State's dental grade improves from F to D
Published: Saturday, January 12, 2013 at 5:52 p.m.
Last Modified: Saturday, January 12, 2013 at 5:52 p.m.
The Pew Children's Dental Campaign Report released last week gave Florida a slightly better grade than two years ago after the state passed a law allowing children to get sealants from dental hygienists without a dentist exam.
The grade improved from an F to a D.
The national report focused on children's access to sealants, the plastic moldings over the molars that children normally get around second grade, after their molars have grown in. Molars, back teeth used for chewing and grinding, are prone to cavities, and sealants help prevent cavities.
“In the world of dental care, sealants are like immunizations,” said Ashley Carr, a spokeswoman for the Florida Department of Health.
The DOH said that 32 of Florida's 67 county health departments have sealant programs in the schools. But apparently, not enough of those are in high-needs schools. The Pew Report gave the state a D grade, based in part on the fact that the school-based programs reached less than 25 percent of the neediest schools. Florida was also one of nine states that has never collected data for the National Oral Health Surveillance System.
Florida did pass the Dental Practice Act, however, which allows hygienists to place sealants, which aims to broaden access to sealants.
“That's the only reason we didn't get an F,” said Dr. Scott Tomar, chair of the Alachua County Dental Health Coalition and a professor of community dentistry and behavioral science at the University of Florida. “Certainly, that change, which we'd been pursuing for a while, is a step in the right direction. But, unfortunately, some things are moving backwards.”
“The reimbursement rates are just as bad as they have been, and now there is additional red tape to become a provider with managed care for Medicaid,” Tomar said.
In 2011, Florida was last in the nation for Medicaid reimbursement and Medicaid-eligible children using dental services. Only one in four used the services in 2009, compared with 38 percent in the nation.
One positive finding from the Pew report was that 78 percent of Floridians, including those who receive city of Gainesville water, have fluoridated water.
According to Roderick King, executive director of the Florida Public Health Institute, “We saw the report as another piece of information that could be a rallying cry to figure out how to strategically improve oral health for our children.”
King said both a statewide strategy as well as local, grassroots efforts are necessary to improve the situation.
“The potential is there for it to get better, but I think there are some of the inherent barriers that we still have to address,” King said. “Not every child is required to have an oral health exam to go to school, but every child has to have a physical exam.”
Tomar agreed that oral care overall has to be more of a priority for people.
“People view it as optional and discretionary health care. We have no problem excluding a mouth infection that occurs, but it makes no sense biologically or financially,” Tomar said.
And untreated oral problems can end up in the ER. According to the Public Health Institute, Florida spent more than $88 million to treat dental problems in emergency rooms in 2010. A sealant costs less than one-third of the cost of filling a cavity.
Tomar said money spent on prevention could “avoid the pain and suffering that leads to ending up in the ER.” Some initiatives aim to do that. In Alachua County, the UF College of Dentistry and United Way started a program that provides sealants to schools with the highest rates of free or reduced lunches. They also started a countywide oral health surveillance program that targets schools with high rates of tooth decay.
They conducted a survey that found that of 1,800 children, 50 percent had some tooth decay by the third grade, and 30 percent had untreated cavities. Although there was no other statewide data, Alachua County places in the highest third of children with cavities of counties in the nation.
“That's pretty disappointing considering our town is the home of the only state-supported dental school in Florida,” Tomar said, adding that he suspects the situation is worse in other counties.
The Pew Report gave a majority of states C, D and F grades. New Jersey, Wyoming, Montana, North Carolina and the District of Columbia got an F. Only five states received an A: Maine, New Hampshire, Alaska, Wisconsin and North Dakota.
Contact Kristine Crane at 338-3119, or email@example.com.
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