County Oral Health Improvement Plan 

County Oral Health Improvement Plan 

In January 2019, a collaborative process including community members, local community-based organizations and other stakeholders united with the intent to improve Fresno County’s oral health conditions. The issues at hand involved high prevalence of tooth decay, limited access to dental care, disparities in dental health and insufficient funding and resources.

Based on the California Department of Public Health’s (CDPH’s) Office of Oral Health, children in the San Joaquin Valley displayed the highest rates of tooth decay in California. The CDPH conducted an assessment during 2018–2019.

That assessment found that 61% of third-grade children in California have had tooth decay. In an executive summary, the CDPH declared four major findings: tooth decay continues to be a significant public health issue, race/ethnicity and socioeconomic status continue to be contributors to tooth decay and untreated decay, preventive services such as dental sealant are low and regional variations exist in children’s oral health across the state.

Fresno County Oral Health Initiative

While considering the growing oral issues across Fresno County, the CDPH gathered with state and local partners to devise strategies to engage the California Oral Health Plan 2018–2019.

The CDPH supported 59 local oral health programs and provided a total of $18 million to promote community-based interventions and encourage statewide initiatives. These initiatives include the improvement of oral health through water fluoridation, school dental programs, kindergarten oral health assessment and the promotion of oral health literacy.

The Fresno County Department of Health (FCDPH) received funding from the California Healthcare, Research and Prevention Tobacco Act of 2016, commonly known as Proposition 56, to address and integrate its oral health improvement plan. Through meticulous research, Fresno County’s Oral Health Advisory Committee (OHAC) determined the goals and objectives for the 2020–2022 Local Oral Health Plan.

Oral Health Advisory Committee

Fresno County implemented the Local Dental Pilot Project with the assistance of the Dental Transformation Initiative, which was led by California Department of Health Care Services.

While developing the partnership, the FCDPH subcontracted with two community-based organizations, the Fresno Economic Opportunities Commission (EOC) and Reading and Beyond (RAB), to strive to achieve the projected goals. The goals of the pilot project were to increase the numbers of enrolled dental providers in the Medi-Cal Dental Program and to improve access to dental services for Medi-Cal dental-eligible children through case management, care coordination and oral health education.

The OHAC’s mission is “to engage diverse community partners to share their expertise and recommendations, to leverage existing oral health programs and advocate for equitable reforms aiming to improve oral health for all residents in Fresno County.”

The OHAC identified multiple ways to support residents who face economic, cultural and language barriers: Fresno County has 13 school-based health centers (SBHCs), three of which provide preventive dental services and one that provides dental treatment services. There are also mobile vans that assist by offering preventive and treatment services.

Fresno City College provides allied health programs that include dental hygiene to assist with affordable dental hygiene services for patients. UCSF in Fresno offers a four-year oral maxillofacial residency program that treats a large volume of patients who need surgical procedures involving the mouth, head and neck.

Within Fresno County, there are also 22 federally qualified health centers that provide dental services. Fresno EOC and RAB have also increased their capacity to provide oral health services and have developed a partnership with Women, Infants and Children (WIC) and Head Start programs by integrating oral health education at many sites.

What are the community’s expectations?

Community members are pleading for Fresno County to continue these efforts to provide dental care. A pre-health graduate from Fresno State and former community health worker says that “Fresno has a major lack in dentists and only a few accept Medi-Cal.”

As a former community health worker, Alex B. mentioned that local dental care is not comprehensive. “Currently, Medi-Cal only allows you to receive services once a year and does not cover many procedures for adults.

“I would like to see a reform in Medi-Cal to provide more comprehensive care for children, adults and seniors. And more dentists accepting Medi-Cal to minimize health and dental inequalities among Fresno County.”

In addition, Alex B. called on Fresno County to improve its federally qualified community centers (FQCCs) and suggested that increasing the number of FQCCs would allow for more residents to receive dental care.

He also urged collaboration between the Fresno County Department of Public Health and the City of Fresno, stating that “there should be more dental offices and educational institutes to coordinate a plan that addresses the needs of Fresno County and the city of Fresno.

“I hope to see a potential dental school in the San Joaquin Valley to improve dental care [and] dental health literacy and local dental health workshops to help parents, young adults and seniors.”

As many advocate for an active dental scene in Fresno, it is important to urge the healthcare departments of Fresno County and California to engage with the community and develop reactive strategies to improve the dental health of Fresno County. The community can provide in the clearest of terms what needs to be done. Dental health is a right not an option.

Author

  • Juana Santana

    Juana Santana was born in Iztacalco, Mexico, and raised in Riverdale, Ga. She completed her undergraduate studies at Eastern Connecticut State University. She is now in her third year of the MFA program at Fresno State. She is currently an intern with the Community Alliance newspaper.

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