Dr. Robert Keene, Nancy DuMont, Shelley Giguere, and Mary Davis

Dr. Robert Keene, Nancy DuMont, Shelley Giguere, and Mary Davis

When you give someone a great big smile, do you think about what your smile looks like first? If you don’t, then you are very fortunate. Feeling good about your smile is a special gift. It probably means that your teeth have been well cared for during your lifetime. Sadly, there are many people who are not so fortunate. It is hard to believe that nearly 50 percent of three-year-old children in the U.S. already have tooth decay.

Here in the Upper Valley, there are people who are passionate about helping children to get a good start on a healthy smile. And, if passion were the only criteria for getting such a job accomplished, there would be smiling children all over the Upper Valley.

During a recent visit with Dr. Robert Keene and Nancy DuMont – Supervising Dentist and Community Health Director, respectively, of Alice Peck Day Memorial Hospital’s Upper Valley Smiles program, it was evident that their goal is to help assure healthy smiles for every kindergarten through fourth-grader in the Lebanon, Enfield, Canaan, and White River elementary schools. Anything less than 100 percent is unacceptable to them.

As the Director of the Department of Community Health, DuMont creates, implements, and evaluates activities related to health improvement/wellness plans for the community. Within the Upper Valley Smiles program, she supervises Mary Davis, the hospital-employed registered dental hygienist, and Shelley Giguere, dental assistant. Giguere provides oral health education, screenings, sealants, and fluoride varnish (the two main improvements in decay prevention now available) to elementary school children in the four towns. DuMont also coordinates referrals of children needing urgent dental treatment to local dentists, writes and manages oral health grants, and chairs the Upper Valley Oral Health Initiative.

A very persuasive leader, DuMont enlisted Keene, who grew up in Hanover, to volunteer for the “Healthy Smiles” Program starting in 2007. Keene’s years of work in many aspects of the dental profession – having owned a private general dental practice from 1963-2000, along with his ideas for improvement that he felt compelled to share – put him in the perfect place to start the Red Logan Dental Clinic in White River Junction in 1997. He remained on the Advisory Board until 2003.

Caring for children’s teeth when families are struggling just to keep food on the table and a roof over their heads can be a daunting task for anyone. Each year, the Upper Valley Smiles staff hears about families where toothbrushes are shared to save money. These parents may not know that, as Keene reports, “dental decay is an infectious disease,” but at the same time, “dental diseases are some of the most preventable diseases of the human body.” For this reason, the oral health education component of Upper Valley Smiles is equally important as the preventive treatments that participating children receive.

More than 1,900 children benefitted from Upper Valley Smiles during the 2013-2014 school year. The weeklong school program starts with oral health education for all children in grades K through four. Davis presents an age-appropriate oral health education lesson, and sends a letter to each parent containing “10 Tips for a Healthy Smile” to reinforce lessons about good nutrition and proper oral care. As she notes, “the focus of our program is on prevention!”

After the oral health education day, participating children receive an oral health screening by the team, and results are sent home to parents. For the remainder of the week, children who do not have a dentist are given preventive treatments including sealants to seal out food and bacteria that cause tooth decay, and varnish to strengthen teeth. Follow-up letters are sent to parents, explaining the preventive services that were provided to their child. Finally, if the child needs more extensive restorative treatment in a dental office, DuMont helps parents find a dentist.

Thanks to grant funds, low-income parents who are uninsured may be offered vouchers to pay for that care. “The local community has been very generous over the years in helping children who so badly need dental services, and who would otherwise continue to suffer,” DuMont says.

For example, the Rotary Club of Lebanon has chosen Upper Valley Smiles as this year’s beneficiary to receive a major portion of the funds raised from this year’s 35th Annual Rotary Auction, being held October 4 at the Fireside Inn & Suites in West Lebanon.

Why is continued community support so important in 2014? The answer, according to DuMont, is simple: “We are doing well in offering oral health education and preventive treatments to many local children, but the benchmarks for success are not yet pointed in our direction. In 2013-2014, the statewide rate of untreated decay found in New Hampshire second and third graders was 12 percent, but the rate for the children we screened in the Upper Valley Smiles program was more than double that, at 28 percent. Similarly, the statewide percentage of that same group of children who had sealants on their teeth was 51 percent, but in our group only 4 percent had sealants.”

For DuMont, the ultimate goal of the program is “to find regular dental care for all of the children in the schools we serve, and to reduce the prevalence of dental disease in our community.”

Echoes Keene, “The Healthy Smiles program for K through grade four leads to a healthier life in many ways. Healthy mouths and teeth make for self-confidence, success in learning, obtaining jobs, and happier lives. Along with early preventive care and treatment, giving children the tools for dental and systemic health is a vital major first step towards a healthier population.”

Although the number of children who participate each year is growing, many children who do not have a regular dentist are not signed up. Some parents are reluctant to have their children participate due to their own fears about dental treatment, but the Upper Valley Smiles team is known for its gentle and non-judgmental treatment.

Keene, DuMont, and the team remain optimistic: “We prefer to view our glass as half full. Each year we reach more and more kids, and we get a lot of satisfaction out of helping those we serve.”

To learn more about the Upper Valley Smiles program, contact Nancy DuMont at dumontn@apdmh.org or (603) 443-9548.

by Betsey Child