Jan. 08Wisconsin is among the five states in the country with the most extensive programs to place dental sealants plastic coatings applied to the chewing surface of molars to prevent tooth decay in children, according to a report from the Pew Center on the States.
The state received the highest grade while 20 states and the District of Columbia were given either a "D" or "F" for their efforts to provide children with dental sealants.
Sealants prevent 60% of tooth decay, according to the Pew Center, which releases annual reports grading states on dental care for children. They also are cost effective: Sealing one molar is less than one-third the cost of filling a cavity.
Yet in a survey done in 2009 and 2010, only half of the children ages 13 to 15 nationwide had received sealants on their permanent teeth.
In Wisconsin, about 20,000 children were given dental sealants at 400 elementary and middle schools in the last school year.
The Seal-A-Smile program considered a bright spot in the effort to improve dental care for low-income children who have a higher risk of tooth decay was significantly expanded in 2009 when Delta Dental offered to match additional state funding.
"They've been a great supporter of this program for several years and contributed significant dollars," said Matt Crespin, associate director of the Children's Health Alliance of Wisconsin, the program's manager and an affiliate of Children's Hospital and Health System. "Without that, we wouldn't be growing at the rate we have."
In Milwaukee, the Smart Smiles program overseen by St. Elizabeth Ann Seton Dental Clinic, an affiliate of Columbia St. Mary's Health System, placed sealants in 6,647 children last year,
St. Elizabeth Ann Seton Dental Clinic has five hygienists, each working with a dental assistant, who set up temporary clinics in schools, typically for two to three weeks.
The hygienists can do a basic exam, cleaning, fluoride varnish and provide sealants.
"Seeing kids in a school setting is just much more effective," Crespin said.
The children miss less school, he said, and a parent doesn't have to take time off work for a child's dental appointment.
The Marquette University School of Dentistry also oversees a school-based sealant program.
The program doesn't replace a dentist visit. But access to dental care has been a longstanding problem for adults and children insured through BadgerCare Plus and other Medicaid programs.
The fees paid by the state health programs to dentists are among the lowest in the country, and most dentists limit the number of patients they will see who are in the programs.
Fewer than one in three children insured by BadgerCare Plus saw a dentist in 2009.
One ongoing challenge is getting parental approval for children to participate in the sealant programs. It requires filling out a one-page form with 14 questions on the child's health history.
Elizabeth J. Nelson, manager of St. Elizabeth Ann Seton Dental Clinic, said about 50% of the students will participate when the Smart Smiles program receives strong support from a school.
About 7% of children screened have an urgent dental need, generally an infected tooth. The program will arrange for those children to get immediate care at the St. Elizabeth Ann Seton Dental Clinic.
"You are making a measurable difference," Nelson said of the program. "It's one thing to feel that you are doing good work. But I can prove it."
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