Montana's dental leader takes issue with report that gives state an 'F'

2013-01-08T00:15:00Z 2013-01-08T08:30:05Z Montana's dental leader takes issue with report that gives state an 'F'By CINDY UKEN cuken@billingsgazette.com The Billings Gazette

Montana is falling short in its policies to prevent tooth decay, unnecessarily driving up health care costs for families and taxpayers, according to a report released Tuesday.

Montana was one of five states receiving an “F” grade, according to a new report by the Pew Center on the States. The other states receiving failing grades were Hawaii, New Jersey, North Carolina and Wyoming. The District of Columbia also received an “F.”

Alaska, Maine, New Hampshire, North Dakota and Wisconsin were the five states receiving an “A.”

The Pew report, “Falling Short: Most States Lag on Dental Sealants,” grades all 50 states and the District of Columbia on their efforts to prevent decay by improving access to sealants for low-income children. Sealants are clear plastic coatings applied to the chewing surfaces of molars that prevent decay at about one-third the expense of filling a cavity.

Sealants are typically first applied to children’s molars when they are in the second grade, shortly after their permanent teeth appear. Molars are the most cavity-prone teeth, and sealants act as a barrier against decay-causing bacteria. Research shows that providing sealants through school-based programs is a cost-effective way to reach low-income children, who are at greater risk of decay. In addition to protecting a healthy tooth, sealants can also prevent a cavity from forming when applied during the early stages of tooth decay, Pew suggests.

Although it has been 45 years since the first research paper reported the successful use of sealants, states have been slow to embrace this prevention strategy. The most recent national survey, in 2009-2010, revealed that only half of teens ages 13 to 15 had received sealants on a permanent tooth.

But David R. Hemion, executive director of the Montana Dental Association, said the report lacks updated information, due largely to the lack of an oral health program at the state Department of Public Health and Human Services.

The MDA launched “Sealants for Smiles” in 2012 with the goal of reaching children across the state who are at risk for dental disease. By year’s end, dentists and their dental teams screened at least 448 Montana schoolchildren and placed 768 dental sealants in schools. More sealant programs are planned for 2013.

In addition, more than 100 schools, including 71 Indian Health Service schools, have established some sort of school sealant programs that are already in place or are planned for this year.

Hemion said he will be working with Pew to make sure it has updated data.

Preventable dental disease is pummeling state budgets, according to the report. Between 2010 and 2020, annual Medicaid spending for dental care is expected to climb from $8 billion to more than $21 billion. Children account for roughly one-third of the program’s total spending on dental services.

In 2009, U.S. children made more than 49,000 visits to hospital emergency rooms for preventable dental problems.

In Montana in 2005, the most recent data immediately available, the Montana Dental Association reported that nearly a half million Medicaid dental dollars each year are spent in hospital emergency rooms, where dental services generally are not provided.

“Children’s health isn’t the only thing that suffers when states don’t invest in sealant programs,” said Shelly Gehshan, director of the Pew Children’s Dental Campaign. “States that miss this opportunity to prevent decay are saddling taxpayers with higher costs down the road through Medicaid or other programs.”

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