Dental and Mental Health

BCBSMT Awards $250,000 in Healthy Kids, Healthy Families® Grants

POPLAR—Joseph Erickson, 12, eases into the padded chair in the Poplar Elementary School dental screening room and fiddles with the overhead light, pulling it down to within inches of his face to hide his mischievous smile.

Dental hygienist Jenny Tolman allows Erickson a fleeting moment of fun before she begins the first of several in-school dental screenings on a cold, February Monday afternoon.

The screenings are part of the Fort Peck Tribes’ Health Promotion Disease Prevention (HD/HP) program, a unique tribally operated initiative to restore the traditional values of the Assiniboine and Sioux Tribes and help tribal communities become healthier.

“This program has allowed the Tribes to take matters into our own hands,” said Kenny Smoker, health program specialist for the Fort Peck Reservation and one of the leaders behind this successful movement. “The success of this program is based on the commitment of the Tribes to create positive health outcomes for our people. It may take a couple generations.”

In time, Smoker and others with the HP/DP program—such as former Indian Health Services Administrator Duane Jeanotte—hope their focus on wellness, particularly for children, can become a model for other Indian reservations in Montana who face similar challenges.

“Over the long run, this will do a lot to improve the overall health around here,” Jeanotte said. “The school-based health program isn’t big in Montana at all. Where it needs to happen in Montana is on the reservations.”

Blue Cross and Blue Shield of Montana (BCBSMT) in February donated $50,000 to the Tribes to help purchase new dental screening equipment for children in Brockton, Frazier, Poplar and eventually in Wolf Point. What she’s learned, she said, is that you can’t assume a child has toothpaste at home, or that the one toothbrush a child brings home isn’t shared by several family members because it’s the only one in the home.

“Every week I come here is a different experience,” she said. “It’s a learning curve. It’s unique for each person. I’m starting to see a bigger picture than just the dental treatment plan.”

Posselt and Tolman, the dental hygienist at Poplar Elementary, are part of a team of hygienists and dentist consultants who provide treatment for children in Poplar, Brockton and Frazier. In 2014, 766 children and adolescents were served at the school-based clinics. Approximately 63 percent of the students screened showed signs of tooth decay.

In the program’s first three years, just four children received the full spectrum of dental care, from basic screening all the way through comprehensive treatment, such as fillings or extraction. Now that number has jumped to 150 kids, causing even Posselt to flash her beaming smile.

Mental Health Care

The HP/DP program also employs Janet Erickson, a psychiatric mental health nurse practitioner who completes the Fort Peck Tribes’ 360-degree approach to bringing health, dental and behavioral professionals together with family members to manage care one child at a time.

The holistic approach is helping the Tribes combat a growing health concern on the Fort Peck Reservation, where the average life expectancy for an American Indian is 59 years compared to 78 years for a non-American Indian in Montana.

Dr. Roman Hendrickson is a physician at the Ruby Valley Clinic in Sheridan who has practiced family medicine for the past 35 years. Hendrickson, a member of the Blue Cross and Blue Shield of Montana Affiliate Board, routinely travels the 520 miles to Poplar to provide care on the Fort Peck Tribes.

“Receiving the proper dental care as a child has a big effect on long-term mental, physical and spiritual health,” Hendrickson said. “I see firsthand the positive impact that this program is having on our youth there.”

Candice Lindh, a dental hygienist from Bozeman who with Posselt and Barbara Bakwin of Bozeman practices for the HP/DP program, sees the potential for other Indian reservations in Montana to adopt similar programs.

“We’d love to take this model, pick it up and move it to other reservations who want to model their school-based health systems on what is successful here,” Lindh said.

Smoker, Jeanotte and the HP/DP team are seeing steady results in the form of better awareness of dental and health care, improved self-esteem among children and a community coming together centered on tradition.

“The biggest thing is creating an understanding,” Smoker said. “We need to do a lot more of getting them into a healthy lifestyle. Everything we do is looking at creating a sustainable program. It’s an uphill battle, but I think over time we’re going to do it.”