Kids Get a Tele-Checkup September 8, 2006
Author: Lauren Stanforth Author: WILL YURMAN staff photographer WILL YURMAN staff photographer Section: Local//State

Jiovanni Diaz sat quietly in a chair in the health office at Ibero Children and Youth Services recently, his 3-year-old legs dangling high off the ground. Carmen Lebrón, a health specialist at Ibero's day care center on Clifford Avenue, held a wand with a bright light on the end close to Jiovanni's face and asked him to open his mouth wide. Jiovanni pulled back at first, skeptical of what the contraption would do to him. But he eventually complied. In a couple of minutes, Jiovanni's attention was riveted to a computer screen as digital pictures of his teeth taken by the wand popped up on the screen. The pictures will be sent to a pediatric dentist at the University of Rochester's Eastman Dental Center, where they will be reviewed to make sure Jiovanni has no cavities.

It's part of a pilot program that local organizers and researchers hope one day will be used routinely to check the oral health of youngsters who miss dental checkups at such early ages. The program uses computers that are already part of Health-e-Access, a computer system run out of the University of Rochester and funded through outside grants. It allows doctors to diagnose simple illnesses such as colds and ear infections over the Internet for children who are in school or day care. Health-e-Access is currently at 21 locations in Rochester and surrounding suburbs. Dental checks are being tried out at six of those locations — Ibero, Wilson Commencement Park, the Volunteers of America day care center on Lake Avenue, Action for a Better Community's Head Start program on North Street, and YMCA day cares at Lewis Street and the Metrocenter branch. "I think it's very exciting. We can at least alert parents that something is going on," said Dr. Dorota Kopycka-Kedzierawski, the UR dentist who is researching the project. "We don't want this to be a substitution for a regular exam. But it's a community service." Kopycka-Kedzierawski and Health-e-Access information data analyst Tyshay Taylor did a very initial study of how the dental program would work, with about 50 kids at Action for a Better Community's Austin Street day care site in 2003. After that, they received $50,000 from the Aetna Foundation to expand their screenings to six other sites. Out of 162 children initially followed, almost 40 percent had at least two cavities. The statistics proved there were children who needed treatment but were perhaps falling through the cracks. Although Health-e-Access sees children from all economic brackets, the dentistry program is initially targeting disadvantaged children who might not otherwise get regular dental care.

Screening by way of digital photography allows many children's cases to be reviewed in a short period, Kopycka-Kedzierawski said. Taylor said many children in these day care programs are already required to have a primary care physician or a dentist look at their mouths as a requirement for entering the federally funded early Head Start and Head Start programs. But Taylor said sometimes that requirement isn't fulfilled, or a parent might do it initially but not follow through with routine check-ups. The computer screenings fill in any gaps and encourage parents to keep up on their children's oral health. Toddlers can get tooth decay if they are allowed to sleep with baby bottles filled with juice or other sugary drinks. Children can be spared frightening extraction if teeth are saved, but early screening also guarantees healthier adult teeth if baby teeth can be maintained and left to fall out on their own, Kopycka-Kedzierawski said. If a pediatric dentist reviews the pictures taken at Health-e-Access and sees cavities, parents are referred to a dentist who can take patients on Medicaid or who have no health insurance. Kopycka-Kedzierawski is seeking more funding from the National Institutes of Health to study how many parents are taking advantage of the referrals. Also, while most insurance companies cover primary care Health-e-Access visits, dental screenings are not covered. The university is seeking more grant money to keep it going. About 226 children have been screened so far. "I think it's a wonderful idea. It really is an innovative use of technology," said Dr. Richard Speisman, chief of dentistry at Rochester General Hospital, where some Health-e-Access patients are referred. Jiovanni's mom, Marisita Santiago, 36, of Rochester, has taken him to the dentist before. But sometime between visits, the dental screening at Ibero caught two cavities. Jiovanni had the cavities filled and was recently given an updated screening to make sure no cavities remained. "I'm glad they have the system here," said Santiago, a single mom with two other children who works full time at Ibero. "They took care of it before it was too late."

Background Teledentistry — taking and transferring digital pictures of the mouth so that they can be reviewed by dentists and other specialists — is gaining momentum nationwide, according to the American Telemedicine Association. While teledentistry is being done in private dental offices, a new screening program in the Rochester area is for disadvantaged children ages 1 to 5 in day care centers. The University of Rochester, which is doing research on the pilot project, says that treatment of early childhood cavities in the Rochester area costs $1 million annually, a cost almost exclusively picked up by Medicaid. Copyright (c) Rochester Democrat and Chronicle. All rights reserved. Reproduced with the permission of Gannett Co., Inc. by NewsBank, inc.
Record Number: roc26858697.