Kids and Fluoride

Are Cavities a Problem?

Preventable oral diseases afflict the majority of California’s underserved children.
Here are the facts.

• Children from low-income and minority backgrounds bear most of the unnecessary burden of pain, suffering, and compromised dental health.

• Fifty-five percent of all California children have untreated tooth decay. Among racial and ethnic minorities, 66% of 6-8 year-old Hispanic children, 60% of Black children, and 71% of Asian children have untreated decay.

• Twenty-seven percent of California preschool children have untreated tooth decay and 9% are in need of urgent dental treatment.
Tooth decay begins when children are less than 1 year old, and almost all of it goes untreated in this population.

In Humboldt County, the number of school days missed due to oral pain translates to four children missing an entire year of school. This does not address the issues of lost revenues to the schools based on absences or the challenges a child faces in trying to learn while suffering in pain.

The dental situation for children in Humboldt County is grim. Although there has not been a comprehensive survey of children's dental health in Humboldt County, several local data sources indicate that untreated oral disease is remarkably prevalent and is a significant unmet health need for Humboldt County children.

In the spring of 2001, 57 school children from an isolated community received a dental examination. Ninety-one percent required further treatment and 85% had untreated cavities, with an average of 4.75 teeth affected. Oral screens performed at various sites by a dentist in the fall of 1999 reveal that 26% to 39% of children suffered from untreated decay or some immediate oral health care need. Twenty-six percent of Humboldt County Head Start children enrolled in the 2000-01 school year required dental treatment. Head Start spent over $35,000, or almost $350 per child, for dental treatment in 2001.

Children with advanced dental decay, beyond what can reasonably be treated in a dentist’s office, must receive hospital-based dental services. These children have an average of nine teeth restored (range one to 19 teeth) or an average of four teeth removed. Three to five children per week are referred for hospital-based dental services and there is a waiting list of over 25 children.

The pressing need for dental care for Humboldt County children is compounded by a shortage of dentists in general and especially of pediatric dentists who will care for children who are underinsured. The community clinics are frequently booked three or more months in advance and have periods of not being able to accept new patients. Willingness and ability to absorb the costs and to handle the special needs of these patients limits care from private practitioners. Fluoridated water helps prevent this.

There are differences in oral health based upon income, education level, and where a person lives. Nationally, children from low-income families endure more untreated cavities, experience more restricted activity days due to dental pain, and are less likely to have an annual dental visit. Humboldt County also experiences income-based disparity in oral health. The survey of untreated cavities conducted by local pediatricians revealed striking differences among children based on income with five times more children on MediCal or CHDP medical insurance suffering from untreated cavities compared to their peers with private medical insurance. In Arcata, approximately 50% of children are eligible for free or reduced school lunches. This is a good marker for low-income children in our community.

“Entire mouth is full of cavities. Counseled to stop soda in a bottle. Can you help get this child in to see a dentist? (20 month old child) --Comments from a Humboldt County Pediatrician

“Fluoridation is the single most important commitment a community can make to the oral health of its citizens.”
Dr. C. Everrett Koop, Former U.S.

Surgeon General

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