have higher rates of heart disease and diabetes and have pregnancies that result in premature births and lower birth weights. Children with tooth pain or cavities get less sleep, are less able to concentrate in school and have higher rates of absenteeism. 

Preventative Measures

In the greater St. Cloud area, the Somali community has faced especially stubborn challenges when it comes to getting quality dental care. “We aren’t yet prepared to address the cultural complexities, from cultural norms around touching to translation challenges to discrimination that can be barriers to people accessing care,” said Wovcha, who also notes that some immigrants are reluctant to seek dental care because they are afraid an immigration officer will show up at the office. 

That’s one reason why, in addition to providing Central Minnesotans access to high pay careers, the grant to SCTCC aims to increase the number of Somali students in its dental programs. A community education initiative teaches elders in the community about oral health care and hygiene and counsels current students about the prerequisites they need to enter the dental assistant training program. This fall, five students of East African heritage will be starting in SCTCC’s program, according to Kelly Halverson, the dean of Natural Health and Sciences.  

Halverson hopes that as word spreads, more people of diverse backgrounds will see the career opportunities in oral health. “Oftentimes the students I’ve talked with who are in the Somali community are interested primarily in nursing,” said Halverson. “They don’t realize we have eight other programs in health care, which include dental assistants and hygienists, both of which can provide a good living.” 

That’s what Taina Williams is counting on. Currently doing an internship at Pine River Dental Arts in Pine River, she’s also studying for her licensure exams. Once she passes, she hopes to find a job close to her home in Pequot Lakes. She says her training and internship has confirmed that she was right to choose this career path. “I love working alongside the dentists and hearing patients’ stories,” she said. “It’s the best decision I’ve ever made.”

Zero to THREE, Cavity FREE

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Improving pediatric oral health in Mille Lacs County

Photography by Paul Middlestaedt

The halls at Onamia Elementary School, normally quiet during summer months, were busy this past June with families taking part in Operation Community Connect, a one-day fair that provides families with the services they need to succeed—from haircuts to pregnancy counseling to connecting with WIC and other agencies that provide assistance to families in Mille Lacs County. Outside the music room, a line was forming for families who were hoping to get dental care from a mobile unit that travels the region on behalf of Children’s Dental Services, the Initiative Foundation and the Mille Lacs County Cavity-Free-By-Three campaign. A grandmother from Isle had brought in her 2-year-old grandson for his first dentist visit. She had been hoping to get him in earlier when Operation Community Connect was in Mora, but couldn’t find transportation to travel 25 miles from home.

While the American Dental Association recommends that a child’s first visit to the dentist happen before a child’s first birthday, the reality, according to the Minnesota Department of Health, is that children under 6 years of age are two times less likely to have a preventive dental visit than children ages 6 to 17 years. “It’s tempting to think that when it comes to young children, it’s just their baby teeth and they will get a new start when those teeth fall out,” said Linda Holliday, an early childhood dental consultant with the Initiative Foundation. “But that’s just not true. If a young child’s teeth hurt, it’s hard to get the nutrition they need to grow and learn.”

What’s more, rural third-graders are 1.3 times more likely to have cavities than their urban counterparts. Because early childhood dental health is so important for a child’s overall development, the Initiative Foundation, together with the Otto Bremer Trust and Delta Dental of Minnesota Foundation, have supported mobile clinics in Mille Lacs County that are operated by Children’s Dental Services to help bridge that disparity. “It’s a cost-effective way to reduce barriers,” said Sarah Wovcha. “We take the clinic to places where families normally congregate, such as schools and community centers.”

It’s a model that is moving the needle to improve pediatric dental care in the county. “Our focus is birth-to-three, cavity-free,” said Sue Peltoma, a health educator for Mille Lacs County. “For a lot of families, this is their dental care.”

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