Commentary, Slider

Dental health gets second-class treatment

By Glenn Ellis
George Curry Media Columnist

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The Affordable Care Act, or “Obamacare,” has changed many lives for the better – mine included.

But its omission of dental coverage, a result of political compromise, is a dangerous development, as though teeth are apart from and less important than the rest of the body. In fact, cavities are a silent epidemic and according to the Center for Disease Control and Prevention, they’re the No. 1 chronic infectious disease in children.

Although many of the health problems associated with obesity are well-known, such as increased risk for diabetes and cardiovascular problems, those linked with cavities don’t receive as much attention. Although tooth decay is almost completely preventable, according to the surgeon general, cavities are five times more common than asthma and seven times more common than hay fever and allergies.

A picture-perfect smile falls just out of reach for many children living in poverty. The burden of poor dental care falls disproportionately on low-income and minority children. Statistics from the Centers for Disease Control and Prevention state that one out of every five child between the ages of 2 and 5 have untreated dental problems including infection, cavities and tooth decay.

About 37 percent of poor children 2- to 9-years-old have one, or sometimes more, untreated decayed baby teeth, compared with 17.3 percent of higher-income children, according to the report for the surgeon general. Low-income children are less likely to receive regular dental care, and the cavities are more likely to go unfilled. The consequences of untreated decay include emergency room visits for dental pain and lost time at school and work. Those with untreated dental issues are then more likely to have the more-severe forms of the disease as they grow older.

Recently, it has been recognized that oral infection, especially periodontitis (gum disease), may affect the course and progression of a number of diseases, such as cardiovascular disease, bacterial pneumonia, diabetes mellitus and low birth weight. Research has even linked poor oral health with Alzheimer’s.

The socioeconomic forces that place these children at risk of food insecurity are the very same ones that increase their risk of developing early childhood caries (tooth decay). This disparity in poor oral health adversely impacts these children’s ability to eat, speak and learn, further cementing social inequities already stacked against this vulnerable population.

The lack of money for visiting a dentist is only the tip of the iceberg that fuels the unfortunate trend. Aside from not being able to afford dental care, the less affluent have unhealthy diets filled with sugar and fat (both are fodder for oral bacteria), may be unable to buy basic oral hygiene tools such as toothpaste, toothbrushes and dental floss and may not get the proper education needed for oral health.

America is a great melting pot filled with people of all ethnicities and geographical origins. However, those who have routes tracing back to Mexico or Africa have higher levels of cavities and dental problems. Data collected from 2001-2004 and presented by the Centers for Disease Control and Prevention has shown that for children 2- to 5-years-old, 24.2 percent of Black children and 29.2 percent of Hispanic children (of Mexican origin) had untreated tooth decay. White children had significantly lower levels, measuring at 14.5 percent.

Parents and caregivers must intervene in order to curb the growing tooth-decay tragedy facing the nation. Teaching children the proper brushing techniques, providing them fresh water to drink instead of soft drinks, encouraging physical fitness and eating a balanced diet following the recommended government nutritional guidelines can go a long way toward improving dental health.

There is no doubt that tooth decay can be prevented, yet one in four children have had tooth decay by age 5. For children of color, the rates of tooth decay are much higher.

Preventing tooth decay can help protect children from dental pain. It can also protect families and taxpayers from the costs of fillings, crowns or other treatments. The average cost of a dental filling is $171. In addition, fillings usually need to be repaired or replaced. So what about the lifetime cost of a cavity? A more recent analysis of California dental data found lifetime costs for a single decayed molar can exceed $6,000. With already unsustainable health care costs in this country, how can we allow this trend to continue?

Good dental health is a smart investment … for our children, our economy and our future.

Remember, I’m not a doctor. I just sound like one.

Glenn Ellis is a regular media contributor on health equity and medical ethics. He is the author of “Which Doctor?” and “Information is the Best Medicine.”

August 24, 2016
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