A Head Start on Oral Health

Risha De Leon, DI16, sets out to improve the well-being of a community of children
Risha De Leon
Risha DeLeon, DI16, MPH16, worked with preschoolers at Head Start in Boston’s Chinatown. Photo: Matthew Healey
October 31, 2016

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Children attending Massachusetts’ Head Start programs have more cavities than other Bay State kids the same age, even though every Head Start child receives free dental screenings. Risha M. De Leon, DI16, MPH16, wants to change that.

She spent much of the last year getting to know the teachers and the children and their families in the Action for Boston Community Development (ABCD) Chinese Church’s Head Start program, just down the street from Tufts’ health sciences campus in Boston. De Leon created a survey to gauge the emphasis parents of children in the program put on oral health and dental care.

Their responses, she hopes, will point to interventions that could improve overall oral health in Chinatown. She’s doing the work for her Schweitzer Fellowship, which supports students across the country in developing sustainable programs that improve the health and well-being of people in underserved communities.

Poor children often have more cavities than their wealthier counterparts. Based on mandatory screenings at the 45 Head Start programs in Greater Boston, the Massachusetts Department of Public Health found that more than a third of the 3- to 5-year-olds who participate in Head Start have cavities. That’s compared to 28 percent of children in that age group throughout Massachusetts. (The screenings are supported by the DentaQuest Foundation.)

Research suggests the disparity is primarily because low-income people either can’t afford dental care or simply find it too difficult to get to the dentist. But neither of those explanations fits the Asian-Americans, often new immigrants, who use the ABCD Chinese Church Head Start.

These families are usually covered by MassHealth, says De Leon, and many live within walking distance of the Tufts dental clinics. De Leon wants to figure out why children in this community still have higher rates of decay, even though they do not face traditional barriers to care.

Although her analysis isn’t completed, it appears that language barriers may be a big hurdle.

De Leon also says the community does not have enough knowledge about the importance of oral health care. Few parents realize they should bring their children to the dentist as early as age 1. De Leon figured that out pretty quickly at her initial meetings with the Head Start children. Wearing her light blue scrubs, she asked the preschoolers what they thought her uniform signified.

“They thought I was a mailman,” she says, laughing.

De Leon is developing basic oral health education seminars for the Head Start community, working with the dental school’s pediatrics department to establish presentations by a pediatric resident to the parents.

Building bonds between the school and the people of Chinatown was absolutely essential to success in this kind of public health arena, says De Leon. “If you want to do good community-based research, the key thing is having a good relationship,” she says.

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