Pressing need for kids
Many children aren't receiving regular dental care
The Post and Courier
Dental hygienist Meg Croghan works with Emmy Sargeant at Stiles Point Elementary School. In-school cleanings are a safety net for some children and a convenience for busy parents who are insured.
A fifth-grader went to the St. Andrew's Middle School clinic with what he thought was an erupting tooth in the back of his mouth. But the spot didn't look right to school nurse Robert Naugle.
Naugle called a Johns Island dentist, who urged the student to come in at once. The boy was diagnosed with cancer and successfully treated.
"It was one of the most profound experiences I had in five years as a school nurse," Naugle said.
In addition to the routine dental complaints of young children — teeth falling out and coming in — school nurses face abscesses, cavities and dental emergencies. Children are going without dental care and dental insurance, according to two studies, leaving schools and public health outreaches as a safety net.
More than 47 percent of U.S. children age 5 and younger have not seen a dentist in the previous year, according to a recent report by researchers at the S.C. Rural Health Research Center at the University of South Carolina Arnold School of Public Health. The American Academy of Pediatric Dentistry recommends children see a dentist when their first tooth appears or within their first year of life, with check-ups every six months.
The report was based on a 2003 survey that used parents' reports to measure the health of children from birth to age 17. Amy Brock Martin, lead author and deputy director for the research center, said they mined data by race and levels of rurality.
The study found that nearly 32 percent of Hispanic children in rural areas had no dental care in the past year. Twenty-six percent of rural black children had no dental care, followed by 23 percent of "other" children and 22 percent of white children.
"Oral health problems for kids is their No. 1 chronic illness need and large contributor to absenteeism," Martin said.
Melissa Prendergast, officer of health services for the Charleston County School District, said, "It's definitely an issue. We have lots of students who are served primarily in school."
The district partners with the S.C. Department of Health and Environmental Control to provide care through two contractors. Health Promotion Specialists sends in dental hygienists for cleaning, sealants and fluoride treatments, and Mobile Dental Care provides dental exams, fillings and other treatments.
Tammi O. Byrd is chief executive officer and clinical director of Health Promotion Specialists, which contracts with school districts statewide. Children who use the service have Medicaid or private insurance or pay up front.
"In most cases, yes, there is a greater need in rural areas; but in inner city pockets, there are less Medicaid providers to refer children to," Byrd said.
Meg Croghan, a dental hygienist with Health Promotion Specialists, calls the Waterpik "Mr. Squishy" and the suction tool "Mr. Thirsty." "There is so much need in rural areas," she said. "Parents with one car and have to go to work. Transportation is an issue when no dentists are around."
Croghan, who works under a supervising dentist, can clean teeth and screen for problems. Hygienists also can apply sealants to teeth to smooth out depressions where food can get caught and act as a barrier, protecting the teeth against decay. She encourages students to get annual check-ups with a dentist.
The recent changes to Medicaid's reimbursement rates are a mixed bag, Martin said. In-school public health services took cuts, she said, and programs such as Health Promotion Services catch the most vulnerable children.
On the positive side, the reimbursement rate for clinical services at private dental practices has increased, which may make Medicaid patients more attractive to dentists, Martin said.
The Center for Studying Health System's Change, a Washington, D.C.-based nonpartisan think tank, visits 12 cities nationally, one of which is Greenville, every two years and conducts interviews. Data collected from the sixth round of interviews, which occurred in 2007, focused on dental health.
Dental care was one of the most difficult health care services for low-income people to obtain, researchers found. Barriers to care were lack of dental insurance, limited benefits and lack of dentists willing to serve low-income patients.
Many low-income people do not receive preventative care or do not seek treatment until infection sets in, researchers found. Also, diseased teeth are often extracted rather than restored.
Glennis Randazzo is a school nurse at Mitchell Elementary School, a Title I school where a majority of children get federally-funded free and reduced-priced lunches. About 15 percent of the children who turn up at her clinic are there for dental reasons, she said.
"If you have a child who's sick, you're not going to have a child who's learning," Randazzo said. Many times children have molars coming in. She also sees many cavities or abscesses that have not been addressed.
Abscessed teeth can turn into fatal infections, such as the widely publicized case of Deamonte Driver in 2007, a Maryland boy who died after a tooth infection spread to his brain.
