A prescription for smiles

A prescription for smiles

UF, Alachua County Health Department working to improve oral health in county

By Karen Rhodenizer and Meredith Rutland

Kevin Gaines, a third-grader at Rawlings Elementary, has his teeth examined by dentist Sharon Cooper./Photo by Maria Belen Farias

Scott Tomar, D.M.D., Dr.P.H, slaps on his gloves and smiles at the chest-high boy walking toward him.

“Isaiah, have you been to a dentist before?” Tomar asked.

The third-grader shook his head to say he hadn’t.

“Well, this is going to be real easy today,” Tomar said.

Isaiah Ellis, an 8-year-old M.K. Rawlings Elementary School student, opened his mouth and Tomar looked from tooth to tooth, using a quarter-sized mirror to investigate. When the dental screening was over, Tomar gave Isaiah the mirror to keep and told him he could get a goody bag from an open box.

Isaiah was one of 1,800 children to get screened by UF dentists throughout September and October during a countywide oral health screening of 22 elementary schools.

Oral health problems consistently rank among the most 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.

The screening project in elementary schools is just one of the ways the Alachua County Oral Health Coalition is already working to improve oral health in Alachua County. The coalition’s template for change could eventually help other counties in Florida, as well.

The coalition’s Oral Health Plan report, issued in January, includes data on the oral health status of third-graders in every county public school, a first for any county in Florida.

“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., who is a public health dentist and an oral epidemiologist at the University of Florida.

Tomar, who chairs the coalition, says the screenings revealed some troubling information.

“More than 40 percent of the third-grade children had untreated cavities and 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, 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 receive dental care. Because of this, patients often wait until the pain is overwhelming and end up in an emergency room. Dental problems resulted in more than $2.5 million in avoidable emergency room charges in 2010 in Alachua County.

The coalition includes representatives from the Alachua County Health Department and the UF College of Dentistry. College of Dentistry faculty members, volunteer dentists, and supervised third- and fourth-year dental students performed the screenings. The DentaQuest Foundation funded the project.

In 2012, the coalition will work to increase access to oral health services, implementing prevention programs and targeting messages for at-risk populations and continuing oral health surveillance.

UF dentists plan to revisit the schools next year to keep track of students and apply sealants to their teeth, Tomar said.

“We’re committed for the long haul,” he said.