Ms. Smith was enjoying substituting for the regular fourth grade teacher who was off on medical leave. If only, she could figure out Michael's behavior. A quiet and generally cooperative 10 year old - except for the paper spitball problems. No sooner would she start writing on the whiteboard or working with another student, and there would be a complaint about Michael and the spitballs from the girls sitting around him. Ms. Smith had asked him to stop for three days so far without success. Finally, the next morning, Ms. Smith asked Michael to come and talk with her. She asked: why do you continue to throw the wet spitballs around your desk after I've asked you not to? Michael looked embarrassed but said: my teeth hurt really bad and chewing on the paper helps make them hurt less. Ms. Smith thanked Michael and called his mother to check on when he had last been to the dentist. He had never been due to the dentist due to the expense. Ms. Smith was able to make arrangements with the community sliding fee scale dental clinic to see Michael and take care of the caries in his teeth. Sheila was at the community health center for her first visit with the obstetrician. She was excited to find herself pregnant as was her husband. Both of them were 25 years old and anxious to start a family. Fortunately, Sheila was able to qualify for the Prenatal Package at the health center. During her assessment, Dr. Rios asked her about her last dental cleaning and check-up. Sheila looked confused, but replied that her teeth were fine, but she had never been to the dentist before. In fact, no members of her family went to the dentist on a regular basis. They had no dental insurance and only sought out dental care if someone had a toothache that did not go away. Dr. Rios took the opportunity to talk with her about the risk of prematurity and gestational diabetes in mothers with poor or no oral health care. Dr. Rios referred her to the county health department's prenatal dental program to assure that she would have her teeth cleaned as well as would receive education on caring for the needed oral health of her unborn child as well.
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