Washington state gets a ‘B’ on national dental exam

March 16, 2010

By David Hayes

Thinkstock The Pew Center on the States graded Washington state’s pediatric oral health with a ‘B.’

A national study has given the state of Washington a “B” grade for its pediatric oral dental care.

The Pew Center on the States recently released its report, “The Cost of Delay: State Dental Policies Fail One in Five Children.” It graded all 50 states in eight categories on whether and how well they are employing what the Pew Center deems as “cost-effective policy solutions to ensure dental health and access to care for children.”

The Pew Center graded each state on the following criteria:

-Share of high-risk schools with sealant programs

-Hygienists can place sealants without dentist’s prior exam

-Share of residents on fluoridated community water supplies

-Share of Medicaid-enrolled children getting dental care

-Share of dentists’ median retail fees reimbursed by Medicaid

-Pays medical providers for early preventive dental health care

-Authorizes new primary care dental providers

-Tracks data on children’s dental heath.

Washington met or exceeded six of the eight, qualifying it for a B grade, tying it with eight other states, including Alaska, Colorado, Idaho, Illinois, Main, New Hampshire, Ohio and Texas.The same number of states received failing grades, which included Alabama, Delaware, Florida, Hawaii, Louisiana, New Jersey, Pennsylvania, West Virginia and Wyoming.

Receiving A grades were Connecticut, Iowa, Maryland, New Mexico, Rhode Island and South Carolina.

The study found in Washington state at least one-fourth of its high-risk schools benefit from sealant programs, and the state makes effective use of hygienists in these settings. It also reimburses medical professionals who offer basic preventive services to Medicaid-enrolled children.

Washington’s Access to Baby and Child Dentistry program provides a national model for training general dentists to care for young children. Washington ranked in the top five states for Medicaid utilization — with about 48 percent of Medicaid-enrolled children seeing a dentist in 2007, the latest year for which data is available.

However, the state Medicaid reimbursement level for dentists fell short of the national average. In addition, the study asserts the state needs at least 110 more dentists to meet the needs of its residents in shortage areas. And only 63 percent of Washington’s population on community water supplies has access to drinking water with optimal levels of fluoride.

Dentist John Liu, practicing with Eastside Pediatric Dental Group since 1994, had mixed feelings about the study’s findings. As a pediatric dentist, Liu sees patients from birth to high school (and on into adulthood if the patient is a part of the special-needs population).

He said the population’s awareness for good oral hygiene has actually stayed about the same in his time here.

“Part of the issue, is the city’s water supply is not fluoridated,” Liu said. “Meanwhile, nearby cities are fluoridated, like Bellevue, Renton and Sammamish as well.”

Liu said fluoridation has been done in public water supplies since the 1940s and studies show benefits outweigh the risks.

“In cities that offer fluoridation, some excellent studies show that oral health improves 60 to 80 percent in the number of kids with cavities,” Liu said.

He attributes the opposition to fluoridation to a very vocal minority who point to what he deems an unproven fear of cancer risk.

Liu said he disagrees, however, with the study’s findings of the state’s use of new primary care dental providers, which he equates to the use of physicians assistants.

“The Pew study is biased toward the use of mid-level providers,” Liu said. “There have been no studies that show they dramatically improve access or cost of care.”

The problem with these mid-level providers, he said, is the slippery slope of shoveling off a portion of the population to a less trained dental care provider.

On the Web

For a look at The Pew Center on the States’ full report, “The Cost of Delay: State Dental Policies Fail One in Five Children,” go to www.pewcenteronthestates.org, click on “Children’s Dental Health” and follow the link to the report.

How well did Washington score?

Measured against the national benchmark for eight policy approaches

State National Meets or Exceeds

Share of high-risk schools with 25-49% 25% 4

sealant programs, 2009

Hygienists can place sealants Y Y 4

without dentist’s prior exam, 2009

Share of residents on fluoridated 62.9% 75%

community water supplies, 2006

Share of Medicaid-enrolled children 47.6% 38.1% 4

getting dental care, 2007

Share of dentists’ median retail fees 46% 60.5%

reimbursed by Medicaid, 2008

Pays medical providers for early Y Y 4

preventive dental health care, 2009

Authorizes new primary care dental N Y

providers, 2009

Tracks data on children’s dental Y Y 4

heath, 2009

Total Score: B — 5 of 8

Grading: A= 6-8 points, B= 5 points, C=4 points, D=3 points, F= 0-2 points

David Hayes: dhayes@isspress.com, 392-6434, ext. 237. Comment at www.issaquahpress.com.

