OYA Cares for All Aspects of Youth in Custody — Including Their Teeth

Youth must be physically healthy before they can engage in treatment to change their behaviors. A new dentist at MacLaren is here to help.

(Above) Dr. Jerome Lee, the new dentist at MacLaren Youth Correctional Facility, inspects a youth’s teeth.

Dental health is important to a person’s overall wellbeing, even if that person lives in a close-custody facility, like the 500-plus youth in Oregon Youth Authority’s care.

“Oral health issues can create physical health issues and can impact self-esteem,” Dr. Marcia Adams, medical director of OYA, said. “They try not to smile and keep their mouth closed. And some get to the point where pain affects what they eat, so then it impacts their nutrition, as well.”

That’s why it’s important to keep OYA’s largest facility, MacLaren Youth Correctional Facility, staffed with a dentist or two, a convenience it didn’t have for many months before Dr. Jerome Lee was hired in January. Since he started on the job, Dr. Lee has mostly only been able to conduct intake appointments, which are routine dental checkups for youth when they first enter OYA custody.

During this dental exam, many youth are found to have cavities or oral decay. Causes sometimes include high drug use (a common issue is called “meth mouth,” which is severe tooth rot brought on by extensive methamphetamine use) or lack of oral hygiene awareness.

OYA tries to make oral health a priority for youth by ensuring that they can demonstrate they understand proper oral hygiene within their first 60 days in close custody. This is one of the performance measurements OYA uses to gauge the success of its health care services.

“Many of these kids come from bad situations and oral health is not the first thing they think about,” Dr. Adams said. “Nurses show them how to brush and floss, then they have a one-month check-in, then again at three months. Our target is to reach 100 percent.”

Dr. Lee said he hopes to get youth scheduled for cleanings every six months as soon as he gets through the list of intake appointments.

“It’s so important because a lot of them haven’t had that for years,” he said.

Dr. Lee is the first dentist at MacLaren since Dr. Deanne Baptiste retired in September. Dr. David Miller, a dentist employed by Department of Corrections, has been seeing patients once a week at MacLaren in the interim, and has agreed to continue through April, Dr. Adams said.

Dental services 2

Dr. Jerome Lee talks with a patient at the MacLaren Youth Correctional Facility dental clinic.

“We’re very grateful to Dr. Miller for helping us out,” she said, adding that a second dentist position at MacLaren should be filled relatively soon.

MacLaren is the only OYA facility to have a dentist employed by the agency. Rogue Valley Youth Correctional Facility in Grants Pass contracts with an outside dentist, who brings a team on site. Staff at the other facilities transport youth to see dental professionals either in the community, or, in Oak Creek Youth Correctional Facility’s case, at MacLaren.

Adding a second dentist at MacLaren would help the facility keep up on its intake dental exams, and allow for follow-up exams and completion of treatment plans for youth who need it.

OYA is careful to provide only medically necessary and appropriate care. Generally, this does not include cosmetic care, except in rare cases where something cosmetic could impact a youth’s overall recovery. In that instance, a review panel would have to discuss and approve a procedure.

While cosmetic treatments such as braces are not included in the dental care OYA provides, if a youth enters the facility already wearing braces, OYA will usually accommodate that youth continuing appointments with their provider from before entering OYA. Dr. Adams said that is because, in most cases, the youth’s family paid for that treatment in advance.

Dr. Adams said she is excited to have someone with Dr. Lee’s level of expertise join her dental team. Dr. Lee comes to OYA from the private sector; he maintained a private practice in Tacoma, Washington, for 18 years until he moved to Oregon in late 2018. He completed his dental schooling at Loma Linda University in California.

Dr. Lee isn’t the only medical professional new to OYA. Dr. Ryan Hutchison, a family practice physician, has been seeing patients at MacLaren four days a week since October. He came to OYA through Oregon Health & Science University. Dr. Adams hopes that Dr. Hutchison’s association with OHSU will lead to a long-term partnership with the school’s residency program.

Dr. Bazil Freedman, a child and adolescent psychiatrist who started in late February, commutes from Eugene once a week to see patients at Oak Creek in Albany. Freedman has decades of experience and possesses a degree from University of Cape Town in South Africa.

Because of child and adolescent psychiatry is such a specialized field, it’s hard to find a psychiatrist to work with OYA youth, Dr. Adams said. She has been looking for one to work at MacLaren since December, when the previous one moved to New Zealand.

While Dr. Adams looks to bulk up her medical team, Dr. Lee said he’s gotten comfortable in his new digs.

“I’m enjoying what I do,” he said. “I’m still learning. I have a good staff to work with and it’s great I can help the kids out.”

The importance of focusing on youths’ medical care is evident in OYA’s recent renovation of the clinic at MacLaren, which was transformed to create a welcoming atmosphere that mirrored the experience of a clinic in the community.

That renovation is just one example of how OYA is motivated to providing quality medical care to its youth.

“Part of our philosophy is these are kids, and … our hope is that they will eventually return to the community and do great and positive things,” Dr. Adams said. “So that is one factor that drives how we (medically) treat kids.”

OYA Health Care By the Numbers

From Jan. 1, 2017, to Dec. 31, 2018, OYA Health Services had:

  • 10,994 medical triage requests
  • 1,516 vaccines administered
  • 930 youth tested for STDs
  • 689 dental assessments
  • 492 youth given glasses
  • 11 youth receiving prenatal care
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