A three-year effort by the Tacoma-Pierce County Health Department to improve children's dental health through public school programs failed to make any discernible headway, a new study says.
The School-Based Oral Health Program, used in 10 local school districts from 2006 to 2009, was designed to bring the number of kids with cavities closer to 42 percent – a health benchmark set by the federal government.
But despite the school program, the percentage of Pierce County youngsters with cavities remained high: 56 percent overall and 65 percent for low income children.
There was “no evidence” the program reduced cavities in the total population of children, the Health Department’s internal assessment of the program concluded.
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In the program, Health Department staff members examined the teeth of nearly 75,000 second- and third-graders, said David Vance, a Health Department division director. Children without cavities were offered a fluoride varnish or a dental sealant, Vance said. Those with decay were referred to low-cost dental providers.
Several factors contributed to the disappointing results, examiners said. Among them:
• Administrative problems. Only 18 percent of children who qualified for dental treatment received it.
• Failed sealant. Only about half of sealed molars remained fully sealed a year later.
• Economic recession: Tough times might have canceled out improvements
• High mobility: Only 28 percent of students assessed the first year were present for assessment two years later.
The Health Department will continue to explore strategies to prevent cavities in Pierce County children, Vance said.
Officials want to expand the sealant program to more children, find better ways to obtain parental approval and figure out a better way to apply sealants so they stay on molars longer.
Next year, Vance said, local dentists and their staffs will visit the schools instead of Health Department employees.
“We’ve reached out to private providers,” he said. “Rather than having Health Department staff go into the schools, we’ll be the ones coordinating the care. We’ll act as a clearinghouse. We think that will be a much more effective role for us.”
A “Smile Survey,” conducted by the Health Department in 2005, concluded the severity of dental decay was worse in Pierce County than the rest of the state.
In that survey, 37 percent of second and third graders had a history of decay in seven or more teeth (“rampant decay”), compared with 21 percent in all of Washington.
Among low-income preschool children, 39 percent had a history of decay in their upper front teeth, compared with 18 percent in the whole state.
A 2010 Smile Survey has just been finished and the results will be released later this month.
“That should give us a much better idea of where we are with the oral health of kids in Pierce County,” Vance said.
Rob Carson: 253-597-8693 firstname.lastname@example.org