We can improve oral health for Hawaii’s children. And we should — because the numbers tell a disturbing story.
In 2010, Hawaii’s Health Department screened more than 9,100 schoolchildren and found that more than 1 in 4 had serious dental problems that required "urgent or acute dental treatment." Most of these serious dental conditions began as cavities. We would do a much better job of preventing tooth decay if Hawaii provided dental sealants to more children.
A dental sealant is a plastic coating applied to the chewing surfaces of back teeth, the most cavity-prone teeth. Sealants reduce cavities by roughly 60 percent for up to five years. Children should receive sealants on permanent molars as soon as they appear (between ages 6 and 12).
Untreated cavities can lead to toothaches that make it hard for kids to sleep, eat, speak, learn or attend school. In fact, a California study last year found that teens with dental pain were four times more likely to have low grade-point averages.
Sealants are a proven, cost- effective method to help kids avoid dental problems. The Centers for Disease Control and Prevention (CDC) describes applying sealants as "quick and easy." It’s also painless. Finally, it’s safe to place sealants over a tooth with early signs of tooth decay because evidence shows sealants help stop decay from worsening.
Why aren’t more Hawaii kids receiving sealants? Our state’s "prior exam rule" is a major obstacle. This outdated rule requires a dentist to examine children before they can receive sealants. This extra step isn’t needed because hygienists are adequately trained to assess molars before applying sealants. In fact, a CDC expert panel concluded that an exam by a dentist is unnecessary to determine if a tooth should be sealed. The Pew Charitable Trusts has found that ending this rule would enable many more children to receive sealants.
Dental hygienists will refer children with complex dental needs to local dentists for follow-up care. For this reason, the prior exam rule adds an unnecessary hurdle to sealant programs. Senate Bill 343 and House Bill 658 would eliminate this bureaucratic step and provide funding so that more children receive sealants. Hawaii’s legislators should pass this legislation without language that would hinder sealant programs.
For instance, SB 343 was recently amended with language requiring hygienists to apply sealants "in consultation with a licensed dentist." This phrase should be removed because it will add an unnecessary step that hinders kids getting sealants. Currently, 31 states have no prior exam rule. Several have recently eliminated this requirement because it was obstructing the key goal — protecting children’s teeth. It’s time for Hawaii to join other states and better protect its keiki.
Sealants can save families and taxpayers money down the road. Officials in Colorado found that every dollar spent on sealants saved $2 because of a reduced need for fillings and other dental treatments.
More than 49,000 U.S. children were treated in hospital emergency rooms in 2009 for preventable dental conditions. State budgets, including Hawaii’s, shoulder a significant share of these hospital costs because many of the patients are enrolled in Medicaid or are uninsured.
Let’s do the right thing and pass SB 343 or HB 658 without any unnecessary "consultation" language to better prevent dental disease in our children.