Skippy+ and Beyond!

Tri-County Health Network’s Skippy dental program has grown up since we started our mobile, in-school services in 2008. Our original scope of work was to bring licensed dental hygienists into the school and let them work at the top of their licensure: cleaning, identifying potential cavities or other concerns, and educating the kids about how to take care of their teeth – including flossing! Over the years, our outcomes for this phase of Skippy was encouraging: Skippy reduced the number of kids who were not receiving oral health services by 50% and Skippy reduced the number of kids with untreated decay from 4.1% to 1.6%.

Unfortunately, we also established that there were many kids that were identified with potential concerns but still not seeing a dentist outside of Skippy. Our Skippy navigators reached out to the parents of these kids to pinpoint barriers including lack of dental insurance, transportation or finding a dentist that takes Medicaid or CHP+ and then making appropriate referrals. But these kids continued to return to Skippy and their previously identified cavities had migrated to other teeth. Now instead of one tooth with a cavity they might have two or three. Our program staff was concerned about these kids and we began to seek ways to expand the Skippy program.

Fast forward to 2016 and the roll out of Skippy+.

To take care of the kids whose parents are not able to get them into a dentist for follow up care we partnered with Caring for Colorado Foundation, and suggested a plan to expand our Skippy services to include review of the initial exam by a dentist, x-rays, and restorative care, including interim therapeutic restoration that will decrease pain and prevent spreading until the cavity is filled.

Now, our hygienists take x-rays, pictures of the mouth and communicate their notes with a “virtual” dentist — Meaning, all clinical notes, charts, x-rays and images are sent electronically to our off-site dentist. The dentist then reviews the notes and x-rays and develops a treatment plan that is put into place prior to the Skippy+ clinic on the following morning. Hygienists then know which students need follow up care and can place interim therapeutic restorations (ITRs) to help stop the pain and further decay of the tooth. The coolest part of this Virtual Dental Home model is that rather than refer the child out to a regional dentist to fix those cavities, we can provide another option, in the same chair. At a later date, maybe later that month, our Dentist comes back to the school and fixes the cavities that were lingering in that child’s mouth. For some, this may not be necessary since they have a dentist they see regularly. In that case, we can send over the x-rays, images and clinical notes to the provider of choice. Talk about collaboration!

Thanks to Skippy+ and this new Virtual Dental Home model, students who are unable to see a dentist regularly can do so right in their school. Families who are unable to travel to Montrose for a check-up, fillings or more, can now do so right from their school.

Another win worth mentioning! Our previous incarnation of Skippy treated children ages 0-14, however, we realize that your child’s dental needs do not end at age 14. So we are now offering Skippy+ to kids in Preschool through High School!

Skippy+ clinics are currently in process. See for a current Skippy+ schedule or to download a Skippy Consent Form, if you did not receive one from your child’s school. Make sure you return the form to your child’s front office at least two weeks before the clinic. And don’t forget, Skippy+ clinics take place in the Fall and the Spring – one Consent Form is good for the entire school year.

If you would like to bring Skippy+ to your school please call Erich at 970-708-7096!

— Contributed by Erich Lange, Community Engagement Supervisor — and all things SKIPPY!

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