Dr. Francisco Rios of Kinston Community Health Center chats with a patient during a recent visit by KCHC’s mobile dental team to Moss Hill Elementary School. Aided by a grant from The Duke Endowment, Kinston Community Health Center is partnering with LCPS to bring comprehensive dental care to elementary and middle school students who do not have a dentist. Submitted photo.

Dr. Francisco Rios likes to kid around with his patients.

“They call me the silly dentist because I make jokes, I dance with them, I sing with them,” Rios said. “We do whatever it takes to take that old fear of dentists away, and we’ve been pretty successful. We make it fun for them.”

But silly is serious business in a school district where an estimated 70 percent of students don’t receive regular dental care or know enough about oral hygiene. That’s a health-care gap Lenoir County Public Schools is filling this school year through a partnership with Kinston Community Health Center (KCHC) and with the support of The Duke Endowment.

A $400,000 grant to KCHC from The Duke Endowment has allowed LCPS to offer expanded in-school dental care for K-8 students who don’t have a dentist, not only increasing the number of visits to elementary and middle schools but, for the first time, creating an easy route to follow-up care.

“We previously had a vendor who was coming in and bringing a van and doing care. They would provide good care, but with the restorative work, the parents would have to make the appointments and follow through,” said Nicole Sugg, LCPS’s lead nurse. “So you had kids who still had toothaches. This is a more comprehensive kind of care and it also connects our parents to a local medical facility. When that kid has a problem, there’s someone here to help.”

The KCHC team recently set up its portable equipment in a small vacant room at Moss Hill Elementary School – three dental chairs, an X-ray station, a reception desk where students checked in and checked out and where, on leaving, they received a gift bag that included a tooth brush and toothpaste. Students came in four at a time, one at the X-ray station and three in the chairs for cleaning, examination and, if needed, sealants.

“It’s like a well-oiled machine,” Sugg said. “It just flows. Our goal is to not have students out of class any longer than they have to be.”

Beginning his exam, Rios bent over a kindergartner, a dark-haired girl who looked comfortable, even relaxed, in the dental chair. A perfect smile of baby teeth bloomed from beneath the sunglasses the patients wear as eye protection.

“How many teeth do you have?” the dentist asked.

“All of them,” the little girl said.

Rios allowed himself a chuckle; but since Moss Hill was the program’s seventh school and the patient roster was heading toward 150 students, he had heard funnier lines – and seen teeth in a lot worse shape than the kindergartner’s.

“We see everything,” said Rios, one of three dentists working in the schools. “We see kids who need only sealings, and we see kids with abscesses, with broken teeth, multiple cavities. If we see a kid in the preliminary screening that has these kinds of things, we call the parents immediately and try to set up an appointment either that same day or the next day. It’s the same if the student goes to the school nurse; the nurse calls me and we see that kid the same day. Our priority population is kids. We’re doing whatever it takes.”

Beyond time in the chair, turning the corner on oral health care in Lenoir County will mean educating both students and parents on the benefits of good hygiene and the danger of dental problems. “We can only do so much,” Rios said. “After that, it depends on how we can educate the parents to take care of the kids and bring them to the appointments.”

The link between lack of education, lack of access and lack of care convinced The Duke Endowment to develop an oral health strategy and put the school-based initiative that’s benefitting LCPS and other school districts at the center of that program, according to Stacy Warren of the endowment’s Health Care Division.

“Dental disease is really a disease of poverty and lack of education and resources, so if we can get to that at a very young age and teach better oral hygiene and get the problems fixed and keep monitoring those children at a young age, we feel like their overall health trajectory will be much better,” Warren said.

“School based programs have proven to be very, very effective for that because it’s so quick and easy to identify something and take care of it right then and there.”

 The grant to KCHC was among the first group of 10 awarded, going to agencies that together serve 79 schools. Another 12 organizations received grants last year and are now in the six-month “readiness and planning phase” that all grantees, including KCHC, go through with technical assistance providers from East Carolina University and the Medical University of South Carolina.

The two-year grant covers the implementation phase that KCHC and others in that first funding cohort are now in, offsetting equipment and supply costs for the agencies and allowing them to figure out staffing needs, scheduling and logistics. The Duke Endowment expects to add about 10 agencies each year of the five-year project.

 “We’re trying to elevate dental care as something that’s really important and, we feel, something that should be really important to schools,” Warren said.

No adult in that small room at Moss Hill would dispute the program’s importance or the need for schools to be involved.

“This has given our kids an opportunity to start early on,” Sugg said. “They’re learning how important oral health care is, because you can’t be healthy if your mouth is not healthy. People don’t understand how important that is.”