Zeroing in on little mouths: El Rio increasing child dental care to head off host of ills
Feb. 3--Failure to thrive, high fevers and cellulitis are some of the more serious yet common results kids suffer when they have undiagnosed dental problems.
"I've had a kid with a dental abscess who had a fever of 105 rushed to the hospital," said Dr. Ray Wagner, a pediatrician at Tucson's El Rio Community Health Center, which is stepping up its dental services to at-risk children this year.
"There are kids with failure to thrive; they are not gaining weight because they can't chew their food properly. Good oral health is an important part of a child's health and well-being."
A pilot dental program that El Rio began last year -- offering free protective sealants and fluoride varnishes to children -- is expanding in 2009 by adding more hygienists on more days. Ideally, officials with the center say they would like to have a dental hygienist giving preventive treatments and offering risk assessments at kiosks in all of its pediatric locations.
The new effort is in part to help implement a recent recommendation by the American Academy of Pediatric Dentistry that children be seen for their first dental visit within six months of their first tooth appearing.
El Rio, which has 16 sites in Pima County, last year served 75,000 county patients. Half of those patients were enrolled in the Arizona Health Care Cost Containment System, Arizona's version of Medicaid.
Early childhood tooth decay, often known as "baby bottle mouth," is the most common chronic disease of children. About 59 percent of school-age children have the disease, whereas 19 percent of school-age children are obese and 11 percent have asthma, Wagner said.
It's not unusual for El Rio dental hygienist Cristina Montiel to see children who appear to never brush their teeth.
"I see gingivitis, abscesses," said Montiel.
Using a purple "disclosing solution," Montiel is able to show kids and parents their "sugar bugs" -- areas where bacteria has built up and is threatening the tooth.
Maydorena Salcido, 36, was at El Rio for a medical appointment Monday but was happy to bring her 13-month-old daughter, Missel Salcido, to get the screening and varnish on her tiny teeth.
Salcido said she waited too long with her eldest son, now 7. She didn't bring him to the dentist for his first visit until he was 4, and he's since had to go through root canals and has crowns on some of his teeth.
"If we don't see a kid until they are 3 or 4 years old, the damage is done already," said Dr. Greg La Chance, who is El Rio's dental director. "The enamel on a baby's tooth is thinner, and it doesn't take much to get through to the underlying tooth structure."
La Chance said El Rio wanted to expand its pilot program because the screening and prevention work has helped give its patients a "dental home" where they will return for checkups.
"When you've been in this profession long enough and seen all kinds of misery, you want to do what you can to do prevention," he said. "We hope as we go along with this program to kind of show how it's affecting our patient population. Hopefully, we will see a decrease in decay rates."
In a waiting room with an aquarium and a bright blue wall decorated with purple fish, younger kids have their teeth cleaned by a hygienist and rinse with the disclosing solution, and then receive a sticky, shiny "fluoride varnish" that's supposed to protect the teeth. They get a toothbrush as a reward. Older kids receive a sealant that fills in gaps and pits in the teeth, also to prevent cavities.
Wagner said in some severe cases the decay is so bad that children have a mouthful of teeth that become nothing but brown stumps that must be pulled.
"In the past it wasn't recommended to see a dentist until the age of 3. A lot of kids by the time they got to the dentist had a lot of tooth decay happening," he said. "Tooth decay in children is a really big expense to society, and most pediatricians have never been educated to look for it."
The American Academy of Pediatrics, the American Academy of Pediatric Dentistry and the American Dental Association have recommended children have a "dental home" by the age of 1.
"Part of our goal is to integrate dental and medical care," said Nancy Wexler, administrator of El Rio's dental department. "Everyone talks about integrated medical care, but the mouth gets left out."
Article source :- Zeroing in on little mouths: El Rio increasing child dental care to head off host of ills
