Study finds financial, racial disparities in dental care

from The Boston Globe

But says more children seen

By David Abel,

Although more Massachusetts children are getting needed dental care than in the past, low-income and nonwhite children lag behind their peers, according to a report released today by Delta Dental of Massachusetts, an insurance company.

Nearly two-thirds of third-graders from low-income families suffer from tooth decay, roughly twice the rate of children from higher-income families. Children from low-income families are less likely to receive treatment than those from higher-income families. The 67-page report, titled "The Oral Health of Massachusetts' Children" also found significant racial disparities in dental disease and treatment.

"More needs to be done," said Dr. Alex White, a dentist and the director of analytics for the Catalyst Institute, which compiled the data from statistical sampling and the examination last year of about 6,000 children by dentists and hygienists at the Boston University School of Dental Medicine. "We know we can make a difference; we're just not doing it for everyone," White said.

Among the causes of persistent dental disease, he said, are the lack of universal dental insurance for children, a diet with too much sugar, and no addition of fluoride to the water in some parts of the state.

The report found that more than 1 in 4 children in the state start school with dental disease, including a disproportionate number of children from minority groups. Some 24 percent of Hispanics and 23 percent of black kindergartners had untreated cavities, about twice the rate of whites.

Still, dental hygiene has improved since the last oral health survey in 2003. The proportion of third-grade children with dental disease declined from 48 percent to 41 percent over the past four years. The proportion of children surveyed with untreated decay declined from 26 percent to 17 percent.

The highest incidence of dental disease occurred in Hampden and Suffolk counties. In Hampden County - where only Holyoke, Longmeadow, and Westfield add fluoride to their water - 58 percent of third-graders had cavities, 17 percent above the state average. In Suffolk, 57 percent of third-graders had cavities.

"This report provides compelling evidence that dental disease remains a serious problem for our children and especially among minority children and children from low-income families, even though dental disease is almost entirely preventable," Fay Donohue, president and chief executive officer of Delta Dental, said in a written statement.

Man Wai Ng, chief of the department of dentistry at Children's Hospital Boston, said that in recent years dentists there have encouraged pediatricians to look for dental disease in their patients. As a result, she said, the hospital has seen a 50 percent rise in the number of children referred to dental clinics.

"We're now able to identify at-risk children at an earlier age and provide care that is less risky and less costly," Ng said.

She suggested that parents brush their children's teeth twice a day, with toothpaste that contains fluoride, as soon as teeth appear. She also encourages parents to bring their children to a dentist twice a year, not to let them take a bottle to bed, and to limit their intake of sugary drinks, such as juice.