CDM Receives Dalio Center Grant to Launch Boca Sana: Keeping Northern Manhattan Children Healthy at Home

The Columbia University College of Dental Medicine has been awarded a new grant from the Dalio Center for Health Justice to launch Boca Sana: Keeping Northern Manhattan Children Healthy at Home, an ambitious, community-centered initiative designed to break the cycle of untreated dental disease among low-income children in Washington Heights and surrounding neighborhoods.

Led by Dr. Richard Yoon, professor of dental medicine at Columbia, Boca Sana (Spanish for “healthy mouth”) will embed community-based prevention and navigation services directly into the College’s pediatric dental clinic. The project runs from March 2026 through December 2028 and marks CDM’s first partnership with the Dalio Center.

Reframing Tooth Decay as a Chronic Disease

“Tooth decay is the single most common chronic disease in children, more common than asthma, obesity, or diabetes, and yet we don’t manage it like one,” said Dr. Yoon.

When children suffer from acute dental pain, he explains, the consequences ripple outward. They lose sleep. They miss school. They struggle to eat. In severe cases, they require treatment under general anesthesia in a hospital operating room. And even then, the disease often returns.

“We repair the teeth at that moment,” Yoon said, “but we haven’t changed the underlying drivers — diet, bacteria, fluoride exposure, access to care. So we fix the teeth, and then we watch the cavities come back. That’s heartbreaking for families and for providers.”

The burden of disease falls disproportionately on low-income children and children of color. In Northern Manhattan, home to a large Hispanic immigrant community, families often seek care only when pain becomes unbearable, cycling through emergency departments that can manage symptoms but not resolve the underlying problem.

Boca Sana aims to interrupt that cycle.

Bridging Oral Health and Community Advocacy

The project’s full name, Bridging Oral Health and Community Advocacy to Support Access and Navigation Assistance, reflects its core strategy: pairing preventive oral health education with hands-on help navigating structural barriers to care.

The initiative will introduce a Community Dental Health Coordinator, a specialized community health worker trained in oral health. Working alongside dental faculty and staff, the CDHC will:

            •           Provide culturally and linguistically tailored oral health education

            •           Screen children for caries risk

            •           Apply fluoride varnish

            •           Help families set practical goals around brushing and diet

            •           Connect families to insurance, transportation, and other social services

At the same time, clinic workflows will be enhanced to support families with appointment scheduling, insurance enrollment, and follow-up, steps that can otherwise derail care.

“Families want to come,” Yoon said. “But when you’re juggling work, language barriers, transportation challenges, and food insecurity, life gets in the way. We want someone there whose job is to clear those roadblocks.”

Built on a Columbia Legacy of Research

Boca Sana builds on decades of scholarship at CDM, particularly the pioneering work of Dr. Burton Edelstein, who argued that early childhood caries must be managed as a chronic disease influenced by behavioral and social drivers.

The MySmileBuddy program, an earlier Columbia-led initiative, demonstrated that community health workers can meaningfully improve parental knowledge, toothbrushing practices, and dietary behaviors among high-risk families. Boca Sana expands that model by integrating navigation services and embedding personnel directly within the clinical setting.

“We’re not jumping straight into solutions,” Yoon emphasized. “The first six months are about listening to parents, to clinic staff, to the community. What works in one place doesn’t automatically work in another.”

The interdisciplinary team reflects that philosophy. In addition to Yoon, the project includes faculty from pediatric dentistry, public health, and nutrition sciences, as well as trained community health workers who serve as the program’s front line.

Measuring Impact and Building for Sustainability

The pilot will focus on children at highest risk: those without a dental home, those who have visited the ER for dental pain, and those waiting for surgery under general anesthesia.

Outcomes will include:

            •           Increased establishment of dental homes

            •           Improved parental oral health literacy

            •           Reduced emergency department utilization

            •           Strengthened preventive behaviors at home

While reductions in cavities and operating room procedures will require longer-term follow-up, Boca Sana is designed to generate the evidence needed for future scale-up and sustainable funding, including potential Medicaid reimbursement pathways for preventive care coordination.

“In five years, success would mean this model is no longer a pilot,” Yoon said. “It’s simply how we deliver care.”

A Relationship, Not Just a Program

Yoon said the goal of the initiative is to support to the community CDM has served for generations.

“No one should ever feel like the system isn’t for them,” he said. “Prevention works when families have the support, access, and trust to act on it. Boca Sana isn’t just a program, it’s a relationship. A coordinator who speaks your language. A navigator who stays with you after you find your dental home.”

For the children of Northern Manhattan, the goal is simple and profound: fewer sleepless nights, fewer missed school days, fewer trips to the emergency room, and more healthy smiles.

“That future is possible,” Yoon said. “And we’re building it together, one family at a time.”