Sonoma County, CA: The latest surveys show an estimated 2,800 Sonoma County children may be suffering from advanced dental disease, with poor and minority children disproportionately affected, according to a report released by Sonoma County health care leaders.

The report, an update about children’s oral health in our local communities, was presented to the Sonoma County Board of Supervisors today and featured key findings of a recent in-mouth survey conducted in local schools. It also outlined five priority action steps to help improve the dental health of Sonoma County’s children.

Dental disease is a silent epidemic, especially in children.

“Often the public perception – especially among those with dental insurance and access to timely dental care – is that tooth decay is natural and a minor concern,” said Dr. Mary Maddux-González, public health officer for the county. “However, if left untreated, tooth decay can lead to needless pain and suffering for children. It can interfere with nutrition, development, self image, and school achievement.”

Dr. Maddux-González added: “The good news is that most oral disease is entirely preventable. It is very important that our local hospitals and health department are working together to bring much-needed attention to this issue.”

Background
In May 2008, representatives from the Sonoma Health Alliance, including Sutter Medical Center of Santa Rosa, St. Joseph Health System – Sonoma County, Kaiser Permanente Medical Center of Santa Rosa, and the Sonoma County Department of Health Services presented the Community Health Needs Assessment for 2008-2011 to the County Board of Supervisors. The assessment focused on four children’s health issues, including an epidemic of dental disease that continues to threaten the health and well-being of children in our community.

The Community Health Needs Assessment highlighted recommendations to address the epidemic of dental disease. These included:

• Increasing access to fluoridated drinking water.

• Collecting more data about the status of children’s oral health to help target prevention efforts.

The Sonoma County Smile Survey
In early 2009, the Sonoma Health Alliance contracted with Community Action Partnership to survey elementary school children to develop an accurate “snapshot” of oral health status. During the spring of 2009, oral health screenings were conducted on both kindergarteners and third-graders at 15 randomly selected schools, insuring a sample size that would support extrapolation to the entire county.

With parents’ permission and under protocols developed by the Centers for Disease Control and Prevention, trained dental examiners completed “in mouth” screenings using four oral health indicators – presence of decayed teeth, presence of filled teeth, presence of dental sealants (a protective coating for permanent molars), and treatment urgency (a measure of the severity of untreated decay). Survey results are captured in the attached Sonoma County Smile Survey.

Key findings of the survey show:

• An epidemic of dental disease is compromising the health and quality of life of Sonoma County's children.

• An estimated 2,800 Sonoma County children may be suffering from advanced dental disease.

• Poor children and children of color are much more likely to have tooth decay and suffer the consequences of untreated disease.

• Most children in Sonoma County do not have dental sealants, a well-accepted clinical intervention to prevent tooth decay on molar teeth.

• More resources for dental treatment are needed, but dental treatment alone will not stem the tide of dental disease. More resources for early preventive activities are also needed.

While the 2008 Community Health Needs Assessment identified eight key strategies to improve children’s oral health, the new Healthy Smiles Survey highlights five of these as the most urgent priorities for action.

Five Priority Actions to Improve Children’s Oral Health:

• Promote early and regular oral health education and screening as a standard of practice in all prenatal and pediatric primary care settings.

• Assure that every child is connected to a “dental home” by age 1 and improve access to dental insurance for low income families.

• Assure that all children begin regular dental visits for screening and preventive care within the first year of life and continue every six months thereafter. Special needs children should be seen every 3 months.

• Enhance children’s exposure to fluoride. Promote the use of fluoridated drinking water, fluoride varnishes, fluoride toothpaste and rinses and fluoride tablets.

• Provide sealants to all children when permanent molars erupt at 6-7 years of age and again at 12-13 years of age.

“Turning the tide on our children’s oral health will require resources, effort and renewed commitment from individuals and organizations throughout the community. Health care providers, insurers, employers, local governments, schools, children’s advocates, families and children themselves each have a unique role to play in the broad spectrum of prevention of dental disease”, said Rita Scardaci, Director of the Sonoma County Department of Health Services. “I am confident that together, we will help all of our children have healthy mouths and happy smiles.”