The tooth fairy would have a lot less business were it up to local health-care professionals who want to slow decay in the mouths of York County’s youngest and poorest residents.

While the cash-for-tooth exchange is fine for natural tooth loss, John M. Bush, DDS, says all too often low-income children lose teeth due to cavities.

He spoke yesterday to about 70 people who attended a meeting to commemorate National Health Center Week, which runs Aug. 5-11. Bush and other speakers at the Family First Health event in York City focused on the state of oral health care, touting access to dental care, oral hygiene education and fluoride in the water.

Access and the push for education have increased since a decade ago, when lack of dental care reached crisis proportions nationwide. Though access to care has improved in York County, Bush and colleagues say more can be done.

And they’re again pushing for a fluoridation program for the public water supply, which is privately owned by York County Water Co.

Dental problems

compared: Rep. Eugene DePasquale, D-York City, spoke briefly to the group, saying benefits of fluoride were evident when comparing dental problems for children in counties that have fluoride in the water — Allegheny and Philadelphia — to York County.

DePasquale looked only at children in WIC programs. Some 0.38 percent of the children in the program in Allegheny and 0.74 percent of children on WIC in Philadelphia reported dental problems compared to 5.45 percent of York County children in the program.

DePasquale said that’s not a direct correlation, but, if nothing else, an adequate comparison.

“(Pennsylvania) spends about $115 million each year for medical assistance for adults
and children,” DePasquale said. “For those who say (fluoride) is too costly, you’re already paying for it. We’re paying for a lot of dental problems on the back end.”

A House bill introduced June 27 attempts to mandate fluoridation in public water statewide. The bill points to the Centers for Disease Control and Prevention, which lists water fluoridation as one of the “10 most significant public health achievements in the 20th century.”

The mandate would reduce dental disease and health-care costs, DePasquale said. Bush, a member of the Community Dentist York County Head Start Advisory Board, has worked with low-income youth for the past 30 years, and he agreed with DePasquale, saying fluoridation has the lowest cost for mass prevention.

Bush said that 50 percent, or 325, of the 4-year-olds in the county’s Head Start program don’t have cavities. But 35 to 40 percent have one to four cavities; 12 percent have five to nine cavities; and 2 to 3 percent of the children have more than 10 cavities with extreme tooth decay.

“I’ve seen as many as 17 of their 20 teeth with decay,” Bush said, and added that those children have a tough time eating, speaking, sleeping and learning. “They are not having a good time.”

Pennsylvania’s dental health

Inadequate dental care, particularly in children, leads to persistent pain, inability to eat, damaged teeth and distraction from schoolwork. Untreated dental problems in adults may lead to stroke, diabetes and pre-term births.

In Pennsylvania, children in households with an annual income less than $20,000 are three times more likely to lack dental care than children in households with an annual income of more than $100,000.

Pennsylvania received an overall grade of “C-” based on the state’s lack of a sealant program for children, its low percentage of dentists who accept Medicaid (13 percent), lack of insurance coverage for older adults and the absence of statewide fluoridation requirements for public water systems.

In 2002, 65 percent of central Pennsylvanians had a dental exam in the past year; 35 percent of uninsured persons had not had a dental exam in more than five years. Hanover is one of 67 Dental Shortage Areas in the United States; one in 8,000 residents in the Hanover area is Medicaid eligible, but one dental office participates in the program, and it is not taking new patients.

Source: Family First Health

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