A report released by the Tacoma/Pierce County Health Department (TPCHD) reveals that applying fluoride varnish and sealants in high poverty, Pierce County public schools is not as effective as anticipated in preventing tooth decay.
The study conducted in Bethel School District and Clover Park School District followed students who qualified for the school-based Oral Health Program.
About 18 percent of students who qualified received sealants and follow-up treatment showed considerable reductions in tooth decay. However, those who had sealants applied did not retain them as long as expected.
Additionally, more than a quarter of the students assessed in the first year of the study were not present for re-assessment two years later, suggesting that student migration within targeted schools may have interfered with the program’s effectiveness.
Linda Gillis, program coordinator for Oral Health Program at TPCHD, said the department has created an improved process to continue providing services to children throughout the county.
“We’ve targeted community oral health providers,” Gillis said. “We’re allowing them to participate as much as possible in selecting services they are able to provide to the children.”
She added that the department will target their resources on four of the highest need areas in Pierce County – Bethel, White River, Lakewood and portions of Tacoma.
“As people become more familiar with services we offer, they should become more willing to participate in the program,” Gillis said.
Tooth decay remains one of the most common chronic diseases of childhood, according to TPCHD. The Washington State Smile Survey conducted in 2005 showed that children across the county suffered from high levels of tooth decay. Of the second and third graders studied, 56 percent of all the children had experienced tooth decay. The number climbs to 65 percent for low-income children.
TPCHD’s Oral Health Program study was motivated by an effort to move the county’s children closer to benchmarks designated by the U.S. Department of Health and Human Services’ Healthy People 2010 initiative. Launched in January 2000, the initiative provides a framework for national poor health prevention.
One component of the initiative’s benchmarks aims to reduce the ratio of children with negative dental issues in their primary and permanent teeth to 42 percent, reduce the ratio of children with untreated primary and permanent tooth decay to 21 percent and increase the ratio of children who have received dental sealants on their molar teeth to 50 percent.
After reviewing the results of this most recent study, Gillis still believes the Healthy People 2010 benchmarks are achievable goals for Pierce County.
“If we can devote resources into maintaining the same types of data collection used in the study, we can reach some of the benchmarks,” she explained.
Researchers suggested several solutions for reducing incidents of tooth decay in Pierce County children based on findings within the report. They suggest expanding sealant services to third and fourth graders to protect teeth of children not served as second graders. This strategy would also provide an opportunity to reseal teeth if the original sealant was not retained.
They also suggest establishing a collaborative oral health business plan including a community partnership in order to provide a sustainable, countywide, school-based oral health program. This business plan would also include monitoring children already receiving services such as Medicaid, developing a system to monitor follow-up with low-cost providers and developing an effective system for data collection on each child.
However, with so many school districts focused on keeping their budgets balanced and their financial heads above water, student oral health could be put on the back burner for most administrators.
“I would think because we are offering these services, districts wouldn’t have to include them in their budgets,” Gillis noted. “As the economy gets worse, people don’t have these resources so they would probably choose to take advantage of the options being offering to them.”
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