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Terri Chandler, RDH

Founder and executive director, Future Smiles

“If you think you want to launch a nonprofit, take adult education classes to learn about nonprofit management and grant writing. This way, you’ll be much more effective at fundraising.”

Tooth decay is one of the most common chronic diseases of childhood. Children and teens from low-income families are more vulnerable. These kids are twice as likely to have cavities as children from higher-income households.  Since 2009, Future Smiles’ programs have provided vital dental health services to 150,000 needy children throughout Nevada. 

The problem I’m trying to solve

I’m committed to finding equitable ways to deliver dental health care to all children that’s affordable, accessible and accountable. Tooth decay may seem like a minor disease, but it can result in serious issues, including tooth loss, trouble eating a healthy diet and even possible death from an infection. A child with dental problems may also have anxiety, fatigue, irritability and depression, causing them to withdraw from normal childhood activities and diminish their ability to learn in the classroom. This has only worsened during the COVID-19 pandemic, especially in impoverished neighborhoods where you have to travel to get to a dentist. It breaks my heart. All kids have the right to live a life with healthy teeth that are free from dental pain.

One way to reduce cavities in kids is to apply sealants — a type of thin protective plastic coating — to their teeth. This process can prevent over 80 percent of all cavities. But most children don’t have sealants, especially kids from low-income families. Our mobile School-Based Sealant Program goes directly to where children are most frequently — our public schools. This removes transportation barriers and avoids lost school time.

The moment that sparked my passion

As a dental hygienist, I have always been deeply troubled by the idea of children suffering in silence from nightly toothaches left untreated. Once I graduated from dental hygiene school, I split my time between private practice and public health and worked to get fluoridated water into southern Nevada to help fight tooth decay.

In 2009, Nevada nonprofit Communities In Schools (CIS) created a school-based health center where there was an empty dentist chair. CIS wanted to start a dental program and hire a dentist, but they had no funding secured. I asked CIS, “What about a dental hygiene program?” CIS replied, “If you can do that, it’s yours.” I went home and told my husband I wanted to quit my job. The next day I gave my two-week notice and started grant writing. Four months later, I was seeing kids at that exact same health center.

What I wish other people knew

An astonishing 80 percent of our new patients report that they haven’t seen a dentist in more than five years, or at all. Dental health matters. Your mouth is an integral part of your body that supports essential human functions like eating and speaking. I’ve heard stories of children as young as 5 years old trying to eat lunch and crying from the pain because every tooth is decayed. If this type of pain were associated with any other health condition, there would be studies to find a solution. Instead, victims of dental disease learn to live with the pain. This only worsened during the COVID-19 pandemic, since so many kids were at home and snacked constantly.

Why my approach is unique

Historically, school sealant programs focus on education and prevention of dental disease. But it’s not just about repairing one tooth or several teeth; it’s about providing comprehensive dental care. We have a care manager who identifies children who have critical dental needs, and we refer them to our free dental care facility. It provides essential dental services — like X-rays, dental cleanings, extractions and fillings.

It’s imperative that we go beyond emergency short-term fixes to be more holistic in our approach addressing all dental needs.

Advice to others who want to make a difference

I’m a big believer in lifelong learning. If you think you want to launch a nonprofit, take adult education classes to learn about nonprofit management and grant writing. This way, you’ll be much more effective at fundraising.

Listen also to your community partners. When I did, it became apparent to me early on that we needed to find a way to provide kids with comprehensive dental services. The first few years, we just referred kids who needed more than just sealants to private practices, but it wasn’t enough. We were able to get a grant to create our own facility to provide free comprehensive dental care, the Nevada Women’s Philanthropy Dental Wellness Center. This allowed us to see over 1,500 kids during the COVID-19 pandemic that we wouldn’t have been able to see with schools closed. Of all those children, two-thirds had no dental insurance, meaning they would have gone without dental care.