A road map for oral health prevention

By: Burton L. Edelstein

A recent New York Times story reported new federal data showing that nearly one in four (23%) preschool-age children in the U.S. has experienced tooth decay, and the article closed with the question “What else can we do?” Today, the Journal of the American Dental Association (JADA) publicly released a new article providing nine specific answers to that question.

The JADA article directs policymakers in the fight against the epidemic of tooth decay that affects America’s youngest and most vulnerable children. This article projects how much each of these nine strategies can improve young children’s oral health and at what cost.

Strategies that target the youngest, highest-risk children and begin early in children’s lives hold the strongest potential to accomplish the magical win-win: better health at lower cost.

Researchers assessed the power of each strategy over 10 years if implemented by New York state health officials. The goal was to direct policymakers to strategies they can support to improve oral health while saving Medicaid dollars. The research team was assembled by the Children’s Dental Health Project (CDHP), and funded by the Centers for Disease Control and Prevention and the Health Foundation for Western & Central New York. 

Using a sophisticated modeling technique called System Dynamics Modeling, the CDHP team analyzed strategies that range from public health to clinical care to home care. We analyzed a variety of approaches to prevention:

  • the power of fluorides delivered in water, toothpastes and professionally applied varnishes
  • counseling of parents by dental and medical providers
  • reducing decay-causing bacterial transmission from moms to young children
  • more intensive dental care for high-risk kids; and
  • various combinations of the previous strategies

The punch line? The variety of population-level and individual-level strategies available to control early childhood tooth decay differ tremendously in their ability to improve children’s oral health and reduce state Medicaid expenditures. Strategies that can be delivered only by health professionals cost more than they save in dental repair costs. Strategies that target the youngest, highest-risk children and begin early in children’s lives hold the strongest potential to accomplish the magical win-win: better health at lower cost.

Now’s the time for policymakers who legislate and regulate health programs and health insurance plans to follow the authors’ leads by investing in short- and long-term strategies that can improve children’s lives as much as they save states’ dollars.

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Did you know?

75% }
of American Indian/Alaskan Native children have experienced caries by age 5.
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