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Dental Health Is Fundamental for All Children

11/29/2001:   In 2000, in a report on Oral Health in America, U.S. Surgeon General David Satcher noted "profound and consequential disparities in the oral health of our citizens…Dental disease restricts activities in school, work, and home, and often significantly diminishes the quality of life." Indeed, attention to personal dental hygiene should begin with the eruption of the first "baby tooth," and all children should have access to preventive and, if necessary, restorative dental services.

When children are first placed in foster care, they are particularly likely not to have received preventive and professional dental care. CWLA's checklist of 16 services needed for children in foster care includes "comprehensive dental services…restoration of teeth, and maintenance of dental health….ongoing primary and preventive health care services, including reassessments at a minimum every six months; and access to appropriate specialty and subspecialty care."

Medicaid is federally mandated to cover children’s dental services, but delivering those services to children remains problematic. Only 21% of Medicaid-eligible children saw a dentist in 1997. Children’s Health Insurance Plan (CHIP) seeks to extend medical and dental services to as many as 10 million children whose family incomes exceed Medicaid eligibility but who cannot afford private health insurance. For information on how to enroll a child in CHIP go to www.insurekidsnow.gov.

This month, a study was published that assessed the dental health outcomes of 15,438 children in North Carolina who were enrolled in Medicaid from 1988 to 1994. Of these children, 23% received at least one sealant, and 33% received at least one filling. Sealant placement was associated with expenditure savings to Medicaid. Thus, Medicaid—and more broadly, society—will benefit by providing for sealant placement in these children. (See J. A. Weintraub, S. C. Stearns, R. G. Rozier, and C.-C. Huang. [2001]. Treatment outcomes and costs of dental sealants among children enrolled in Medicaid. American Journal of Public Health; available online at www.ajph.org. Select November 2001, Volume 91, Number 11, click on "public health then and now;" then scroll to pages 1877–1881.)

According to the American Dental Association (ADA) website www.ada.org, basic preventive and restorative dental services are within economic reach of most Americans, through insurance coverage and government programs such as Medicaid. The ADA notes that each year dentists provide $1 billion in free and discounted dentistry to needy patients. For too many, however, access to care remains difficult. (For more information, go to the website, click on Government and Advocacy, go to Dentistry Works, then click on Access to Oral Health Care. On the same page, a link to the Indian Health Service website notes that only 25% of Native Americans receive dental care today compared to 33% 10 years ago.) For many more topics, go to www.ada.org/public, click on Oral Health Topics, and choose from the alphabetical listing or the category listing (e.g., Children, the Kids Section).

HRSA-HCFA Oral Health Initiative (www.hrsa.gov/oralhealth/resources) has many links to other websites—such as those of the National Oral Health Resource Center, American Academy of Pediatric Dentistry, Rural Information Center Health Services such as the National Oral Health Resource Center, American Academy of Pediatric Dentistry, Rural Information Center Health Services—providing data, research, and information on professional groups and other organizations.

Extensive resources on oral health in children, as well as links to other organizations, publications, databases, newsletters, and research reports, are available through the Knowledge Path on Oral Health and Children (www.ncemch.org/RefDes/kporalhealth.html) developed by the National Center for Education in Maternal and Child Health at Georgetown University.

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