Linda Pharand, Senior Dental Hygienist with WRHA’s S.M.I.L.E plus Children’s Dental Program, clearly cares about oral hygiene. She’s made a nearly 35-year career out of helping to instill positive lifelong practices among children and providing dental care to those who may not have been able to afford it otherwise.
“S.M.I.L.E plus stands for ‘Saving Mouths in Limited Income Environments’ and we’ve been doing this important community work for more than 30 years,” says Linda of the regional program, which operates a recently renovated pediatric dental clinic (infancy to age 18) out of Machray School on Mountain Avenue in Winnipeg’s North End.
Their mission is to work with families under a certain income level to ensure their children can access dental services, from regular check-ups and cleanings, to more intensive work like extractions, restorations and even interceptive orthodontics.
“No matter the scope of work we do during the visit, the family’s fee will depend on a variety of factors like total income, government benefits they may be receiving, number of children, etc. And the convenience of being located in a school is that if a patient from the community cancels a scheduled appointment or doesn’t show up, we can go into the student population and fill the appointment with a child in need of dental care.”
Their small oral health team gets quite a lot done, teaching school children how to brush and floss properly and conducting cavity screenings. They track cavity rates in some schools in the Winnipeg School Division, and they focus on addressing the needs of high-rate schools – those in which they’ve identified cavities in 15% or more of students.
According to Linda, there are many significant scientific studies pointing to the connection between good oral hygiene and overall health, and poor oral health can even be dangerous. The mouth is the first stop in the gastrointestinal system, which means it’s the initial collector of bacteria found in food and from other items that kids may put in their mouths, like soothers, toys, fingers, etc.
Researchers have also found links between periodontal disease and risk for pre-term, low-birth weight-babies, as well as connections to an increased risk of heart disease and stroke.
S.M.I.L.E plus provides important knowledge to patients all over the city, in schools and daycares, and to parents through community groups like Healthy Start. In addition to operating the Monday to Friday dental clinic, the team delivers presentations to teach new parents about the importance of oral health and how to minimize risks, so they can pass on the knowledge to their kids.
In addition, every three months, they visit 44 preschool/daycare facilities to apply a fluoride varnish on the teeth of more than 1,000 children. The varnish protects against the effects of improper brushing, sugary drinks, being put to bed with a bottle, or simply having the bacteria that cause cavities. For 20 years, Linda has been going directly into homes to perform this varnishing service, working mostly with low-income families, Indigenous people and newcomers.
“This is public health dentistry and much of the work we do is preventive,” says Linda, who was nominated in 2018 by a colleague for The Canadian Dental Hygienists Association Superhero Award for the origins of the varnish program and her ongoing commitment to community.
“Many of us don’t realize just how difficult it is for a low-income, uninsured family to access dental care. Recently, with rising costs due to inflation, combined with things like unexpected job loss or benefits termination, we’ve been seeing children whose parents never thought they would need to access a service like ours. There is no judgment when you enter our clinic. We want to help make sure all children have healthy mouths, so we are working to secure pedodontics dentists (children’s dentists) to work in our program so we can increase community appointment availability.”
Linda plans to spend her retirement years enjoying cottage life in Belair, while continuing to advocate for access to pediatric dental care across Manitoba’s health regions.
“S.M.I.L.E. plus is an important training ground for senior-level dental and dental hygiene students. We’re making a real difference to children’s health and an unhealthy mouth can lead to significant costs to the health-care system down the line. I would love to see this program expanded to help people throughout Manitoba, not just in Winnipeg. We know there are great needs for care everywhere and we do it cost-effectively and professionally.”
The Winnipeg Regional Health Authority’s S.M.I.L.E. plus team of dentists, dental hygienists and assistants works with senior dentistry students from the University of Manitoba, Faculty of Dentistry and School of Dental Hygiene to deliver services, including:
- Oral health needs assessments
- School and community-based oral health promotion
- Dental pit and fissure sealant treatment
- Topical fluoride treatment
- Assertive follow-up for children in need of treatment
- School-based clinical treatment
