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FirstHealth of the Carolinas, Inc. ADI Foundation 2018 Grant Recipient Mid-Year Report by Dr. Sharon Nicholson Harrell, Director, FirstHealth Dental Care

Dental Director, FirstHealth Dental Care, Southern Pines, North Carolina, United States, NC 28387.
Corresponding author: Sharon Nicholson Harrell, Dental Director, FirstHealth Dental Care, 105 Perry Drive, Southern Pines, North Carolina, NC 28387, United States. E-mail:


  • Public Health Practice in a Private Practice Setting

  • The FirstHealth Dental Care Purpose: To Care for People

  • FirstHealth Dental Care serves Moore and Montgomery counties providing comprehensive dental care to low- income children from birth to age 21. In these counties, almost 29,000 medically indigent children have been served since inception.

  • Target Population:

    • Children up to age 21

    • Medicaid recipients

    • Health Choice recipients (Children’s Health Insurance Program)

    • Uninsured patients who qualify by income pay a small fee per visit

  • Range of ages of children receiving oral care at Dental Care Centers:

    • Birth – 5 years old 25%

    • 6–12 years old 44%

    • 13–21 years old 31%

  • The Dental Care Centers accept about 50 new patients each month and have over 600 patient visits per month across the three centers.


  • Approximately 70% of patients seen in the 1st year of operation had either never seen a dentist at all or had not seen a dentist in over a year.

  • The Dental Care Centers serve as a role model for other FirstHealth entities in identifying and assisting eligible families in the enrollment process for public assistance coverage, contributing to significant growth in the insured rate (Medicaid and Health Choice) – from 72% in 1998 to 97% in FY 2018.

  • The Dental Care Centers apply more than 3000 preventive dental sealants each year.

  • The FirstHealth Dental Care Centers apply fluoride varnish, which is modeled after the innovative “Into the Mouth of Babes” program, which has created a wonderful link between the Dental Care Centers and local pediatricians and family physicians. Children under 3 who receive fluoride varnish at the recommended intervals have a 40% reduction in cavities compared to those who do not.

  • By working with patients consistently, more than half of all appointments are now for preventive and diagnostic care.

FirstHealth of the Carolinas is pleased to provide a mid- year report to outline the impact of the generous grant awarded from the ADI Foundation to provide toothbrushes, toothpaste, and floss to underserved children.

The $1,000 grant award was used in collaboration with FirstHealth Dental Care to provide toothbrushes, toothpaste, and floss for 2000 children. The grant seeks to ensure that underserved children have access to the preventive ‘tools’ to maintain oral health and thus avoid the systemic health problems often associated with poor oral health.

Approximately 99% of the children treated at FirstHealth Dental Care are at 200% or less of the poverty level. Every week, children ask us for a toothbrush because a brother or sister either used their toothbrush or threw it away. They share how they no longer have any floss and can we please give them another sample? Many of the children treated rely on grandparents or the local county van to transport them to their dental appointments. Many are not able to purchase preventive dental supply items on a regular basis.

Appropriate-sized toothbrushes were purchased for preschoolers, elementary school-aged children, and teenagers, and young adults. Toothpaste and floss, as well as dental bags, were included as part of the toothbrush purchase from the dental company at the cost of $1,003.68 of which FirstHealth absorbed the overage and then matched the grant amount.

Since the grant’s inception, 1138 children have received the preventive kits.

It is anticipated that by the grant’s end, 2000 children will have received a preventive kit.

By providing these preventive kits, the ADI Foundation gives children the tools needed to level the playing ground by giving them the opportunity to better achieve and maintain good oral health.

The ADI Foundation Project does not just give away preventive kits; the project also involves the following components: Cleaning, oral evaluation, caries risk assessment, nutritional counseling, sealant placement, and the application of fluoride varnish. However, the “giving away” part is crucial because it is futile to prove preventive care such as fluoride varnish and sealants and needed restorations and send the patient away without the tools and resources needed to maintain oral health.

Two-year-old practicing brushing Ollie’s teeth
Happy child with new toothbrush
Kelly and mouth model and child
Teenager with an oral hygiene goodie bag
Dr. Sharon Harrell, FADI with patient
Twins with FirstHealth Staff

The preventive kits allow the child to immediately start practicing what they have just learned. Interestingly enough, the kids are “passing it forward,” because we hear them on countless occasions giving oral health instructions and repeating what we have taught them with their caregivers who often have not had adequate access to preventive care themselves.

Sharon Nicholson Harrell

Dental Director, FirstHealth Dental Care, Southern Pines, North Carolina,

United States, NC 28387.

*Corresponding author:

Sharon Nicholson Harrell, Dental Director, FirstHealth Dental Care, 105 Perry Drive, Southern Pines,

North Carolina, NC 28387, United States.


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