Partnership boosts access to pediatric dental care for Minnesota’s refugee and immigrant families

After continually seeing young patients with mouths full of cavities and decaying teeth during routine well-child visits, Family Medicine Physician Jim Letts, MD, and his colleagues at M Health Fairview Clinic – Roselawn in St. Paul knew something had to be done.

Severe dental disease is preventable if children can get connected to proper dental care at an early age. If it goes untreated, it can have serious consequences.

“Children would come in with mouths full of cavities and black, painful teeth,” said Letts. “It was causing them physical health problems and affecting them socially. The severe dental disease we were seeing was 100 percent preventable with proper dental care.”

The families Letts was seeing, overwhelmingly Karen and Hmong refugees and other immigrants, lacked insurance coverage and experience navigating the healthcare system. Many of them were overwhelmed trying to build a life in a new country or struggled to overcome a language barrier. They were falling through the cracks in dental care. 

To address this problem and help families access dental care, the Roselawn Clinic launched its Medical Dental Integration Program in 2017 in partnership with Community Dental Care. Since then, the program has grown from treating a few dozen children to over 200 kids aged 0 to 15 last year.

The Medical Dental Integration Program is a partnership between M Health Fairview and Community Dental Care, one of the largest nonprofit dental practices in Minnesota. The program provides a dental appointment with a collaborative dental hygienist during wellness visits. Services are varied depending upon each person’s needs, but include teeth cleaning with a toothbrush, fluoride treatments, patient and parent oral health education, referral assistance, as well as x-rays and tele-dental exams.

“If children have obvious decay, we’re able to apply silver diamine fluoride (SDF) to active dental cavities,” said Kate Iverson, the Community Dental Care dental hygienist and program manager who helps families at the Roselawn Clinic. “An application of SDF can slow down or stop cavities, providing families with more time to find a ‘dental home’ or access follow-up care.  We also work to get families connected with a dental clinic for lifelong care.”

Nearly all participants are uninsured or have public insurance, according to Iverson. There’s no out-of-pocket cost for qualifying families to access the program. The program is funded in large part by the Minnesota Department of Health’s Community Clinic Grant Program, with Community Dental Care and M Health Fairview providing in-kind support in the form of staff, space, and supplies.

Lack of transportation, education, and cost are common barriers to good dental care, so the ability to have both appointments at once – and at no extra cost – is a huge help to families. Critically, the clinic has interpreters on hand to translate during wellness and dental visits.

“We quickly understood what a valuable resource this could be for families, especially those who have recently immigrated or come from refugee camps where dental care wasn’t a priority,” said John Swanholm, M Health Fairview’s vice president of community advancement. “Exposing families to dental health at an early age can help prevent more serious problems down the line.”

Our Community Advancement team helped launch the program in partnership with the Roselawn Clinic and Community Dental Care. The clinic is part of the East Side Health and Well-Being Collaborative, which focuses on health equity and public health in the East Metro.

After the success of the program, other M Health Fairview clinics have expressed interest. Letts says the program, funded by grants, is in the early phases of planning an expansion. 

“There are pretty deep inequities in healthcare and dental care in Minnesota,” said Letts. “This has been a way to start chipping away at some of those inequities.”

Read more: “How a Twin Cities partnership is tackling serious dental issues among refugee and immigrant children.”