Dental Care for Low Income Children: NYS gets a “C”

Approximately one in five low-income children in America goes without dental care each year, according to The Cost of Delay: State Dental Policies Fail One in Five Children, a newly released report from the Pew Center. Pew assessed and graded states  on proven policy solutions that ensure dental health and access to care.

Here are some of the findings for New York State:

  • Untreated Decay and Sealant Prevalence: 33.1% of third graders with untreated tooth decay
  • Percentage of Low-Income Children Receiving Dental Services:  33.7%
  • Dentist Shortage: 222 Dentists Needed to Remove Shortage Designation
  • State has sealant programs in place in at least 25 percent of high-risk schools: less than 25%
  • State provides optimally fluoridated water to at least 75 percent of citizens on community systems:72.9%
  • State meets or exceeds the national average of 38.1% children ages 1 to 18 on Medicaid receiving dental services:33.7%

To see how other states fared read the full report.

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5 Responses to Dental Care for Low Income Children: NYS gets a “C”

  1. nyscof says:

    New York City spent $24 million on water fluoridation in 2008 (manpower, equipment, chemicals, paperwork, etc). Yet NYC populations studied have among the highest rates of tooth decay in the country.

    Further, NYS Department of Health statistics show that NYS non-fluoridated counties have among the lowest rates of tooth decay in the state.

    National data shows that the most fluoridated states have the highest rates of tooth loss.

    Dr. J Kumar of the NYS Department of Health’s bureau of dental health published an article in the Journal of the American Dental Association revealing national statistics which shows that rates of tooth decay are similar no matter how much fluoride is in the water supply.

    Clearly, NYS’s 73% fluoridation rate is not reducing tooth decay and never will

    The Pew Foundation used meaningless bench marks because that states receiving an “A” still have high rates of tooth loss and/or tooth decay while some states getting a worse grade have better oral health statistics.

    Rotten diets make rotten teeth and no amount of fluoride, sealants and more money for dentists will stop that.

    We have to stop feeding the dentists and start feeding poor children whose poor diets are what’s really causing their teeth to decay and their inability to find dentists willing to fill their inevitable cavities is exacerbating the problem.

  2. Picker22 says:

    NYCOF’s claim that water fluoridation doesn’t work (usually she says it is money down the drain) is based on a mistaken reading of J.V. Kumar’s study in the July 2009 Journal of the Am. Dental Association.

    This study showed that teeth which developed fluorosis as a result of ingesting fluoride were more resistant to cavities. Kumar’s study is important as yet another testament to water fluoridation’s effectiveness and also as further evidence of the importance of the systemic effect of ingested fluoride.

    The data used in the Kumar paper comes from the National Institute of Dental Research survey published by Brunelle, Carlos and Heller in 1990. These authors found that, averaged across the United States, fluoridation reduced caries by 18 to 25%. In the Pacific Northwest, where few communities were then fluoridated and the “halo effect” is not operative, caries were reduced by a whopping 60%.

    In the early 90’s well known anti-fluoridation activist, John Yiamouyiannis, separately analyzed these data and concluded that fluoridation did not prevent caries. However, Yiamouyiannis erred by only considering the prevalence of cavities and ignoring the information in the data on caries severity. NYCOF’s recounting of these data from Kumar’s paper simply restates Yiamouyiannis’s error.

    Suppose a vaccine for a hypothetical viral disease prevented all deaths but had no effect on whether or not a person would acquire the viral disease. Clearly for many severe illnesses this would be a wonderful result. If NYCOF and Yiamouyiannis were to apply their severity-blind methodology to such a vaccine they presumably would advise against the its use because the same number of people “got” the virus whether vaccinated or not. The foolishness is transparently obvious.

    Readers are invited to read the Kumar paper for themselves: Am Dent Assoc. 2009 Jul;140(7):855-62. The association between enamel fluorosis and dental caries in U.S. schoolchildren. Iida H, Kumar JV. http://jada.ada.org/cgi/content/abstract/140/7/855

    There is no doubt that diet is an important factor causing cavities. There is no argument that diets with fewer concentrated sweets, particularly sugar based drinks, will improve oral health. That fact, however, has absolutely no bearing on the decision for water fluoridation. Both water fluoridation and dental health education and nutritional support are in order. The benefits of water fluoridation are easily and inexpensively achieved. Changing oral health habits and food selection in entire populations is a long term, difficult matter. I am unaware of any published report showing the efficacy or costs of NYCOF’s idea in the public health scientific literature.

