Ky. voices: Clark Co. team leads way to brighter smiles, better futures for Ky. kids

Al Smith of Lexington is a journalist and former federal co-chairman of the Appalachian Regional Commission. He co-founded UK's Institute for Rural Journalism and Community.
Al Smith of Lexington is a journalist and former federal co-chairman of the Appalachian Regional Commission. He co-founded UK's Institute for Rural Journalism and Community.

A community effort to fight tooth decay in children in Clark County has been named a model for the nation. Tooth decay is the most common disease during childhood and can bring on a lifetime of problems. Rampant in Kentucky, it has helped make us one of the unhealthiest populations in the country.

A national association of 3,000 local government health departments gave the Clark County Dental Health Initiative for kids its top award for excellence last month at a meeting in Dallas.

This was a remarkable turn-around after the New York Times, in a front page story Christmas week of 2007, ranked Kentucky last of 50 states for children's oral health.

Clark is just one of our 120 counties, but its five-year campaign for change by volunteer dentists, hygienists and engaged citizens should inspire all Kentuckians in a state further scandalized by its own Diane Sawyer in her 20/20 program on ABC in 2009 when she showed 11 million viewers shocking scenes of Appalachian kids with disfigured teeth called "Mountain Dew Mouth."

Earlier, a mission-minded Winchester dentist, Dr. Rankin Skinner, and his wife, Ruthi, had initiated a preventive program for poor children in Ecuador. He developed a similar plan for Clark County, became its unpaid director and persuaded all 16 other Winchester dentists and 116 volunteers to apply dental fluoride varnish to children in preschool through fifth grade. Every Winchester dentist donated service and staff to take the initiative inside the schools.

Five years later the decay rate in sixth graders has dropped to 11 percent, a decline of 78 percent since 2008 when Kentucky's decay rate for children was reported in national media to be a shameful 50 percent, the country's worst.

Skinner won over all of his colleagues and neighbors with a simple appeal, "Folks these are our kids who are in need. We can't wait for someone else to fix their health."

"Dropping children's decay rate was our common goal," says Skinner. "I have never seen such commitment."

Two influential citizens joined the cause — a local banker who raised money with help from the Clark County Community Foundation and First Lady Jane Beshear who urged Gov. Steve Beshear to use the Clark initiative as an example in organizing treatment for underserved children in Eastern Kentucky.

The Clark County Health Department hopes to employ the state's first public health dental hygienist when schools open this month and, with continued help from the local dentists and citizen volunteers, eventually extend the program to students through high school.

The back story of the Clark achievement could be a made-for-TV docudrama. It is how Rankin and Ruthi ( not a dentist but a project partner) tested an innovative preventive treatment on thousands of children in Ecuador, then came home and sold it to their neighbors.

In Ecuador, the Skinners enlisted native dentists and scores of volunteers to treat the country's poorest kids with conventional fluoride varnish supplemented by a new additive, ACP, which extends the benefit of the fluoride. Never shy about talking truth to power in 40 years of missions, Skinner won support from Ecuador's president and U.S. dental companies who gave him toothbrushes, toothpaste and the varnishes for free or at discount.

Inspired by grandparents who were farmers and "good neighbors," the Skinners and family members have taken free dentistry to the poor in five countries, mostly through the Partners of Americas network in Latin America and the Caribbean. Rankin Skinner started this soon after beginning a private practice when he returned from Navy service in 1971.

The American Public Health Association has asked Skinner to explain the Clark Initiative at its winter meeting. He will repeat what he said in Texas last month to the National Association of County and City Health Officials, that "volunteerism is alive in Clark County, and ours is a community award."

Historians may rank the Skinners' story with that of Appalachian volunteers Eula Hall, who created the Mud Creek Clinic, and Mary Breckinridge, who founded the Frontier Nursing Service. They were all humanitarians who made a difference because they would not "wait."