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White Mountain Pediatrics - Lakeside, AZ
Program Description
 
 
Preceptorship Recipient:
2006


Site Contact:
Edith Bailey, MD
dredith@frontiernet.net

Preceptor:
Todd Hartsfield, DDS
Todd.Hartsfield@itcaonline.com
Our community is rural, the population of the 3 nearest cities (Show Low, Lakeside, and Pinetop) was roughly 18,000 with a draw area of 50,000. Our draw area is from the lower portion of Navajo County, Apache County, and western New Mexico. Navapache Regional Medical Center is the only non-IHS hospital in either Navajo or Apache Counties that has obstetrical services. We had over 1000 babies born there in 2005. This is one of the older areas of settlement in the state. There are Apache and Navajo towns in the area. Show Low, Lakeside, and Pinetop abut the Fort Defiance Apache Reservation. Our primary industries are tourism, ranching, TEP expansion in Apache County, healthcare, and education.
Preceptor
 
Todd Hartsfield, MD has been a dentist for 34 years. He spent 2 years as a dentist in the U.S. Army and had a full time family dental practice for 9 years in Louisiana. For 20 years he worked in children's dental public health programs in Canada with the First Nations and Inuit people. Dr Hartsfield became the Dental Director at the Inter Tribal Council of Arizona in October 2001. His focus is on early intervention with American Indian children and their caregivers to prevent dental disease. He travels to Indian reservations throughout Arizona to coordinate dental care for children and adults. He has trained numerous local tribal nurses, medical assistants, and parents to perform regular oral health risk assessments on the children on these reservations. He has also established fluoride varnish and xylitol chewing gum programs in which local, non-dental personnel on the reservations are trained in applying fluoride varnish and treat children in programs such as Head Start. According to Keith Dveirin, MD, Clara Vista Medical Associates, Dr Hartsfield is an excellent preceptor for this type of training, and one that the national AAP or other state AAP chapters may want to consider using in the future. Dr Hartsfield has extensive experience in the use of fluoride varnish and in the education of non-dental personnel in doing oral health assessments and recognizing early signs of dental decay. He has worked extensively in public health dentistry, both in the United States and Canada, as well as in private practice general dentistry. He brings a passion to this subject that is infectious and helps make him a great presenter.
 
Training Day    
Dr Hartsfield presented information about the use of dental varnishes to me, the nurse practitioner, and the staff. He covered the positioning of the patient, the application technique, and the after care. He provided information about risk assessment and the recommended frequency of varnish application. Other topics addressed were risk reduction for preterm birth by rigorous dental care of pregnant mothers and risk reduction for infants prior to dental eruption by rigorous maternal dental care. We also discussed the CDC statement against the use of supplemental fluoride in fluoride poor areas.    
Next Steps    
I have begun using the dental varnishes in those patients who wish it. It would be helpful if the insurance plans would cover this since I live in a very poor area of the country and most of my parents can't afford to pay for the varnishes. I regularly discuss dental care and give parents the risk assessment tool that Dr Hartsfield developed for the tribe. I discuss using this tool to reduce the risk of decay in my patients. Dr Hartsfield and I have discussed (and plan to implement) a dental care/varnish information booth at the next annual health fair and bike rodeo to be held in May of 2007.    
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