'I've Seen Babies With Every Single Tooth Decayed'

A dental hygienist talks about work on the front lines of children’s health

'I've Seen Babies With Every Single Tooth Decayed'

Jackie Ventura loves working on people’s teeth. Because October is National Dental Hygienist Month, this is a good time to highlight the work of one hygienist and the impact she has on families and communities.  

As a public health hygienist in Massachusetts, the 51-year-old may spend her day in an elementary school, giving 10 kids a good cleaning and teaching them how to care for their teeth. She will visit a Head Start program, where she’ll see a 3-year-old who’s getting dental care for the first time—and treat the parents as well. At a homeless shelter, she helps restore confidence to those down on their luck by polishing up their smiles.

Ventura began in dental hygiene in the U.S. Navy, first on active duty for five years, then in the reserves for three. When she got her private license in 2004, she began to work with lower-income families. She had a great job in a private practice, with good benefits close to her home. Then, Ventura saw a newspaper article about a public health program for hygienists that could help families “increase their dental IQ.” She knew about the tremendous need for dental care in her communities, applied for a grant, and trained to become a public health dental hygienist. As the name implies, this practitioner works primarily in public health settings—schools, community centers, long-term care facilities—and has a collaborative agreement with a licensed dentist in Massachusetts.

Often on the road, Ventura travels from town to town in southwestern Massachusetts with her portable dental operation, which includes a dental chair, a 50-pound compressor, a sterilizer for the instruments, and a stool. She treats patients who have Medicaid, private insurance, or no insurance at all. She can perform a screening, complete a cleaning, and apply sealants and fluoride treatment in 30 minutes, so her patients “won’t miss a lot of work, or in some cases a paycheck.”

In the six years she’s worked in these communities, “I’ve established an efficient routine,” she says.

Though the work is rewarding, Ventura has a tough job. She sees rampant tooth decay “on a daily basis.” Some infections go untreated and spread.  When a tooth needs to be extracted or an infection treated, Ventura helps connect the child with a dentist. “I have patients who need to be seen by dentists, but often we have a hard time finding one, depending on where the child lives. When this happens, I get on the phone and call around the area I am in and get names of providers because I can’t provide the services.”

While it is not technically part of her job, Ventura works directly with providers to find those who will accept her patients’ insurance—or in some cases, perform services for free. It’s not an easy task. Dentists frequently change insurance carriers, and many in the commonwealth choose not to accept MassHealth, the state’s Medicaid and children’s health insurance program.

Ventura supports a proposal considered by the Massachusetts Legislature that would allow dentists to hire dental therapists, because she wishes she could get advanced training and perform more dental tasks. As a hygienist, she can’t extract a painful tooth, fill a cavity, or treat an abscess, an infection caused by severe tooth decay. “If I could provide some of these services myself, it would change everything,” she says. “If I could do restorative care, I could keep kids out of pain. I could keep them comfortable.”

Some children, she says, think it’s normal to feel pain due to tooth decay because they’ve never known anything else.

“I’ve seen babies with every single tooth decayed,” she says. “Lots of parents are under the impression they don’t need to bring their children to the dentist until age 3. But by then, primary teeth have already erupted, and in some cases it is too late to treat the extensive decay.”   

With 30 years of dental hygiene practice under her belt, Ventura shows no sign of slowing down. She has been nominated as Dental Hygienist of the Year by the Yankee Dental Congress and chairs the Council on Public Health of the Massachusetts Dental Hygienist Association.

“I never consider it work,” Ventura says of her chosen profession. “I love helping the families.”

States Expand the Use of Dental Therapy
States Expand the Use of Dental Therapy
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States Expand the Use of Dental Therapy

Access to care increases when dentists are authorized to hire midlevel providers

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Dental therapists—midlevel providers similar to physician assistants in medicine—deliver preventive and routine restorative care, such as filling cavities, placing temporary crowns, and extracting badly diseased or loose teeth. As states grapple with provider shortages, especially to serve vulnerable populations, a handful have acted to allow dentists to hire these practitioners, and many others are exploring the option. Dental therapists also practice in several tribal communities, where access to care can be especially limited.