Since it was founded in 1996, Mira Consulting, Inc. has been the state’s most visible and effective provider of school-based oral health care. Mira partners with schools throughout New Mexico to deliver dental health care to the uninsured, underinsured, and Medicaid-eligible children in school-based, portable dental clinics and in our Safety Net Dental Clinic. Through our school-based programs and clinic, Mira has treated more than 130,000 at-risk children. Many of these children had received no dental care in their lives before Mira provided them with safe, comprehensive dental care.  

This is so important because, while the dental health of affluent children has risen over the past decade, that of racial/ethnic minorities and lower income children is in crisis nationally.

 

“A silent epidemic of oral diseases is affecting our most vulnerable citizens—poor children, the elderly, and many members of racial and ethnic minority groups.”
— Office of the U.S. Surgeon General A National Call to Action

Consider these startling facts:

  • An estimated 51 million school hours per year are lost because of dental-related illness.
  • Minority children and children from low-income families and communities had nearly 12 times as many days of missed school because of dental problems as did children from families and communities with higher incomes.  
  • 80% of caries (cavities) occur in only 25% of the children, with higher rates found in low-income populations and certain ethnic groups.
  • Rampant decay in young children’s teeth often requires treatment in a hospital setting under general anesthesia, which not only increases the risk for the child but adds to the high cost of treating early childhood tooth decay.
  • 30% of all children’s health expenditures are devoted to dental care. Although most dental diseases are preventable, many children unnecessarily suffer the consequences of dental diseases because of inadequate home care and inability to access preventive and treatment services in a timely manner.
  • Lack of continuous insurance coverage is a problem for many children and adults. Nationally, nearly 36% of all children lack dental insurance coverage. For every person without health insurance coverage, there are as many as 2.3 persons without dental health insurance.
  • Although the Academy of Pediatric Dentistry recommends children have their first dental visit by age 1, very few children in this age group are seen by a dental provider.
  • In New Mexico, children suffer rates of dental disease far exceeding the national average.
  • Ultimately, a child with poor oral health will likely face health problems later in life.

Mira believes that all New Mexicans should have the opportunity to attain their full health potential. No one should be disadvantaged from achieving this potential because of their socioeconomic position or racial/ethnic group. As stakeholders, we affirm that oral health is essential to general health and well-being and are dedicated to increasing access to care for all citizens.  


Best Practices

Mira’s school-based oral health program is a proven model based on best practices as identified by the Association of State and Territorial Dental Directors  (ASTDD), the Centers for Disease Control and Prevention (CDC), the American Dental Association (ADA), the American Academy of Pediatric Dentistry (AAPD), and the American Dental Hygienists’ Association (ADHA).

Our commitment to best practices means that Mira continually assesses our service delivery processes and procedures to ensure that we incorporate the most current, evidence-based preventive and restorative dental protocols.


Public-Private Collaborations

In the spring of 2003 the Office of the US Surgeon General published its landmark report: A National Call to Action to Promote Oral Health. The report states that no less than a “silent epidemic of oral diseases is affecting our most vulnerable citizens—poor children, the elderly, and many members of racial and ethnic minority groups.” 

The report called upon policymakers, community leaders, private industry, health professionals, the media, and the public to affirm that oral health is essential to general health and well-being and to take action. No one should suffer from oral diseases or conditions that can be effectively prevented and treated. 

The report recognizes that the private sector and public sector each has unique characteristics and strengths. Linking the two can result in a creative synergy capitalizing on the talent and resources of each partner. However efforts are needed within each sector to increase the capacity for program development, for building partnerships, and for leveraging programs to ensure that all sectors of society--the public, private practitioners, and federal and state government personnel--have sufficient knowledge, expertise, and resources to design, implement, and monitor oral health programs.

The appeal for organizations to take action has been accepted. Mira, the New Mexico Office of Oral Health, and Community Dental Services have joined in a private/public collaboration to realize the primary goal identified in the report: increasing access to oral health care.

Our collaboration reflects the partnership of public and private organizations that have a shared vision and goals. Each organization recognizes that bringing their expertise and experience to enrich the partnership will help to accelerate a movement to enhance the oral and general health and well-being of not just New Mexicans but all Americans.


Services Provided

Mira’s school-based program offers comprehensive preventive and restorative dental services:

“Although dental problems don’t command the instant fears associated with low birth weight, fetal death or cholera, they do have the consequences of wearing down the stamina of children and defeating their ambition. They go to sleep with it. They go to school with it. Sometimes their teachers are alarmed and try to get them to a clinic. But it is all so slow and heavily encumbered with red tape and waiting lists that dental care is often long delayed.
Children live for months with pain that grown-ups would find unendurable. The gradual attrition of accepted pain erodes their energy and aspirations…to me, most shocking is to see a child with an abscess that has been inflamed for weeks that he has simply lived with and accepts as part of the routine of life.”
— Jonathan Kozol, Savage Inequalities: Children in America’s Schools
  • Comprehensive dental exam. During a comprehensive examination, the dentist will look at much more than just problems with teeth. The dentist will check other areas inside and outside of the mouth for signs of disease or other problems. All this information is thoroughly recorded on the patient’s chart.

  • Digital x-rays. Decay is often overlooked when only a visual exam is performed. Digital x-rays help the dentist detect interproximal (between the teeth) decay.

  • Comprehensive dental cleaning. Subgingival scaling (which can only be provided by a licensed dentist or licensed hygienist) is crucial to preventing and treating periodontal disease. Mira only uses Dental Hygienist to provide cleanings. Without a comprehensive cleaning students are left vulnerable to further oral health problems.

  • Dental sealants. Sealants are highly effective in preventing caries but can only be effective if they are retained on the tooth surface. While more costly to provide, Mira utilizes four-handed technique (a Dental Hygienist and a Dental Assistant) to provide dental sealants. Numerous studies have shown that a four-handed technique optimizes retention rates, thereby ensuring long-term protection against caries development.

  • Fluoride varnishes. These are safe, easy to apply and well accepted by patients. Many studies show that fluoride varnish offers an efficient, nonsurgical alternative for the treatment of decay in children.

  • Dental home. Mira’s full treatment dental clinic serves as a dental home for many of the children who are seen in our school-based dental program. A dental home is the ongoing relationship between the dentist and the patient and includes all aspects of oral health care delivered in a comprehensive, continuously accessible, coordinated, and family-centered way.

    In those cases when Mira’s clinic cannot serve as the permanent dental home for the patient, they are referred to one of our community partners/co-providers. As part of our case management process, Mira ensures that all students have access to ongoing dental care.

  • Restorative services. Mira can provide restorative services for communities that have limited access to ongoing dental care.

  • Data Collection. Mira utilizes a proprietary database to track a number of variables including: participation rates, treatment history, retention rates, and decay rates. This allows us to continually monitor our success and modify our service deliver methodologies to better achieve our goals.

“We believe that all New Mexicans should have the opportunity to attain their full health potential. No one should be disadvantaged from achieving this potential because of their socio-economic position or racial/ethnic origins. As stakeholders, we affirm that oral health is essential to general health and well-being and are dedicated to increasing access to care for all citizens.”