Promoting Oral Health Among Michigan’s At-Risk Children
Altarum Institute, in collaboration with Delta Dental of Michigan, the University of Michigan (UM) School of Dentistry, and the Michigan Department of Community Health, is working on a comprehensive program to reduce the burden of childhood dental disease.
Childhood dental disease is relatively inexpensive to prevent, yet dental decay is the most prevalent chronic condition among children in the United States and the most common unmet health care need of poor children across the country. Left untreated, the disease often has broad dental, medical, and quality-of-life consequences.
There is profound disparity in the impacts of childhood dental disease. Reports of prevalence vary by area of the country with rates ranging from as low as 12% to as high as 90% in certain vulnerable populations. As much as 80% of dental issues are experienced by only 20–25% of the population, with children from the lowest socioeconomic groups experiencing issues at significantly higher rates and younger ages.
There are also clear issues related to access to preventive services. In some areas, as few as 25% of children saw a dentist in the past year. During 2011, in 22 states— including Michigan—more than half of the children covered under Medicaid didn’t receive any dental care during the year.
Untreated dental disease has broad impacts. It can affect learning, speech development, nutritional intake, self-esteem, social development, and quality of life. Failure to identify and prevent dental disease in our youngest children has consequential and costly long-term effects. Statistics related to dental disease prevalence, disparities, access to care, and the effectiveness of prevention and early treatment are well documented in a robust body of research. In terms of cost implications, it is surprisingly common for dental decay to become severe enough to require ambulatory surgery, emergency room treatment, and even hospitalization.
Available evidence increasingly suggests that preventive interventions within the first year of life are critical to altering the trajectory of dental disease and related costs. While childhood dental disease has recently received more attention, in many ways, oral health continues to be the “silent epidemic” described in the U.S. Surgeon General’s report more than a decade ago, which advocated for better integration of oral health into general health policies, priorities, and funding.
 Savage, M., Lee, J., Kotch, J., & Vann, W. (2004). Early preventive dental visits: Effects on subsequent utilization and costs. Pediatrics, 114(4), e418–e423.
 Clark, S., & Fontana, M. (2012). Oral health care for young children 0–5 years: A report for the early Childhood Investment Corporation.
 U.S. Department of Health and Human Services. (2012). Annual report on the quality of care for children in Medicaid and CHIP. http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Quality-of-Care/Downloads/2012-Ann-Sec-Rept.pdf.
 U.S. Department of Health and Human Services. (2000). Oral health in America: A report of the Surgeon General. http://silk.nih.gov/public/hck1ocv.@www.surgeon.fullrpt.pdf.
photo courtesy Baltimore Sun