Preventing cavities in children's teeth is a major goal for good overall health and for the best use of health care dollars.
Thus, the Montana Legislature's Interim Committee on Children and Families supported a bill to allow school-based clinics for dental hygienists to apply cavity-preventing sealant.
However, at a hearing Friday in Helena, the committee bill, sponsored by Sen. Mary Caferro, D-Helena, drew opposition from the Montana Dental Association and from dentists around the state. Not one dentist spoke in favor of Senate Bill 2.
The Montana Dental Hygienists Association, several dental hygienists, public health representatives, elementary school teachers, the Office of Public Instruction and the Department of Public Health and Human Services all spoke in support of SB2.
Dental sealants have been shown safe and effective in reducing dental decay when applied properly soon after molars have appeared.
In 2009, the American Dental Association wrote to President Obama that adequately funding “school-based sealant programs” is among the community prevention measures that will lead to significant health improvement with relatively small government investment.
60% fewer cavities
“School-based dental sealant programs increase sealant use and decrease tooth decay,” said Dr. Barbara F. Gooch, Centers for Disease Control and Prevention dental officer in a 2009 report. “Although we have evidence that dental sealants provided in school programs can prevent about 60 percent of tooth decay in sealed permanent posterior teeth, this preventative intervention is underused, especially in children from low-income families.”
The state of Ohio started school-based sealant programs in the mid-1980s and now 39 states have them.
Montana dentists have been generous in providing free or reduced-cost care to needy children. Historically, Montana Medicaid has paid dentists much less than the private rate for their services, thus discouraging participation.
Dr. Andrew Hyams, president of the state dental association, testified Friday that the new Healthy Montana Kids program is “a workable program” and asked that it be given a chance to work instead of creating “an alternative treatment system.”
Some dentists who testified Friday against SB2 described their own work in school dental screenings and the great need of many students to get into a dentist's office for more care.
“They don't need sealant; they need a dental home,” said one dentist.
Mary McCue, executive director of the Montana Dental Association, testified that “this is an issue of parents not getting their children to the dentist.”
“Unfortunately, many children never get to a dentist till they have a toothache,” said Colleen Grass, president of the Montana Dental Hygienists Association.
Dental hygienists in this state are already allowed to work in nursing homes and to apply dental sealants to children's teeth under public health supervision. SB2 allows them to one more thing: apply sealant in schools. These dental hygienists must pass muster with the Montana Board of Dentistry before they can legally perform any of these services.
1 more tool for health
As one proponent pointed out at Friday's hearing, SB2 places the burden for starting up these sealant clinics on the dental hygienists who want to provide that care. They would have to obtain the portable equipment, make arrangements with schools and arrange for payment. Potential payment sources include federal grants and Healthy Montana Kids.
It's unfortunate that proponents and opponents have been unable so far to find common ground in this legislation. Both sides clearly understand the importance of preventive dental care.
SB2 can be one more tool in the fight for healthy smiles. Along with placing sealant on the teeth of schoolchildren whose parents authorize it, dental hygienists should refer families to local dentists for follow-up and continuing care. Dentists also could go into schools and place sealant on the teeth of students whose parents want it.
We urge the members of the Senate Public Health, Welfare and Safety Committee to pass SB2. Montanans need to use health care resources efficiently and effectively. This two-page bill furthers that cause.