    The sad matter is that specious arguments such as this are politically effective in creating opposition to water fluoridation. Water fluoridation is a very important public health intervention. The most dramatic effect is the avoidance of approximately 3/4 of the severe childhood cavities which require treatment with general anesthesia. Hopefully the truth will eventually prevail.

    Picker22

  3. nyscof says:

    Toxicology. 2010 Feb 24. [Epub ahead of print]

    Fluoride increases lead concentrations in whole blood and in calcified tissues from lead-exposed rats.
    Sawan RM, Leite GA, Saraiva MC, Barbosa F, Tanus-Santos JE, Gerlach RF.

    School of Dentistry of Ribeirao Preto, University of Sao Paulo (FORP/USP), Av do Café s/n, 14040-904, Ribeirão Preto, SP, Brazil.

    Higher blood lead (BPb) levels have been reported in children living in communities that receive fluoride-treated water. Here, we examined whether fluoride co-administered with lead increases BPb and lead concentrations in calcified tissues in Wistar rats exposed to this metal from the beginning of gestation. We exposed female rats and their offspring to control water (Control Group), 100mg/L of fluoride (F Group), 30mg/L of lead (Pb Group), or 100mg/L of fluoride and 30mg/L of lead (F+Pb group) from 1 week prior to mating until offspring was 81 days old. Blood and calcified tissues (enamel, dentine, and bone) were harvested at day 81 for lead and fluoride analyses. Higher BPb concentrations were found in the F+Pb group compared with the Pb group (76.7+/-11.0mug/dL versus 22.6+/-8.5mug/dL, respectively; p<0.001). Two- to 3-fold higher lead concentrations were found in the calcified tissues in the F+Pb group compared with the Pb group (all p<0.001). Fluoride concentrations were similar in the F and in the F+Pb groups. These findings show that fluoride consistently increases BPb and calcified tissues Pb concentrations in animals exposed to low levels of lead and suggest that a biological effect not yet recognized may underlie the epidemiological association between increased BPb lead levels in children living in water-fluoridated communities. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

    PMID: 20188782 [PubMed – as supplied by publisher]

    http://www.ncbi.nlm.nih.gov/pubmed/20188782?itool=Email.EmailReport.Pubmed_ReportSelector.Pubmed_RVDocSum&ordinalpos=6

  4. nyscof says:

    The Pew Report fails to report the obvious. Are any of these grading measures actually reducing tooth decay & loss

    e.g., South Carolina (95% fluoridated) got an “A” but ranks 31 in tooth loss of those over 65 and ranks 37 in those who have lost 6 or more teeth due to decay or gum disease.

    In Connecticut which received an “A,” fluoridation is state-mandated. Yet a 2007 survey of Connecticut schoolchildren found that 31% of children in Head Start aged 2-4 have already experienced tooth decay and that 14% of those children had 5 or more teeth decayed or missing from decay. By Kindergarten, more than one in four children have experienced dental decay, 16% of which have untreated decay

    In New York State (73% fluoridated), county data shows that tooth decay is lowest in the NON-fluoridated counties.

    Nation-wide, tooth loss is highest in the most fluoridated states.

    States that received an”F” from Pew:

    Arkansas (64% fluoridated),
    Delaware (74% fluoridated),
    Florida (78% fluoridated),
    Pennsylvania (54% fluoridated),
    West Virginia (92% fluoridated)

    These uncomfortable facts are being ignored.

    Dentists must be mandated to treat more low-income Americans. We know they like mandates because they are behind virtually every fluoridation mandate in the country. Fluoridation doesn’t hurt dentists bottom line because it doesn’t reduce tooth decay.

  5. Picker22 says:

    NYCOF has got to be kidding. . an animal study at fluoride intake 100 times higher than optimized fluoride is a reason to oppose community water fluoridation (CWF).

    With respect to surveillance information (the previous post re Arkansas, Delaware etc) . . clearly this has no bearing at all on whether or not CWF prevents cavities. Caries is a multifactoral disease. Information not designed to test for fluoridation’s effectiveness cannot reasonably be used as arguments against it.

    WHO data showing international downward trends in caries rates is often cited by those who oppose water fluoridation. But Ireland, the only nation which reported rates for both fluoridated and non-fluoridated water systems showed a clear benefit with fluoridation. Yes, rates are generally lower but they are lower yet where the water is fluoridated.

    Picker 22

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