Louisville’s Home of the Innocents has been a vital part of the community’s social fabric for over 135 years, offering comprehensive services for children in need. In 2011, the organization started its Open Arms Children’s Health clinic, located at the Home of the Innocents’ campus east of downtown Louisville, and offering services in 10 different health care disciplines to children and families.
The Open Arms Children’s Health dental clinic is an important part of the Home of the Innocents’ mission and has filled in several gaps in Louisville’s oral health care safety net for children from at-risk groups.
KET producer Angelic Phelps recently visited the Open Arms Children’s Health dental clinic to learn more about its mission and services. This report is part of KET’s ongoing Inside Oral Health Care initiative, funded in part by the Foundation for a Healthy Kentucky.
According to Paul Robinson, President and CEO of the Home of the Innocents, Open Arms Children’s Health served over 3,900 patients in 2015 and is on pace to reach a new record of around 4,400 this year. These include children who live on campus but also those from outside in the surrounding communities. The dental office has a staff of 13 team members, including three dentists, one of those a pediatric dentist.
“The children that we serve are the ones who have difficulty finding access elsewhere,” he says. “We serve the children that are here underneath of our roof, children that have developmental challenges, children who have behavioral challenges, and children who just can’t be seen at traditional facilities elsewhere. We are able to serve them and they are able to fit and to find a place here with us.”
A Clinic Dedicated to Those with Special Needs
“What makes us a little different at Open Arms is that we tailor our approach and style to help soften the complexities of the children that are brought to us,” says Robinson. At the clinic, each child is treated according to his or her individual personality and background, whether they have a developmental disability or are from another underserved group.
“Some of our patients have special needs that require them to go through a process we call desensitization,” says Dr. Krysta Manning, DMD, who started working at the Open Arms clinic in 2014. “Desensitization is a checklist of 14 items that we move through to help a patient acclimate to the dental environment.”
The process begins with simply accompanying the child into the waiting room. Taking one step at a time, staff members then lead the child into the dentists’ office, have them sit in the dental chair, place a dental napkin on them, and guide them through the appointment. This gradual progression establishes familiarity for children who may have developmental disabilities such as autism and are very uncomfortable with trying a lot of new things at once, Manning says. She adds that using this approach works for roughly nine out of 10 children.
Another method the staff often uses is called “Tell Show Do.” Manning says that this is also very helpful with autistic children and those with similar developmental issues. With this method, Manning will show the child an unfamiliar tool such as a rotating bristle toothbrush used for cleaning, explain what it does and how it is used, and then touch the tool and let the child also touch it with their finger. After the child establishes a tactile sense of the toothbrush, Manning will begin cleaning.
For parents Amy and Charlie Svihilk, the Open Arms Children’s Health dental clinic is a godsend. Graham, their 8-year-old son, has autism and apraxia of speech, and usually relies on an iPad app to communicate. The staff at Open Arms uses desensitization and Tell Show Do to make routine checkups a calm and even appealing experience.
“Being a parent of a special needs child, it is hard to find health care providers who are able to understand Graham’s issues and understand that just because he can’t speak doesn’t mean he doesn’t have thoughts and feelings,” says Amy Svihilk. “This is a place where I know we can come, and it’s a monthly thing for Graham, and he looks forward to it.”
Serving a Growing Refugee Population
Robinson and Manning both point out that some of the patients most in need of dental health come from the refugee population in greater Louisville. To help treat them, “We provide translator services so that we are able to reach out and effectively communicate to refugees from 15 different countries, speaking 26 different languages,” Robinson says.
During KET’s visit, Dr. Manning welcomed a brother and sister from a family of refugees in for checkups. The adolescent boy used a wheelchair and was treated in an office accessible to those with disabilities, using a bean bag to accommodate his body frame once he lay down for dental cleaning. The boy has been coming to the Open Arms clinic for five years.
“When we see patients with special needs, we take the time,” Manning says. “We don’t rush anybody through quickly. I think what makes Open Arms different is that we seek out those patient populations and make it a point to help them.”
“The feedback we’ve received over the past five years from the families that we serve has been overwhelmingly positive,” Robinson adds. “They see the caring side of the staff, the wonderful facilities that they have access to, and they see the end result, which is a child who has been made to feel very comfortable with the procedures and get an end result of better oral health. The satisfaction is very high.”