Plan, surveillance could help improve oral health across state

Kevin Gaines, 10, third grader at Rawlings Elementary, has his teeth examined by Sharon Cooper, DMD.
Kevin Gaines, 10, third grader at Rawlings Elementary, has his teeth examined by Sharon Cooper, DMD.

GAINESVILLE, Fla. ― Oral health problems consistently rank among the most prevalent unmet health needs in the nation, and in Florida, that need is higher than most states. Florida was one of just three states that received an “F” grade on two consecutive Oral Health Report Cards issued by the Pew Center on the States.
 
To improve this problem, the University of Florida College of Dentistry and the Alachua County Health Department formed the Alachua County Oral Health Coalition and released a plan outlining a template for change that could help other counties in Florida, too.
 
The coalition’s Oral Health Plan, issued in January 2012, includes data on the oral health status of third-graders in every county public school, a first for any county in Florida. Funded by a grant from DentaQuest Foundation, the data was collected during screenings at each school in September and October.

Scott Tomar, D.M.D., Dr.P.H., a public health dentist and an oral epidemiologist with the UF College of Dentistry
Larisha Stephens, 9, third grader at Rawlings Elementary, has her teeth examined by Scott Tomar.

“One of the reasons Florida received an “F” grade is because of a lack of an oral health surveillance system in the state. Surveillance is just the first step in a public health approach to assessing, planning and evaluating policies and programs to improve the oral health of our communities,” said Scott Tomar, D.M.D., Dr.P.H., a public health dentist and an oral epidemiologist with the UF College of Dentistry.
 
Tomar, who chairs the coalition, says the screenings revealed some troubling information.
 
“More than 27 percent of the third-grade children had untreated cavities, and in some schools, nearly one in five had an urgent need for dental care due to oral pain or a clinical sign of infection,” Tomar said, “For children, oral pain contributes to missed school days and poor performance in school and can create long-term issues with overall health for children and adults.”
 
Low-income families can have a difficult time finding dentists who accept Medicaid patients, a problem caused by Florida’s extremely low Medicaid reimbursement rates for dental care. An analysis of Medicaid claims data shows that only about one-fourth of children received any dental care. Because of this, patients often wait until the infection or pain is overwhelming, and they end up in an emergency room. Dental problems experienced by Alachua County residents resulted in more than $2.5 million in avoidable emergency room charges in 2010.
 
“There is an inextricable link between oral health and general health, and it is critical that we find better ways of taking care of the oral health of our most vulnerable population,” Tomar said.
 
The dental screenings were performed by College of Dentistry faculty, volunteer dentists from the community, and third- and fourth-year dental students under faculty supervision. In 10 weeks, about 1,800 third-graders received screenings.
 
In 2012, the coalition, which includes representatives from more than 20 organizations, will take steps in Alachua County to create a better oral health future, including working to increase access to oral health services, implementing prevention programs, educating the public and policymakers on oral health issues and continuing oral health surveillance.
 
The Alachua County Oral Health Coalition is a member of the Florida Oral Health Coalition and is helping to advance these programs statewide.