Confusion surrounding the health care system is partly to blame, Randazzo said. "Navigating the system can be intimidating, so many don't even try," she said.
Access to care
-- 40.3 percent of the parents of rural S.C. children said their children have teeth in excellent condition; the number was 44.4 percent among urban children.
-- Rural "non-white" children were less likely to have dental insurance than non-rural children (80.1 percent versus 88.1 percent).
-- Among children ages 12-17, rural children had teeth in poorer condition and were less likely to have dental insurance than urban children.
-- South Carolina ranks 20th in the nation for the number of rural children not having dental visits in the past year.
-- South Carolina ranks 30th in the nation for the number of rural children not receiving preventive care.
-- South Carolina ranks 10th in the nation for rural children with dental insurance — a positive statistic for the Palmetto State.
-- Most counties in South Carolina have been designated by the federal government to have Health Professional Shortage Areas for dentists.
Source: S.C. Rural Health Research Center, Arnold School, University of South Carolina.
Reach Jill Coley at 937-5719 or jcoley@postandcourier.com.
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Comments
pirate42 (anonymous) says...
Its about time this happened now what about kids with Acme can we help tham so there self esteme is not in the toilet also money need to be spent wisley you bunch of policticians
November 10, 2008 at 4:54 a.m. ( permalink | suggest removal )
scrad123 (anonymous) says...
kids with Acme???? I'm supposing you mean Acne....Yes, the government should spend millions to give children dangerous acne medication that could possibly harm their liver. Yes, that is what my tax dollars should be used for. give me a break
November 10, 2008 at 6:30 a.m. ( permalink | suggest removal )
back2u (anonymous) says...
I feel saddened by this. I've always been diligent about my children's oral care. I figured that if the mouth was healthy, then the rest of the digestive system has a somewhat better chance of getting healthier nutrition going down. Junk food & the environment in general is bad enough. Why add unnecessary bacteria and other icky stuff seeping through tiny cracks & holes in the teeth & gums? How's that for early morning imagery? yuck!
November 10, 2008 at 6:48 a.m. ( permalink | suggest removal )
counterpoint (anonymous) says...
Pirate... wow. Please tell me your spelling and grammar errors were deliberate? If not then I suppose we could argue that more money should go to bolstering education...
November 10, 2008 at 7:15 a.m. ( permalink | suggest removal )
eyfigueroa (anonymous) says...
As much as I dislike government interference in what should be parental responsibility, the idea of another 12 year old like Deomonte Driver dying of what should have been a simple fix is repulsive to me.
No, as a nation we cannot help everyone with everything. However, simple preventative care is far less expensive than reactionary care or even death.
A fifth grader diagnosed with cancer was successfully treated due to this program. I'm no bleeding heart but the idea of this child possibly dying because his parents (for whatever reason) didn't or couldn't get him to regularly scheduled dental appointments is patently ludicrous to me.
I don't advocate the unilateral medical/dental care for adults. But a few hundred thousand 'tax' dollars a year in supporting programs such as these could definitely save not only lives, but academic productivity and tax dollars used in costly treatments of illnesses that could have been prevented.
November 10, 2008 at 9:51 a.m. ( permalink | suggest removal )
coolfreaknbeans (anonymous) says...
I don't see this as a political issue. Dental care can be expensive and problematic, even for the insured. I have yet to have dental insurance that wasn't riddled with expensive co-pays. I can't imagine trying to do it without insurance. I agree with your post 100% Early. Dental insurance seems to amount to a lame coupon. Like Oh yeah...10% off, wow.
November 10, 2008 at 10:36 a.m. ( permalink | suggest removal )
coolfreaknbeans (anonymous) says...
I agree Cswoman. But a lot of poor people take the " If it ain't broke don't fix it" mentality due to finances. It is the parents responsibility. But I don't want to see sick children. It's not their fault they are poor. Let's face it, every dentist I have ever been to has a sign at the front door that reminds you full payment is required at time of service. Not many folks can afford it. These dentists(none Ive seen) are flexible as far as payments go. I'd rather my tax money help kids in need here than other countries.
November 10, 2008 at 11:06 a.m. ( permalink | suggest removal )
eyfigueroa (anonymous) says...
speaking of hyperbole...
