Recently, the Pew Charitable Trusts released their latest report card on children’s dental health Maryland came out on top, meeting seven of Pew’s eight benchmarks, followed by Alaska, Connecticut, Maine, Massachusetts, Minnesota and South Carolina, which each met six. Florida, Hawaii, Indiana, Montana and New Jersey all rated F, meeting two or fewer marks.
And California? According to Pew’s standards, our state did about as well this year as last, which is to say not that great, meeting half the standards to come in with a middle-of-the-pack C.
So what, pray tell, were these benchmarks?
- Sealant programs for high-risk schools
- No dental exam needed before a hygienist may apply sealants
- Fluoridated water
- Dental care access by Medicaid-enrolled children
- Medicaid reimbursements to dentists
- Early preventive dental care reimbursements
- Authorization of new primary care dental providers
- State tracks data on children’s dental health
But are these really the best or most accurate measures of children’s oral health?
They do seem a bit short-sighted – a point not lost on other dentists. For instance, corresponding via email with a reporter for Bangor, Maine’s Daily News, pediatric dentist Dr. Jonathan Shenkin observed that
“Pew’s measures ignore the etiology, or cause of disease. By not having any measures relating to etiology, and by not challenging legislators, policymakers and the dental community to break the cycle of disease, Pew is guaranteeing very limited improvements in oral health outcomes for children.”
Shenkin said policymakers and public health advocates must focus on improving Mainers’ oral health literacy — the ability to understand and adopt behavioral changes — such as brushing regularly and avoiding sugary beverages and treats — that protect children’s teeth from disease and decay.
“The simplest steps [to promote] good oral health are not known by those at the highest risk for disease,” he said.
In addition, Shenkin said Maine policymakers should examine ways to decrease consumption of foods and beverages that promote tooth decay through such measures as eliminating the purchase of soda with food stamps and developing stricter guidelines regulating the marketing of junk food and beverages to children.
This is a more profound and holistic approach to preventive care – which is also, in the long term, a less expensive approach than treating problems after the fact. Sure, the dental establishment promotes fluoridation and sealants as preventive measures, but these are passive approaches based on the cynical belief that people cannot or will not take an active role in maintaining their children’s health, let alone their own. It’s the path of least resistance. But as we and many others have noted before, any good they do – a matter of debate itself – comes with costs to kids’ health and well-being. (Read our previous posts on fluoride and sealants.)
That said, even judging by other criteria, we’re still faced with a dreary picture of kids’ oral health here in California. Consider, for instance, these facts compiled by the California Dental Association:
- Tooth decay is children’s #1 chronic health problem.
- More than half of all kindergarteners have a history of tooth decay, 28% have untreated decay and 19% have extensive decay.
- By 3rd grade, more than 70% of kids have had some tooth decay.
- More than 500,000 kids missed school last year due to dental problems.
What’s more, 1 in 5 California kids under the age of 12 have never even seen a dentist.
So how do we turn things around? Education is a good place to start – not just with kids but adults, too. The more we understand oral health’s relationship to our overall health and well-being – and how to have good oral health – the better teachers and role models we can be.