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Dental care at parish school draws opposition
A drawn-out discussion about dental care at a parish school dominated much of the Ouachita Parish School Board's meeting Tuesday night.
Dr. Gregg Folse of Lafayette has made four visits to Swayze Elementary School to provide dental care to students.
The Northeast Louisiana Dental Association members voiced their opposition to Folse's presence at Swayze Elementary.
Folse, though, says he is providing a service to students who, for whatever reasons, do not see local dentists for dental care.
"I am not the only answer to the dental problems across the state," Folse said. "It's going to take us all to bone up and see as many of these children as we can."
Swayze principal Marquita Bowman told the school board that she believes Folse is offering a service that benefits her students.
"Most of the kids at Swayze have not been receiving dental services, and they have been coming to the office complaining about tooth aches," Bowman said.
She said she received a facsimile communication from Folse about his dental program and applied for the service.
"They (Folse) have been in our school four times," Bowman said. "The children's teeth have been cleaned, filled, and they received root canals and any other dental services they needed. These are children who normally would not have gone to a dentist. So, it was very convenient for them to come to us and provide all the services that we need. It's been very beneficial for us and we hope we can continue with this service."
She said dentists—Folse and other dentists associated with him—treated more than 100 students in the school's gym. Once students received dental care, they returned to class.
Folse provides the same service, utilizing local dentists, in several other areas of the state. Folse and dentists like him are reimbursed for the service through Medicaid.
Dr. Kirt Touchstone, past president of the Northeast Louisiana Dental Association, said Folse does not have the support of local dentists in the region.
Touchstone is currently a member of the Louisiana Dental Association's task force, which, according to Touchstone, is investigating school-based dental programs. He said many of Louisiana's dentists are asking for legislation to prohibit for-profit, in-school dental treatment.
"The kids may like it, and the teachers may like it to some degree, but do you want children being treated in Swayze gym, or in the gym of some other school?" Touchstone asked the school board. "All the dentists here will testify that portable equipment is not as good as the equipment in a brick and mortar office."
He said many northeast Louisiana dentists also believe that for-profit, in-school dental programs eliminate a parent's right to oversee their child's dental care.
Creating a "dental home" is the key to establishing quality care for a child, according to Touchstone.
He said a dental home is based on establishing a relationship of 24-hour care between the dentist, child and parent/guardian.
"While in-school dental treatment programs seem helpful on the surface, these programs actually open the door for a lack of quality care, a potential lapse in infection control, a lack of parental supervision, as well as informed consent and invasive dental surgeries occurring in school, not in the safety of a dentist's medical office," Touchstone said.
Bowman said her students' parents were required to sign a consent form to allow their child to receive treatment.
"Some parents even came to the school while the dentist was working with their children," she said.
Folse said dentists who go into the schools use state-of-the-art equipment and students are treated behind screens to insure privacy.
"We're HIPAA compliant and everything we do is done with dentists who are already doing these services out in their offices every day," Folse said.
If a child has any problems later, Folse said a dentist is available to address the child's needs.
"I have offices in the area that provides emergency call services for us," Folse said. "I have a brick and mortar office in the area that has said in writing they will provide those emergency services."
Folse said his dental practice over the last 15 years has been focused on treating the indigent population which typically received no dental care.
He said his group does not provide services to students who are already seeing a dentist. In order to be eligible to receive treatment, a student must not have received dental treatment in at least a year.
"I check my Medicaid records to see if they don't have a dental visit for the last year, then they are allowed to go on our rolls," Folse said. "I am not into seeing children who are in practices of other dentists. I'm just here to help these children who don't have a dentist and need care."
He said last year more than 400,000 Medicaid eligible children in Louisiana received no dental care.
"That's out of 670,000 or so," Folse explained. "Sixty-four percent of those kids with no dental visits."
"That's a societal sin to me," Folse added.
According to Touchstone, there are roughly 26,000 Medicaid eligible children in Ouachita Parish. He said there are about 26 dentists in Ouachita Parish who provide services to Medicaid patients.
"We see patients during holidays, after school and all summer, so there's plenty of time for us to take care of these kids," Touchstone said. "We're not so busy we can't see these patients. We're here to help, 24 hours a day."
Dr. Lance Donald, a practicing dentist and current president of the Northeast Louisiana Dental Association, said there is financial assistance available for transportation to and from a dentist's office.
"Too much progress has been made by the dental providers and the Legislature to open the doors for thousands of children to receive quality dental care, regardless of their financial means," Donald said. "The do not deserve quick examinations and less than stellar treatment just because the dentist happens to come to their school."
Donald said the local dental community was working to educate schools and parents about the opportunities that are available in the community for quality dental care for the entire family.
School board member Susan Spence said something needs to be available to students who are not getting any dental care.
"We have so many parents that don't take responsibility to take their kids to the dentist," Spence said. "Therefore, I am not so sure I am against or for what's going on in the gym. I can say I do appreciate the effort that's there."
"There's no reason we can't set up something to have some type of dental program available at schools," she said. "Something is better than nothing. I want the children to have access to some type of dental program that's right there at school."
Touchstone said Medicaid is addressing the issue of parents not taking their children to dentists to "force" parents to get dental care for their children.
School board member Scott Robinson asked Touchstone if "portable treatment" was "better than no treatment at all."
Touchstone responded, "A number of us do mission dentistry with portable equipment in third world countries. Is that what you're asking? Is that what you want for these kids? Is that better than no treatment at all?"
Robinson said, "Well, yeah. If the kids are not going to where the service is, some times we need to bring it to where they are."
Robinson also said he was not ready to make a decision on whether the school board should intervene in the issue at Swayze.
Following lengthy discussion with both parties, the school board did not take any action.
Superintendent Dr. Bob Webber said there are some liability concerns that must be addressed before the school board makes a decision. |
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