State stresses prevention in childhood dental care
Occurrence of baby tooth decay seen as a significant health risk
(Anchorage, AK) - A national report on state oral health policies gives Alaska a grade of B for providing services intended to improve children's access to dental care. The report, by the Pew Research Center, highlights the estimated 17 million low-income children in the United States - one in five, ages 1 to 18 - who go without dental care. Thirty-six states earned a C grade or lower, compared to Alaska's higher ranking.
The report noted Alaska's efforts in providing dental access for children enrolled in Medicaid, dental reimbursement increases authorized in the 2008 and 2009 legislative sessions and dental sealant activities in rural and village communities. "We're glad this report acknowledges our state's efforts," state oral health director Dr. Brad Whistler said, "especially given the challenges Alaska faces with respect to providing dental health services and the high rates of early childhood tooth decay in Alaska."
Despite the favorable Pew rating, a study released today by the Department of Health and Social Services's Alaska Oral Health Program still confirms high rates of serious dental disease among Alaska's kindergarteners and preschoolers. While overall rates for the state are about average compared to other states, low-income children, Alaska Native children, and children from racial/ethnic minority groups have rates of early childhood tooth decay that are among the highest in the nation.
According to the study, about 40 percent of Alaska kindergarteners screened had current or treated tooth decay. Unfortunately, as Janine Schoellhorn, a state maternal child health epidemiologist and author of the report, pointed out, the 67 percent rate of tooth decay among Alaska Native kindergarteners far exceeds the state average.
Even more worrisome than the finding that Alaska Native children have twice the tooth decay as white children is that they are four times more likely to develop Early Childhood Caries (ECC) - a bacterial infection that destroys the teeth of young children, sometimes as early as age 1.
"Left untreated, early childhood tooth decay can rapidly progress to involve the pulp of the tooth leading to pain, infection and tooth loss - affecting speech development, nutrition and school readiness," Whistler said. "Our report supports the need for early dental screening as soon as primary teeth come in, offering the opportunity to apply topical fluorides and to counsel parents on diet, feeding practices and oral hygiene."
Although Alaska Native children had higher rates of tooth decay, they were more likely to have had their tooth decay treated, a finding Schoellhorn attributes to the efforts of Alaska Native dental providers who have made prevention and treatment a long-time priority.
Still, access to early dental care is limited for many of Alaska's children. "With that in mind, we're recommending that a child's regular family doctor or local health aide conduct dental assessments and apply fluoride varnish to children's teeth between the ages of 1 and 3," Whistler said. "The Department of Health and Social Services is currently studying how to implement Medicaid reimbursement to medical providers for provision of these preventive dental services."
The state's report goes on to recommend that health-care providers stress dental care as an important part of a child's overall health. Avoiding putting toddlers to bed with bottles, limiting sugary drinks and soda, and parental assistance with brushing teeth are recommended. Vitamin D supplements also are recommended, as are fluoride supplements in communities that lack fluoridated water.
A copy of the state's report is available at: http://www.epi.hss.state.ak.us/default.jsp
A copy of the PEW report, "The Cost of Delay: State Dental Policies Fail One in Five Children", can be found at http://www.pewcenteronthestates.org/uploadedFiles/Cost_of_Delay_web.pdf.