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Dental Health Is Fundamental for All Children ?



Question:

Dental Health Is Fundamental for All Children ?


Answer: When children are first placed in foster care, they are particularly likely not to have received preventive and professional dental care. CWLA's checklist of 16 services needed for children in foster care (www.cwla.org/programs/health/checklist.htm) includes "comprehensive dental services...restoration of teeth, and maintenance of dental health....ongoing primary and preventive health care services, including reassessments at a minimum every six months; and access to appropriate specialty and subspecialty care."

Medicaid is federally mandated to cover children's dental services, but delivering those services to children remains problematic. Only 21% of Medicaid-eligible children saw a dentist in 1997. Children's Health Insurance Plan (CHIP) seeks to extend medical and dental services to as many as 10 million children whose family incomes exceed Medicaid eligibility but who cannot afford private health insurance. For information on how to enroll a child in CHIP go to www.insurekidsnow.gov.

This month, a study was published that assessed the dental health outcomes of 15,438 children in North Carolina who were enrolled in Medicaid from 1988 to 1994. Of these children, 23% received at least one sealant, and 33% received at least one filling. Sealant placement was associated with expenditure savings to Medicaid. Thus, Medicaid-and more broadly, society-will benefit by providing for sealant placement in these children. (See J. A. Weintraub, S. C. Stearns, R. G. Rozier, and C.-C. Huang. [2001]. Treatment outcomes and costs of dental sealants among children enrolled in Medicaid. American Journal of Public Health; available online at http://www.ajph.org. Select November 2001, Volume 91, Number 11, click on "public health then and now;" then scroll to pages 1877-1881.)

According to the American Dental Association (ADA website (www.ada.org) basic preventive and restorative dental services are within economic reach of most Americans, through insurance coverage and government programs such as Medicaid. The ADA notes that each year dentists provide $1 billion in free and discounted dentistry to needy patients. For too many, however, access to care remains difficult. (For more information, go to the website, click on Government and Advocacy, go to Dentistry Works, then click on Access to Oral Health Care. On the same page, a link to the Indian Health Service website notes that only 25% of Native Americans receive dental care today compared to 33% 10 years ago.) For many more topics, go to www.ada.org/public, click on Oral Health Topics, and choose from the alphabetical listing or the category listing (e.g., Children, the Kids Section).

HRSA-HCFA Oral Health Initiative (www.hrsa.gov/oralhealth/resources.htm) has many links to other websites-such as those of the National Oral Health Resource Center, American Academy of Pediatric Dentistry, Rural Information Center Health Services such as the National Oral Health Resource Center, American Academy of Pediatric Dentistry, Rural Information Center Health Services-providing data, research, and information on professional groups and other organizations.

Extensive resources on oral health in children, as well as links to other organizations, publications, databases, newsletters, and research reports, are available through the Knowledge Path on Oral Health and Children (www.ncemch.org/RefDes/kporalhealth.html) developed by the National Center for Education in Maternal and Child Health at Georgetown University.

What age should a child first visit the dentist then? I've heard that as soon as they have six teeth, they should go, from other sources I've heard that you shouldn't take them until they're about 3 years old. My son is ten months old, getting three new teeth at once, which will bring his total up to seven when they're all through. I can't imagine him letting a complete stanger looking into his mouth, most of the time, he won't even let ME look, and he knows me!

If you know how to clean your child's new teeth, there is probably no reason for a formal dentist visit until 3. If you aren't sure how, ask your pediatrition to show you. Toothpaste can be dangerous for babies so it is important to see how much is the right amount to use.

I use a baby toothpaste, I put a teeny tiny amount on his brush as, one, he hates the taste, and two, I didn't think that he needs much at all for the seven teeth he has. I think 3 is reasonable too, like I said, I can't see him even opening his mouth for the dentist, let alone getting his teeth checked out!


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