Several philanthropies are pouring millions of dollars into dental care for working class and low-income Minnesota families, seeking to give poor kids the kind of healthy smile that will boost self-esteem and ease entry into the workforce.

The Delta Dental of Minnesota Foundation has given $25 million to expand dental offices for low-income clients, fund education and tooth sealant programs and provide dental treatment for the needy.

The Otto Bremer Trust has awarded nearly $6 million in grants since 2013 for public education campaigns, dental equipment, office expansions and mobile clinics. Four of the state’s Initiative Foundations have launched or expanded Early Childhood Dental Networks in nearly 50 Minnesota counties.

“If you don’t have a healthy mouth, you don’t have a healthy body,” said Diane Benjamin, an Otto Bremer senior program director. “It impacts heart disease, low birth weight. It can cause life-threatening infection. It causes children to miss days of school and impacts learning.

“If you open your mouth and you are missing teeth, it’s hard to get hired.”

One of the biggest hurdles facing low-income residents seeking dental care is access, said Joseph Lally, executive director of the Delta Foundation.

State lags in payments

Minnesota’s reimbursement rates for dental care for welfare clients are some of the lowest in the nation, prompting many dentists to limit the number of low-income patients they take. Only 37 percent of children on medical assistance in Minnesota received preventive dental care in 2015, well below the national figure of 46 percent.

The Delta Foundation has donated $4.6 million for a larger, state-of-the art dental clinic now under construction at Hennepin County Medical Center that will accommodate 27,500 visits a year, including patients on public assistance.

It also gave $1 million to the Maplewood-based nonprofit Community Dental Care for their fifth clinic, in Rochester; Otto Bremer gave the clinic $450,000.

“It blew us away, showing the commitment to increase access to dental care and making sure people have a place to go,” said Crystal Yang, development coordinator for Community Dental Care.

Community Dental last year treated 46,000 patients at its clinics, 83 percent of whom were on public programs and 8 percent uninsured, Yang said. The new clinic will allow them to add as many as 10,000 patients and cut the wait time at their other Rochester location from seven to three months.

“It’s not very glamorous grant making, buying an X-ray machine or a second instrument sterilizer, but there is a long-term payoff,” Benjamin said.

Tooth decay can start before kids are even walking. A baby’s cute new toothy smile is marinating in sugar and susceptible to decay if he takes bottles of milk or juice at bedtime, a message that the state’s Early Childhood Dental Networks are delivering to new parents.

West Central Initiative started the first network in 2005, working through schools, nonprofits and public health departments to teach parents and kids about the importance of early dental care. It has helped more than 13,000 children, age 5 and under, receive dental checkups.

At the urging of the Otto Bremer Trust, three other Initiative Foundations started early childhood dental networks in 2013 around the state.

“Clearly the need is enormous,” said Don Hickman, vice president of workforce and community development at the Initiative Foundation in Little Falls. “When families are just struggling to keep it together, it’s easy to ignore dental as an urgent need.”

Nipping trouble in the bud

The first myth that network leaders run up against is that baby teeth don’t matter. According to the American Dental Association (ADA), baby teeth are critical for a child’s speech, nutrition, health and socialization. Rotten or missing baby teeth can cause permanent teeth to drift, resulting in crooked and crowded adult teeth that also are more susceptible to decay.

The Rice County Early Childhood Early Dental Network, in coordination with the county public health department, targets parental behaviors. The network sends home a “tooth fairy letter” to the parent of every year-old toddler born in the county.

“It talks about the importance of going to the dentist starting at age 1 or the emerging of the first tooth,” said Ellen Haefner, coordinator of Rice County’s Early Childhood Dental Network, which is overseen by the Southern Minnesota Initiative Foundation.

Many parents, and even some dentists, don’t realize that the ADA recommends a trip to the dentist at age 1, Haefner said. So they’ve created a grant program to reimburse dentists up to $100 for appointments for underinsured tots. They’ve also launched a public health campaign about bottle decay and are creating a similar campaign to warn parents about sugary juices.

The Initiative Foundation in Little Falls, which covers a 14-county region, is deploying mobile dental clinics in Mille Lacs County for young children and expectant mothers. It has contracted with Minneapolis-based nonprofit Children’s Dental Services to host six mobile clinics in Princeton, Milaca and Onamia that have logged 100 appointments, said Kristine Klopp Mille Lacs County WIC coordinator.

Klopp said doctors in the area have agreed to apply fluoride varnish to the teeth of kids during checkups. She noted that while many low-income parents may struggle to find a dentist, they are generally diligent about well-child checkups.

Addressing dental health is critical for early childhood education to be effective.

“If you are a child whose mouth hurts, if you have teeth that ache, you are not going to be learning your ABCs,” Hickman said.

And that can have an impact on the community at large. “We talk about early childhood programs as economic development,” said Teri Steckelberg with the Southern Minnesota Initiative Foundation. “They are the future workers of our communities.”