Little teeth need lots of dental attention
January 12, 2007
More than half a million of California’s children miss school each year due to dental problems, but local dental programs are gaining the upper-hand on children’s oral health in Truckee and on the North Shore.
This month, a national organization called Children Now released its 2006-2007 California Report Card, which applies letter grades to areas related to health, education and family well-being.
Children Now assigned a C- grade to children’s dental care in California, reporting that one-third of third-graders have untreated cavities, and that an estimated 138,000 children in California have severe dental problems that require immediate attention.
Hard data related to childhood dental care is not available for Placer and Nevada counties, but health care providers in the area say educational programs are working, and the incidence of tooth decay is decreasing.
“California has had a hard time with dental care, but I would say that [our local communities] are pretty aware,” said Lisa Abrahams, a nurse for the Tahoe Truckee Unified School District. “I have parents who are really desiring dental health for their kids, and I think that we have been proactive in providing that. We’ve really come a long way.”
The school district provides annual dental screenings for some students with the help of local dentists who volunteer their time, but because of costs, scheduling and staffing limitations, not all students receive a check-up.
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Students found to be in need of dental attention, and who require low-cost or free services, are referred to local resources, Abrahams said, such as the North Tahoe Family Resource Center and the Truckee Family Resource Center, which have both received grant money to fund dental outreach programs in schools and private homes in Placer and Nevada counties.
Through the family resource centers, “promotoras,” or community liaisons, hold private in-home or group discussions with families to teach them about dental care. The program was originally designed to educate the Latino population, but has since expanded to include assistance for the entire community.
Placer County also has a county dentist who works at the community dental clinic in Kings Beach and serves children from both Placer and Nevada counties, Abrahams said.
The efforts have been well worth the results, said Sarah Coolidge-Elcin, resource coordinator for the North Tahoe Family Resource Center.
“We have seen anecdotal evidence that in the last four or five years there is a lot less really bad decay among children who are growing up here because their parents have been educated,” Coolidge-Elcin said. “Second and third siblings seem to have a lot less trouble as well.”
This proactive approach is critical, providers say, because without it many low-income families would not have access to the resources they need.
“It’s very hard, even for someone who is motivated but doesn’t have a high income level, to get what they need,” Coolidge-Elcin said.
Getting into a dentist’s chair isn’t always as easy as making an appointment, Coolidge-Elcin said.
The number of local dentists is sufficient to fulfill needs such as cleanings and cavity fills, but is insufficient for meeting the needs of children with significant treatment requirements, according to Dr. Jon Dickson D.D.S of Tahoe City.
Dickson said that many local dentists won’t treat children because a child’s needs can be so challenging.
Furthermore, many people don’t have access to transportation. And, if a child will require anesthesia for a tooth extraction, a physical examination is often a prerequisite.
Plus, Coolidge-Elcin said, only a few hundred pediatric dentists are in practice in the entire state, so travel to Sacramento is often necessary.
“We are seeing many children who have such extensive decay that they are needing oral conscious sedation, which is not available locally, so we have to seek providers down the hill,” said Julie Gutstadt, health education coordinator for the North Tahoe Family Resource Center.
A few pediatric dentists practice in Reno, but they can’t accept Medi-Cal.
And therein lies yet another obstacle to receiving treatment. In Nevada County in 2003, nearly 24 percent of those under 18 lacked dental insurance. In Placer County, that number was 15 percent.
“If a family makes too much money, then they don’t qualify for certain (insurance) programs,” Gutstadt said. “And when they are above the poverty guideline, then they fall into a gray-area for coverage.”
A full quarter of California’s children do not have dental coverage, according to Children Now, and too few dentists accept Denti-Cal, the state’s public dental care program.
“Most of the [parents we see] don’t have dental care either, because they don’t have any way to pay for it,” Coolidge-Elcin said. “But if you can learn to prevent the problem, then you don’t need to worry about how to pay for it.”