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3 Responses to “Washington state gets a ‘B’ on national dental exam”

  1. jwillie6 on March 16th, 2010 8:29 pm

    Congratulations to Washington State on a good dental score; however, Isn’t it strange, doctors cannot force one person to take a drug, yet the government wants to force everyone to be drugged with fluoride, a prescription drug, against their will and with no medical supervision
    Europe has rejected fluoridation and is now 98% fluoride free, and their decay rate is better than any fluoridated country. They and most of the world including China, India, and Japan caught on to this fluoridation hoax years ago.
    Fluoridation not only causes cancer, brittle bones, etc., but is an absolute waste of tax money. People only drink 1/2 % of the water they use. The remaining 99 1/2% simply goes down the drain in toilets, showers, dishwashers, etc. If you doubt this, just ask your water department  For example, for every $1000 of fluoride chemical added to water, $995 would be directly wasted down the drain, $5 would be consumed in water by the people, and less than $1.00 would be consumed by children.  Can you think of a more wasteful government program? Voters get  very angry when they learn of this waste of tax money. 
    Those promoting fluoridation simply refuse to read the current research showing it is ineffective and dangerous to health. Go to  (www.fluoridealert.org) and read several scientific  articles.
    Read the letter  from  Dr. Hardy Limeback ( DDS, PhD Biochemistry) — Head, Preventive Dentistry, University of Toronto entitled
     “Why I am now officially opposed to adding fluoride to drinking water” 

      He was the principal research advisor to the Canadian Dental Asociation for over 10 years in promoting fluoridation. His letter is an apology to other dentists and the public for ever recommending it.                       
            Dr. Limeback includes over 140 Research studies, including:
       Increased risk of bone cancer —  13 studies
       Lead, arsenic, radium contaminants causing toxic water — 10 studies
       Link with fluoride and other cancer — 12 studies
       Fluoride causes birth defects — 5 studies
       Fluoride affects the immune systems — 12
       Fluoride is neurotoxic (brain, nerves, lowering IQ) — 11
    Also see the petition signed by over 2700 professionals opposing fluoridation.

  2. nyscof on March 17th, 2010 6:29 am

    This report fails to report the obvious. Are any of these grading measures actually reducing tooth decay & loss

    e.g., South Carolina got an “A” but ranks 31 in tooth loss of those over 65 and ranks 37 in those who have lost 6 or more teeth due to decay or gum disease.

    In Connecticut which received an “A,” fluoridation is state-mandated. Yet a 2007 survey of Connecticut schoolchildren found that 31% of children in Head Start aged 2-4 have already experienced tooth decay and that 14% of those children had 5 or more teeth decayed or missing from decay. By Kindergarten, more than one in four children have experienced dental decay, 16% of which have untreated decay

    In New York State, county data shows that tooth decay is lowest in the NON-fluoridated counties. Nation-wide, tooth loss is highest in the most fluoridated states.

    These uncomfortable facts are being ignored. Rotten diets make rotten teeth. Healthy foods must be subsidized or poor kids fed for free. Fluoridation wastes money.

    If the first remedy is too much government for your taste, then fluoridation is even worse because fluoridation doesn’t reduce tooth decay but costs cities such as New York City approximately $30 million every year.

  3. Maureen Jones on March 17th, 2010 9:20 am


    Brain damage in rats
    from fluoridated water

    An animal study links low levels of fluo-
    ride in water to brain damage [Brain
    Res.. 784, 284 (1998)]. The research was
    a collaboration among a chemist and two
    psychologists (including lead author Julie
    A. Varner) at Binghamton University,
    Binghamton, N.Y., and an EPA neurotox-
    icologist. Twenty-seven rats were divided
    into three groups and for one year were
    given either distilled water, distilled wa-
    ter with 2.1 ppm NaF—the same concen-
    tration of fluoride normally used in fluori-
    dated drinking water—or distilled water
    with 0.5 ppm AlF3. In both treated groups,
    the aluminum levels in the brain were el-
    evated relative to controls. The research-
    ers speculate that fluoride in water may
    complex with the aluminum in food and
    enable it to cross the blood-brain barrier.
    Both treated groups also suffered neural
    Injury and showed increased deposits of
    B-amyloid protein in the brain, similar to
    those seen in humans with Alzheimer’s
    disease. “While the small amount of AlF3
    . . . required for neurotoxic effects is sur-
    prising, perhaps even more surprising are
    the neurotoxic effects of NaF” at 2.1 ppm,
    the authors write.

    April 27, 1998 C&EN 29

    Hydrogen bonding is a weak interaction that holds molecules together. They make and break easily and this is what makes them so versatile – indeed the hydrogen bonds formed between amides (the links between amino acids) are the most important weak hydrogen bonds in biological systems. That these can be disrupted by fluoride in the formation of much stronger bonds may explain how the chemically inert fluoride ion could interfere in the healthy operation of living systems. Thus some of the serious charges that are being laid at its door – genetic damage, birth defects, cancer and allergy response – may arise from fluoride interference after all.
    Reference: New Scientist Jan. 22, 1981.

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