Dental decay remains a problem for Utah, U.S. kids, study says
Ravell Call, Deseret News
SALT LAKE CITY — Bubble gum-flavored toothpaste and electric spinning toothbrushes have made a big difference in how often and how willingly Cindi Barraclough's kids brush their teeth.
But it helps to have the added assurance that their teeth are protected, should any sugar get past the burgeoning brushing habits.
A dental assistant at Kidz Dental Works in Syracuse placed sealants on 6-year-old Braxton Barraclough's teeth Tuesday, forming a plastic shield to protect surfaces on his molars furthest back. It's something each Barraclough family member has had done as soon as they are old enough, and "it really cuts back on the number of cavities they've had," the Farmington mother said.
"It's nice to feel like you have that protection, but you still have to brush all the time," she said. "I think of it as a really good backup plan."
According to a Pew Center report released Tuesday, more Utah kids are in need of the preventive dental treatment. However, some insurance plans don't cover it and for other individuals, dental care is out of reach altogether.
"It really is a problem," said Michelle Martin, a hygienist and oral health specialist for the state of Utah. She said fluoridated water has helped prevent cavities in some kids, but a recent survey found that 23 percent of Utah kids drink only bottled water, circumventing the benefits available in public water sources in various counties.
In addition to education outreach, specifically that tap water is OK to drink, and increasing access to all dental services, putting sealants on more kids is a top priority of the Utah Oral Health Program.
Most states, according to the report, are not doing enough to prevent tooth decay, which is consequently driving up health care costs for families and taxpayers. Between 2010 and 2020, annual Medicaid spending for dental care is expected to climb from $8 billion to more than $21 billion. Children account for roughly one-third of the program's total spending on dental services.
"I would much rather have, as a parent, a procedure that could save a tooth for a lifetime, as opposed to an $80 filling or something else worse down the road," Martin said. "We're all about prevention and the more we can preserve a natural tooth, that's the goal."
Preventive dental care, including biannual cleanings and examinations, can also preclude unnecessary visits to the emergency room for painful dental issues down the road. In 2009, children made more than 49,000 visits to hospital emergency rooms for preventable dental problems, according to the report.
Pew gives Utah a C grade in its most recent report, down from a B in 2011, but up from a D in 2010. The grading system changed over the years, but one constant was a judgment of the percentage of high-need schools with sealant programs.
The nationwide goal is to provide access to sealants at 75 percent of schools within low-income regions, whose students are presumably at greater risk for decay. In Utah, about 25 to 49 percent of schools provide access to programs by which sealants are available at little or no cost to families, and are applied during school hours with parental permission.
Another option, for individuals with public assistance insurance (Medicaid, Children's Health Insurance Program and Primary Care Network), is the Utah Department of Health's Family Dental Plan, offered at clinics throughout the state. Plan manager Butch Luers said sealants are a common procedure, done quickly and usually without a long wait.
Sealants are clear plastic coating applied to the chewing surfaces of permanent molars, the most cavity-prone teeth. They are most effectively applied when molars fully emerge, usually when kids are in the second or third grade and research has shown that the simple procedure can reduce tooth decay by 60 percent, at one-third the cost of a filling, the report states.
Martin said a number of local programs work to provide the service to school kids, but much of it doesn't get reported, resulting in poor ratings nationally.
"We definitely have room for improvement," she said. "We could use more funding to provide more children with these preventive services."
In conjunction with sealants, the state program advocates for twice daily brushing — for at least two minutes each time — and regular flossing, as well as fluoride treatments at dental appointments. Proper dental care can prevent gingivitis, inflammation of the gums and plaque buildup, all of which can lead to major complications if left untreated.
Only five states earned an A grade from the Pew study, which was based on four indicators, including the sealant programs, hygienist regulations against placing sealants, data collection and meeting a national objective on sealants set by the federal government's Healthy People 2010 goals. Eight states earned a B grade, although half did not have sealant programs in place in most of their high-need schools, the report states.
Along with Utah, 16 other states earned a C grade, 15 made D's and five failed all indicators, lagging far behind the national average in prevention efforts for dental health.
"States that take dental prevention seriously are making a good faith effort to get sealants to more low-income children," said Shelly Gehshan, director of the Pew Children's Dental Campaign. "When states don't do enough, they and low-income children pay a higher price both in dollars and decay."
Although preventable, dental decay remains the most common chronic childhood disease, the report states. The full report can be found online, at www.pewstates.org.
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