Tompkins County health staff propose mobile dental-hygienist program to reduce pediatric access gaps

Sigrid, a presenter for Tompkins County’s public-health team, told the Board of Health that a 2024 oral-health survey of schoolchildren and caregivers found about 58% of respondents reported a dental visit within six months, 24% reported a visit within six to 12 months, and 18% reported a visit a year or longer. She said roughly 43% of caregivers report traveling outside Tompkins County — most frequently to Binghamton, about an hour away — to receive dental care for their children.

Sigrid said qualitative interviews with parents identified consistent barriers: missed wages from taking time off work, difficulty scheduling appointments, insurance costs and transportation. Most parents who were interviewed were positive about a mobile or portable dental clinic as a way to reduce travel burdens.

To illustrate a working model, staff summarized Tioga County’s Tioga Smiles mobile program. The presenters said Tioga’s recent output included about 1,227 dental exams, roughly 540 sealants and 325 newly enrolled dental clients in 2024. Financial data shared by Tioga Smiles listed a county contribution of $115,000 and revenue of $133,000 for 2024; the transcript lists "total expenses for 2024 was 248" but does not specify units in the record provided to the board.

Drawing on those comparisons, Sigrid and colleagues (PK and Rachel) proposed beginning with a mobile dental-hygienist model in Tompkins County focused on preventive services (exams, cleanings and sealants), oral-health education in schools, and a coordinated referral process to connect children needing further care with dentists. The presenters emphasized starting small — for example, using portable equipment or a staff hygienist who travels between schools — with the option to scale to a dedicated mobile unit if demand and funding support it.

Board members asked about grant opportunities, equipment costs and whether education and take-home supplies (toothbrushes, toothpaste) would accompany clinic visits. Staff noted school nurses already provide some education and distribution of supplies when available and said a proposal would include an education component. Board discussion also flagged long appointment wait times in existing clinics: staff reported anecdotal parent reports of waits of six months to a year for pediatric dental appointments.

Presenters acknowledged county-level surveillance data are limited; New York State’s most recent statewide third-grade screening data cited by staff dates from 2017. To better estimate local need and program impact, the board discussed pursuing Medicaid emergency-department admission data (SPARKS), primary-care provider diagnosis pulls, and school-based screening additions to capture dental-related ED visits and absences.

Sigrid said staff will develop a formal business plan that outlines startup and operational costs, equipment and maintenance needs, staffing hours, the number of schools to serve and potential county cost-share, and will return with cost estimates and funding options. Board members offered to share grant leads and local contacts to support planning.

The presentation and discussion produced no formal vote; staff will prepare a business plan and funding research for future board consideration.