November 10, 2008 at 12:30 p.m. ( permalink | suggest removal )
eyfigueroa (anonymous) says...
Coolbeans: you and I are in total agreement. I have no problem with using tax $ to give PREVENTATIVE care to children.
CSwoman: If your response to me was an attempt at being sarcastic or facetious, I humbly suggest you try again.
Curious, you agreed with coolbeans who essentially agreed with me and reiterated my point.
Why the change of heart?
November 10, 2008 at 12:32 p.m. ( permalink | suggest removal )
eyfigueroa (anonymous) says...
i apologize cswoman. I'm really not clear on what you are trying to say. Perhaps I'm lacking somewhat today but you aren't making any sense.
"no kiddin about the pizza and stromboli - you will soon have to pay the man weekly to stay in business, dude."
November 10, 2008 at 1:21 p.m. ( permalink | suggest removal )
eyfigueroa (anonymous) says...
Pardon me if I raise an eyebrow.
I place that one right up there with Obama is a 'Manchurian Candidate' created by mad liberal scientists.
Don't get me wrong.
Are there very real issues that need to be confronted.
Absolutely.
But these 'rumors' and 'innuendos' sound more like an episode of George Noory's Coast to Coast AM than real political concerns.
November 10, 2008 at 1:50 p.m. ( permalink | suggest removal )
eyfigueroa (anonymous) says...
"I just don't think this man with less than a year on a job and the rest spent campaigning has any experience, credability or knowledge of what he has gotten into."
Perhaps not. However he is the President-Elect. Short of something untoward happening to him, he is in office and will be for the next four years.
So unless someone, some entity can come up with credible and verifiable facts, all of these 'rumors' are just that, rumors.
I find it difficult to believe that the RNC and their surrogates could NOT come up with more than just ideological aspersions about this man. I see no logic in just giving the election to this so-called terrorist.
Unless of course there wasn't any proof for them to give up.
He's a Muslim. He was born in Kenya. Muslim extremists paid his Harvard tuition. He took the oath of Senate Office on a Koran. He and his wife and children secretly worship Islam in the basement of their home. He's connected to the mob. He is a Manchurian Candidate. He is actually an alien sent by a nefarious race to conquer Earthlings from the inside out. He is the Anti-Christ.
I mean this goes on and on.
And to counter Jane's assertion that the mainstream media is in the tank (of which I somewhat concur) that doesn't explain why Politico, Fox News, National Review, The Weekly Standard, Sean Hannity or even Rush Limbaugh ALL have not brought forward PROOF of these allegations.
Am I to believe that they too are in the tank for President-Elect Obama?
Again, I will agree that Mr. Obama has some questionable associations and he may not have been the most 'experienced' politician to have won the Presidency, but let's talk facts and not scurrilous claims put out for the sole purpose of frightening the uninformed.
November 10, 2008 at 2:57 p.m. ( permalink | suggest removal )
shoelaces (anonymous) says...
Great job Naugle!!!! Let's actually credit a school and an employee for catching this one in time to save a life!!
Too bad the kids own parents dropped the ball on this one.
November 10, 2008 at 3:20 p.m. ( permalink | suggest removal )
geekguy2008 (anonymous) says...
Why not focus on basic dental care? Give out free toothbrushes, paste and floss. Hold clinics on proper brushing and flouride...whatever. This 'problem' seems to stem from parents who don't supervise their kids and make sure they are taking care of their teeth and not eating candy and sweets all the time.
November 10, 2008 at 6:34 p.m. ( permalink | suggest removal )
coolfreaknbeans (anonymous) says...
Great Point geekguy2008! You reminded me of something. When I was growing up they did that a lot. We even had a school field trip to the old little "mall" in West Ashley. They had some dental place there. They gave out floss, toothbrushes and those nifty tablets that tracked plaque. They educated all of the kids on good dental hygiene.
November 10, 2008 at 6:46 p.m. ( permalink | suggest removal )
wonderdog (anonymous) says...
Interesting caption under the photo states that the dental checkups are also "a convenience for busy parents who are insured." Take it from a single parent who has raised two children and worked at least full time - you FIND the time if you have your priorities straight.
November 10, 2008 at 8:03 p.m. ( permalink | suggest removal )
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