The health care reform debate has generated a lot of discussion about savings associated with preventing disease. When it comes to dental disease, our state has adopted several innovative approaches aimed at prevention and improving children’s oral health. A newly released statewide survey indicates these efforts are working.
Dental decay is a significant health problem. Kids who don’t receive treatment often end up with abscessed teeth and other problems that can cost thousands of dollars to treat. Some even require expensive treatment in hospital operating rooms.
Five years ago, tooth decay among young children in Washington was on the rise, among the highest rates in the nation. Several efforts were initiated to increase prevention and access to dental care. As a result, children’s oral health has improved. This is very good news, because preventing dental disease saves money.
The Smile Survey conducted every five years by the Washington State Department of Health shows that the percentage of untreated tooth decay among young low-income preschoolers has declined from 26 percent in 2005 to 13 percent in 2010, and the percentage of low-income preschoolers with tooth decay has decreased.
Statewide low-cost programs support efforts to ensure that all children have access to dental care. For example, Access to Baby and Child Dentistry (ABCD) programs provide preventive care and treatment for young Medicaid-enrolled children. ABCD helps families with children younger than 6 find a dentist and get preventive and restorative dental care. ABCD started in Spokane 15 years ago and has been operating in Clark County since 2005.
Apple Health for Kids, a state program that provides insurance coverage to low-income kids, includes preventive dental care. In 2009, about 48 percent of children enrolled in this program received dental care.
An important addition in Washington is primary care medical providers screening for dental disease during well-child checkups. Many physicians statewide are trained to provide oral health screenings, family oral health education, fluoride varnish application and dental referrals during young children’s well-child visits.
Despite improvements over the last five years, dental disease remains a significant problem in our state. The Smile Survey showed that 40 percent of kindergarten children had preventable decay. Dental decay among minorities and low-income children was higher than the statewide average. Clearly there is more work to be done.
Early detection is key
All children should have their teeth checked by a dentist or physician by age 1. Detecting potential problems early is important, because when it comes to dental disease, problems start small but can spread quickly. Early treatment can lead to a lifetime of good oral and overall health.
Other local statistics help define the issue: From 2005 to 2010, there was an increase in the percentage of third-graders in Clark County that are cavity-free (38 percent to 45 percent). The percent of Head Start students with untreated decay in Clark County decreased from 2005 (20 percent) to 2010 (12 percent). In large part, this is due to state and local efforts to make dental care and prevention of dental disease available to those who could not afford or could not access dental care.
Although tooth decay is the most common chronic disease of childhood, it can be prevented. Community water fluoridation, topical fluoride treatments and dental sealants are among the best ways to prevent tooth decay. Unfortunately, only 34 percent of Clark County’s first- and third-grade children have dental sealants, only 48 percent of local residents have access to a water fluoridated system, and only 39.8 percent of eligible children are enrolled in the ABCD program.
In order to improve the oral health of our children, continued efforts must be made to assure that all children have access to these valuable preventive services. Programs that help prevent dental disease and protect baby teeth must be maintained even when budgets are tight because they save money. Plus, children are spared the unnecessary pain of a preventable disease. That is why preventing children’s dental disease should be a priority.
Remy Eussen is a pediatric dentist practicing in Vancouver.
