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I think the public healthdental hygienist
is the next step.
In private practice you maynot see the underserved
population the way that I see itin the school systems.
We can take the skills thatwe've learned as a hygienist
and apply them in a differentsetting.
I think there are manyhygienists out there who would
really love the opportunity tobe in a nontraditional setting,
with all of the challenges andrewards.
DR. MINA PAUL: Legislationwas recently passed
which allowed or actuallycreated the role of
the public health hygienist forthe first time
in the state of Massachusetts.
It allows public healthhygienists to be able to deliver
care without having to make surethat there is a dentist on site,
which allows more freedom.
CATHY MARSHALL: A publichealth hygienist is someone
that has chosen to take theskills that they have developed
over their career and bring thatto an alternative setting.
PAULA MORRISON: Basicallywhat we're trying to do
is reach a population that isconsidered
the underserved population.
MARSHALL: The program that wedo here at this school
and other schools in Springfieldis a prevention program.
So what we do is we screen thechildren,
we do fluoride varnish, we dosealants
when they need sealants, andthen we have
a case management referralprogram.
MORRISON: Sometimes we haveto make a follow-up phone call
to the parent in regards to thechild
if they need dental services.
And when we make that call, notall families speak English,
and that can be difficult,because you're not always
certain that the parent isunderstanding your message.
And in some cases we may requirean interpreter.
ROBERT JENNINGS: For somestudents, when they had this
opportunity, when they wereselected, it was their
first time receiving dentalservices at all.
It was the first time anyone hadasked them to
"Open up and letme see what's going on inside."
And they were very excited aboutthat.
MARSHALL: When I came intothe schools, they told me
that the key to these programsis the collaboration
with the school nurses.
And I knew that was true, but Ididn't know the depth
of that relationship until I gothere.
In the schools that I serve,when the school nurses
are really enthusiastic, andwhen I have a great relationship
with them, the program is sosuccessful.
DINAH SINNEMA: The oralhealth program here
follows our policy that we havealso in the city of Springfield
where we want the children tohave
the best education possible.
If your mouth doesn't feel good,
you're not going to do well inschool.
MORRISON: You have toestablish a relationship
with the principal, with thenurses, and you have to build
that relationship so thatyou can come into the schools
and provide your program.
But you need to understand that,first and foremost,
education is the priority in theschool.
Dentistry or the dental sealantprogram is secondary.
MARSHALL: A lot of timeswe'll get into a school,
and there's testing.
Not just MCAS testing, but anykind of testing
in a certain grade.
And so you may come in fullyprepared for your day,
only to find out that you can'tbe there that day.
And you have to be accepting,and you have to be flexible,
and you have to work with theschool to make sure
that you can get in another daywhen it's better for them,
not necessarily for you.
MORRISON: Sometimes you're ina very small, tight space.
I actually work in one of myschools outside of a gym.
And I have to put barriers upoutside
to protect the patient'sprivacy.
But the space is small andtight.
As long as you have an outlet,you're all set to go.
MARSHALL: The equipment thatwe use in the schools
is very heavy.
The black unit that we havewhich carries our suction
and all of our equipment isabout 70 pounds.
And it packs up nicely into asquare suitcase,
but it has little wheels, it'svery difficult to drag,
and in a lot of the schools thatI'm in, anyway,
some of the schools areover 100 years old,
and they have no elevators.
So we lug that thing up and downthe stairs,
and it's quite cumbersome.
DAWN SUMMERVILLE: Putting itin the school, the kids view it
as a part of the school, thecurriculum.
They weren't petrified, theyweren't afraid,
as if they would be in adentist's office.
MARSHALL: You've got to beopen to looking
at the evidence-based dentistrythat exists,
and incorporating that into yourpractice in the school.
So it isn't taking what you'velearned in private practice
and bringing it to analternative setting.
There are a lot of things thatyou need to learn
and that you need to keep up on,which is very recent data,
that will help you do yourpublic health hygiene job.
MORRISON: Sometimes I'mseeing children that have never
seen the dentist before, havenever been to a dental office.
So this is an opportunity forthem to receive a service.
And if we can seal their teethand prevent them from ever
experiencing decay, that's agreat thing.
JENNINGS: Sullivan MiddleSchool is certainly
a better place because of, youknow, the program
that Paula has infused in ourschool.
And, you know, and what makes ita better place
is it has becomea part of our school culture.
It's not an appendage, it's notan addendum.
It is what we do.
And it's just another wonderfulservice that we offer.
So it makes Sullivan special.
PAUL: I think this wasprobably one of the most
rewarding things, because itallows an independent person
who is a self-starter toget out there and sort of set up
their own day, and also be ableto regulate themselves
as they practice.
They get to make decisions aboutthe treatment and
the treatment plan that they'regoing to deliver.
Certainly the other part of it,or the other component of it,
is that it's public health, soyour variety of patients
that you treat and the type ofcare that you can deliver
and the fact that you're thereto deliver that care
I think is incredibly rewarding.