Nothing to smile about
IT’S HARD TO BELIEVE THAT an epidemic of dental disease could exist in a place like California, the global epicenter of teeth-whitening ads and million-dollar smiles. But the rotten truth, according to a report released last week by the Dental Health Foundation, a nonprofit public health advocacy group, is that tooth decay is emerging as the most serious health crisis facing California’s children.
The results of the study should serve as a stark wake-up call to parents, healthcare providers and policymakers. Evaluators, who screened 21,000 kindergarteners and third-graders in 186 schools, estimated that two-thirds of California’s elementary school students have tooth decay by third grade. Of those, more than one-third -- about 750,000 children -- aren’t getting any treatment. For 138,000 kids, the situation is dire enough that they require “urgent” dental care to manage pain and infection.
One student didn’t realize he should be able to chew on both sides of his mouth. Another had an abscess that caused recurrent kidney infections. Latino children were especially hard hit: 26% had “rampant” decay on seven or more teeth -- twice the rate of non-Latino white kids.
Of the 25 states participating in similar studies, only one, Arkansas, scored worse than California.
This is not merely a cosmetic crisis. Kids whose teeth are killing them have trouble sleeping at night and concentrating in school, and they are more susceptible to ear and sinus infections. In adults, having unattractive and painful teeth can impair confidence (and therefore earnings potential) and limit nutritional intake (and therefore good health). Scientists have shown that diseased teeth and gums may cause or complicate diabetes, heart disease, strokes and premature births.
These outcomes are entirely preventable. Regular brushing, a healthy diet, dental checkups and the application of dental sealants (a coating that goes on the chewing surfaces of back teeth) can virtually eliminate tooth decay in children. And preventive care is far less expensive than fillings and extractions.
But policymakers seem toothless in the fight against decay. The state Legislature has balked at early dental screening programs in schools, citing high costs. And as of Jan. 1, reimbursements to Denti-Cal providers -- which typically cover only about half of reasonable and customary charges -- were reduced by another 5%, offering even less incentive for dentists to give care to the neediest Californians.
