Oral health is improving for many Washington kids but disparities remain

The oral health of children in Washington is continuing to improve with big drops in untreated tooth decay and 88 percent of all kids surveyed (preschool, kindergarten and third grade) receiving dental care for cavities. These and other results from the latest Smile Survey, a statewide oral health assessment, demonstrate that children’s oral health programs are reaching and helping more kids.

“It is good news that many more children are receiving the benefits of prevention and treatment, because oral health is essential to overall health and no child should have to experience the pain and other negative effects of tooth decay,” said Diane Oakes, President and CEO of Washington Dental Service Foundation.  “But significant work remains because there are still many children who are not receiving the care they need.”

While largely preventable, cavities remain the most common chronic childhood disease and can adversely affect nutrition, sleep, school performance, socialization, self-image and overall health. Cavities in baby teeth can lead to cavities in permanent teeth and create lifelong oral health problems. Dental disease and its impacts are costly for families, communities, businesses and government, while prevention and early treatment save money and improve overall health.

The 2015-2016 Smile Survey found that the prevalence of untreated decay declined significantly among preschoolers and third-graders from low-income households and among all racial and ethnic groups, compared to the 2005 Smile Survey.

Washington was among the top five states in the country for the lowest amount of decay among third-graders. Fewer 3rd graders had ever had a cavity, 53 percent compared to 60 percent in 2005, and decay in permanent teeth among 3rd graders was also lower, 13 percent compared to 24 percent in 2005.   Untreated decay among low-income preschool children (17 percent) was significantly below the national average (25 percent).

Children in third grade from low-income households had at least 60 percent higher rates of decay and need for treatment. Children of color in second and third grade also higher rates of decay and need for treatment compared to white children.  For example, Hispanic and American Indian/Alaskan Native (AI/AN) children have about 50 percent more caries experience and more than twice the rate of rampant decay.

On the other hand, the Survey showed that the disparity gap appears to be shrinking for dental sealants.  Children from all races and socioeconomic backgrounds had improved access to dental sealants, which are effective in preventing cavities. Hispanic children have a much higher rate of sealant placement than non-Hispanic white children.  At 54 percent, the application of dental sealants among third-graders in Washington was significantly higher than the national average of 32 percent.

Still, more than half of children in second and third grade in Washington have had tooth decay. “This means that on any given day across the state, approximately 144,000 seven-, eight- and nine-year-olds are affected by this largely preventable disease,” the Survey report said.

Since 2005, Washington has provided health care coverage including dental care for children from low-income families through Apple Health for Kids (Medicaid).  More than 50 percent of children in Washington are eligible for medical and dental coverage through Apple Health.

Washington’s Access to Baby and Child Dentistry (ABCD) program, which links Medicaid-eligible children up to age 6 to dental care, has expanded to all 39 counties today.  ABCD provides enhanced payments to dentists who receive training in how to manage young children, promotes collaboration between medical and dental professionals to expand access to oral health services, and outreach to families to let them know care is available for their children.

“Scientific research has shown there are substantial benefits from preventive care and early dental treatment for young children.  Children are not healthy if their mouths are not healthy and a child’s overall wellness must include dental care, said Emma Medicine White Crow, Co-Chair of the Governor’s Interagency Council on Health Disparities.  “There is a correlation between poor dental health and other chronic conditions like diabetes and heart disease.  We have made progress but significant disparities remain.  Our challenge is to be persistent to attain health equity in the benefit of oral health for every child.”

The Smile Survey is conducted every five years by the Washington State Department of Health to evaluate the oral health of Head Start preschool and elementary school children.