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Preventative dental care limited for rural North Carolina children

While tooth decay is sometimes perceived as a childhood rite of passage, elementary school-aged children missing school and causing parents to miss work due to painful toothaches are no laughing matter. Parents of children with poor oral health miss twice as much work as their counterparts, due to preventable, unnecessary tooth pain.

new report from NC Child shows that dental decay is not spread evenly across the state; children from poor, rural counties tend to have the highest rates of decay. Dentists are also spread unevenly across the state. In three counties — Camden, Hyde, and Tyrrell — there are no dentists. In Sampson and Duplin counties there are just 1.7 dentists per 10,000 people, far below the national average of 6.1 dentists per 10,000. Wake County, by contrast, has 7.9 dentists per 10,000 people.

Tooth decay is a preventable chronic disease that has far-reaching health and social consequences. School-based sealant programs are a proven approach that the state should expand to prevent dental caries. North Carolina can follow models established in other states to save money and eradicate this unnecessary, painful condition for children in our state.

According to the report, school-based sealant programs offer a powerful solution to address dental decay. Sealants cut cavities by 80 percent for up to two years, and 50 percent for up to four years. Because dental hygienists provide sealants in school-based programs, children in areas without an accessible dentist can receive much-needed preventive care.

States like Kansas, Ohio, and Oregon have achieved impressive declines in expensive, painful dental decay with school-based sealant programs. North Carolina could follow suit — but current regulations are getting in the way.

Unfortunately, the interpretation of current policy prevents dental hygienists from providing preventive care, including sealants, without a prior dental exam. This restriction makes the wide-scale adoption of SBSPs challenging, since so many of the children in need don’t have access to dental services.

The report includes the following recommendations to improve children’s oral health and academic outcomes:

  1. Reduce oral health disparities and target all children at high risk for tooth decay by promoting and expanding dental sealant placements in school-based settings.
  2. Staff school-based sealant/prevention programs with dental hygienists operating under the direction of public or private dentists.
  3. Increase children’s access to sealants by eliminating unnecessary rules that limit the use of appropriately-trained and licensed dental hygienists in placing sealants.

Ready for Kindergarten means a new backpack, a box of crayons, pencils, and a bright smile. Too many children show up on the first day of school with painful, untreated tooth decay that will mean missed school days and missed opportunities to learn on track with their peers.

It’s time to fix this totally preventable, painful problem with a common-sense solution that is already saving money and alleviating children’s suffering in other states.

Editor’s note: This article was originally published by NC Child. It has been posted with the author’s permission.

Sarah Vidrine

Sarah is an Oral Health Policy Analyst for NC Child. For over 20 years, she has worked to promote opportunities for children and families. Her career has included direct service, systems reform, and policy advocacy.  From 2007-2014, Sarah worked as the Director of Policy and Systems Initiatives at Prevent Child Abuse North Carolina. She continues to do freelance consulting with a variety of nonprofit agencies. A native of Kansas, Sarah attended universities in New York and Seattle before settling in North Carolina in 2002. She and her husband, Dominique, share their home with three children, a dog, a cat, and a rabbit.