By Sean Bailey

Staff Writer

Knox Central High School is more or less like any other public high school in rural Americ — except, of course, for the distinctive whir of dental equipment heard behind the doors of Room 116B, the school’s dentist office, every Friday.



And though the sounds and thought of visiting a dentist can be intimidating, there are always students willing — and in need enough — to slip into the dentist chair to ensure the future of their teeth.

“You would think, I would think, you wouldn’t be able to get a lot of (dental) work done, because here they are without a parent,” Dr. Stephen Bryson said after treating a patient at Knox Central. “But it’s amazing how little students refuse treatment. They understand the need and they are very appreciative. A lot are apprehensive and scared, but they get the treatment.”

Bryson donates many of his Fridays to treat students at Knox Central’s Kid’s First Dental Care program. He’s been donating his time for two school years now, driving from his private practice in Harlan to Barbourville to treat students who might never have the opportunity to visit a dentist if it wasn’t for Kid’s First Dental Care.

Kid’s First Dental Care treatment center at Knox Central is the result of several years of collaboration between Barbourville dentist Dr. Edwin E. Smith and Knox Central’s youth resource center coordinator Kevin Buchanan.

When Buchanan first took the job as youth resource center coordinator in the 1990s, the life-long Knox Countian saw the great number of oral health problems that the school nurse had to deal with.

Some of the students live out in the remote hills of the county, and their parents have no means to transport them to a dentist.

Put simply, Buchanan’s job is to remove barriers that block students from being successful — so he began to transport students who needed dental attention to Dr. Smith’s practice in Barbourville. Eventually, Smith moved some dental equipment he had in storage to Knox Central High School and the treatment center, formerly a small office, was born.

“It takes care of two problems,” Buchanan says of the treatment center. “The transportation issue and the attendance issue. The students are not counted absent while they are here at school. If a kid leaves school for the dentist, they could be gone maybe the whole day. We’re eliminating that issue.”

The treatment center at Knox Central targets seniors who are on their last few months of Medicaid benefits. In Knox County, about 75 to 80 percent of children qualify for Medicaid coverage, but that coverage usually is cut when a child turns 18 and becomes a legal adult.

After a student turns 18 and graduates, he might not be able to get a job that has dental benefits — if his dental situation doesn’t prevent him from getting a job in the first place.

“We don’t want our students to lose their employability,” Buchanan said. “And if you are toothless, not many people want that in their business.”

Knox Central’s treatment center can do just about any dental service a regular dentist’s office can preform, Buchanan said, but the center stops short of performing invasive services like tooth extraction.

The treatment center receives its funding through Medicaid reimbursements for the services performed. But Dr. Smith says around 25 percent of the center’s work isn’t reimbursed by anyone.

Treating seniors at Knox Central is far from the only work Kid’s First Dental does. Buchanan said the treatment center at Knox Central was a pilot program for Kid’s First Dental mobile dentistry program.

The mobile dentistry unit has been featured in the New York Times and most recently on a Diane Sawyer 20/20 special about poverty in Appalachia. The unit visits schools in the region providing young students with dental evaluation and in some cases dental work.

During the special, Dr. Smith talked about what he and other doctors around the area call “Mountain Dew Mouth.” Smith said that much of the dental problems he sees in students are caused by the sugary drink’s penchant to cause tooth decay. A short time after the 20/20 special aired, Pepsi Co., Mountain Dew’s producer, announced it would help recruit dentists and pay for a second mobile dentistry van.

Besides treating seniors and reaching out into the community with the mobile unit, Kid’s First Dentistry is in the business of preventing dental problems in children.

“We’re doing a two prong approach, I guess you could say,” Dr. Smith says. “We try to provide preventative care and education to all school kids, pre-school right through high school.”

With the help of University of Kentucky, Kentucky Area Health Education Centers (AHEC), Kid’s First Dental has programs in Knox County elementary schools that organizers hope will prevent students from having to use the treatment center when they reach high school.

“If we effect enough in the early grades — we want children to grow up without tooth decay,” Smith said. “And then we will not have a need for this treatment center.”

Both Smith and Buchanan said they have no reservations about “working themselves out of a job” when it comes to preventing dental problems in Knox County’s youth. But Knox County, Buchanan says, is just the start.

“It’s not just here,” Buchanan said. “It’s not just Knox Central. You know, I’m not the one to say how far out this reaches, but it’s definitely a problem in East Kentucky.

“It’s hard to tell how many kids in Kentucky are sitting in a classroom right now, not able to concentrate because of an abscess tooth.”

For more information on Kid’s First Dental visit www.kidsfirstdental.org