Washington often is regarded as a health innovator. But when it comes to oral health, we’re falling short.
Proven safe and effective efforts, including water fluoridation, are not as widespread as they should be, and many continue to disregard the connection between oral health and overall health.
This is particularly important in Pierce County, where the most recent children's oral health assessment found widespread oral health problems, as well as disparities among lower-income children and children of color. Overall, in Pierce County, 38 percent of kindergartners and 59 percent of third-graders have had tooth decay, even though it is easily preventable.
The State Board of Health aims to change this and has adopted strategies – including water fluoridation and sealants for children –that have been shown to reduce cavities. The strategies also call for greater collaboration among health professionals to improve oral health. Recognizing that state agencies cannot act in isolation, more than 150 community leaders from a variety of health sectors gathered recently to bring the State Board of Health’s plan to fruition.
This high-level attention to oral health is warranted because dental decay remains the top childhood chronic disease in Washington and across the country. Tooth decay is painful and is a leading cause of missed school days, affecting children’s speech development and school readiness. The negative effects of cavities continue throughout life.
Poor oral health can impact work productivity and make it difficult to eat healthy. Gum disease is linked to serious health conditions, including diabetes, heart disease and stroke. And, people with rotten and missing teeth have difficulty finding work.
Dental problems also are expensive to treat. In Washington, dental pain is the top reason uninsured adults visit our state’s emergency departments and a major driver of avoidable emergency room visits.
For 70 years, water fluoridation has improved the oral health of tens of millions of Americans. It is one of the most carefully studied and effective steps a community can take to improve oral health. It also is one reason why adults are keeping their teeth longer than ever. Yet, Washington ranks 35th in the nation in community water fluoridation.
Nearly two-thirds of Pierce county residents do not have access to water fluoridation. Lakewood, Puyallup,Sumner and neighboring communities such as Federal Way and Olympia, are not benefitting from fluoridated water. It is time for these communities and others to provide this low-cost, safe preventive measure that has been proven to benefit people of all ages.
According to the Tacoma-Pierce County Health Department’s analysis, children attending schools with nonfluoridated water are 50 percent more likely to have a history of widespread decay than children attending schools with fluoridated water.
Sealants, which create a barrier between teeth and bacteria, reduce decay by more than 70 percent. They are a cost-effective strategy; the average cost of sealing one tooth is less than one-third the cost of filling a cavity.
Only about 39 percent of third-graders in Pierce County have sealants, which is worse than the statewide average. More action is needed to ensure that all children have access to this proven preventive measure. No child should miss school due to painful tooth decay.
Increased collaboration among health care professionals is important because it underscores that what happens in the mouth can affect the rest of the body. It is encouraging to see that many pediatricians, obstetricians, primary care doctors and other health professionals are looking into their patients’ mouths during checkups and collaborating with dentists to ensure diabetes patients, pregnant mothers, seniors and low-income families get the dental care they need.
So, let’s move ahead with strategies that work and improve the lives of our families. Sealants, collaboration among health care professions and community water fluoridation will prevent problems that are now needlessly widespread, painful and costly. The result will be better oral – and overall – health for all.
Dr. Bob Crittenden is a senior health policy adviser to Gov. Jay Inslee and a former faculty member at the University of Washington School of Medicine.