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New screening shows highs and lows in state third graders' oral health


Sat, Feb 12th, 2011
Posted in Health & Wellness

Oral health data collected in Minnesota for the first time show that the mouths of state third graders meet and exceed some national norms but fall short on others.

"The data show mixed findings," Dr. Edward Ehlinger, commissioner of the Minnesota Department of Health (MDH) said. "Oral disease is nearly 100 percent preventable, and this new information will help MDH determine what resources are needed and where best to place them to improve oral health statewide."

The percentage of screened third graders whose teeth are protected by dental sealants is significantly higher than the national norm. Those screened also have fewer untreated cavities than both the national average and the U.S. Department of Health and Human Services' Healthy People target for 2010, according to the Oral Disease Prevention Unit's "Third Grade Oral Health Basic Screening Survey."

However, survey data also reveal that the percentage of pupils screened who have a history of tooth decay (current fillings and untreated cavities) is higher than both the national average and the Healthy People 2010 target. The Healthy People initiative provides science-based, 10-year national objectives for promoting health and preventing disease.

"Sealant rates indicate that Minnesota school children receive preventive treatment, yet rates of untreated and previous tooth decay are on par with the rest of the nation," Merry Jo Thoele, dental director of MDH's Oral Disease Prevention Unit said.

This is the first time the state has collected random oral screening information, and the findings are a topic at today's (Feb. 11, 2011) Minnesota Oral Health Summit in St. Paul. The summit also marks the release of the new "Minnesota Oral Health Plan," another first for Minnesota, Thoele said. The comprehensive plan is a blueprint for reducing the prevalence of oral disease by focusing on access to care; prevention, education and awareness; and workforce development. Among conference speakers are William Bailey, U.S. assistant surgeon general; Marcy Frosh, associate executive director of the Children's Dental Health Project; and Commissioner Ehlinger.

According to screening data, an average of 64 percent of state third graders screened has dental sealants on teeth, Thoele said. The national average is 23 percent and the Healthy People 2010 target is 50 percent. Dental sealants are thin plastic coatings applied to grooves on chewing surfaces of back teeth to protect the surfaces from tooth decay. Sealants keep germs and food particles out of the grooves, where most tooth decay in children and teens occurs. Sealants and fluoride work together to prevent tooth decay.

While statistics also show that 18 percent of pupils screened have untreated tooth decay, this rate is better than both the national average of 29 percent and the Healthy People 2010 target of 21 percent. However, 55 percent of children screened have a history of cavities. This is slightly higher than the national average of 52 percent and exceeds the Healthy People 2010 target of 42 percent.

Data further show that race, ethnicity and socioeconomic status are factors in oral health, Thoele said. Only 49 percent of Hispanic pupils have dental sealants compared to 67 percent of non-Hispanic white pupils. While the prevalence of previous tooth decay is statistically insignificant between different populations, non-Hispanic white students generally have lower prevalence.

"The burden of oral disease in Minnesota is disproportionately borne by children from minority populations and schools with higher proportions of lower income families," Thoele said.

Schools with higher proportions of pupils on or qualified for free or reduced-price lunch programs had increased rates of fillings and/or untreated tooth decay. In general, schools with 25 percent or less of students qualified for these lunch programs have better oral health than peers in schools with 75 percent or more qualified students.

"Results indicate that opportunities exist to strengthen disease prevention efforts and to put into motion strategies that lead to treatment access for specific populations," Thoele said. "Our new plan addresses this and other oral health issues by setting goals and providing specific, measurable and time-phased objectives and activities for accomplishing them."

Third grade pupils received oral screenings at 40 randomly selected public schools with classroom sizes of ten pupils or more. Screenings of 1,766 third graders took place in 2010 between February and the end of May. It involved a standardized cross sectional open-mouth survey developed by the Association of State and Territorial Dental Directors and conducted by trained contract and state health department staff and 31 volunteer dental hygienists. Data analysis lasted about six months. The dental survey was pre-tested in three pilot schools.

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