Tuesday, June 7th, 2022

Preventative Oral Care, A Necessity for Mississippi

Written by UMMCC student participating in the Center’s Health policy Fellowship program with assistance from Center’s staff.

Introduction

It is not uncommon for oral health to be pushed to the wayside when traversing the massive landscape of healthcare, despite oral health’s crucial influence on overall health. The immediate need for treatment of chronic conditions and diseases distracts from the need to emphasize preventative care. However, Mississippians need to invest in preventative care if there is to be a reduction in future health issues, especially preventative oral care.

In 2018, the CDC reported that 55% of older adults in Mississippi suffered severe tooth loss, and 25% of adults over 65 had no teeth at all.¹ In the same year, the Mississippi State Department of Health found that 63% of children under the age of nine experienced tooth decay, 31% of which were untreated.² Tooth loss and tooth decay can result in disease, cancer, infection, and, in extreme cases, death.³ Oral health impacts an individual’s daily life and ability to function in society.⁴ Research shows that early childhood prevention efforts can help prevent oral disease and decay.⁵ Increasing oral health awareness, initiating school sealant programs, Medicaid-covered dental preventative services, and promoting fluoridated water treatments are all preventative measures that could result in improved oral healthcare outcomes.

Oral Health Awareness and Education

In a 2012 survey, conducted in Jackson by Dr. Teresa Perkins, it was found that 62% of parents admitted that their child did not own a toothbrush.⁶ Studies, such as “The State of Little Teeth” by the American Academy of Pediatric Dentistry (AAPD), show that more than one-third of children have early childhood caries by the time they enter kindergarten.⁷ Oral Health education and care must begin early. “Two is too late,” and, “First tooth, first exam,” are mottos that have been used in the IHS Early Childhood Caries Collaborative.⁸ Other initiatives and programs are attempting to help children at even earlier stages, such as Minnesota’s “Healthy Teeth, Healthy Baby” initiative⁹. This initiative seeks to partner community health workers, nurses, and doctors with dental professionals to educate pregnant women, parents, and young children about preventative oral care and help them find access to care. This awareness combined with education leads to better care at home which prevents poor oral health outcomes.

School Sealant Programs

According to the CDC, school sealant programs could save state costs up to $300 million by providing low-income children with sealants.¹⁰ Each tooth sealed saves more than $11 in dental treatment costs.¹¹ According to the AAPD, it can cost anywhere between $10,000 to $25,000 per child per year to provide treatment for severe tooth decay.¹² In Mississippi, a program such as this could help families in rural areas where there is a lack of access to oral health care and where routine checkups prove to be a logistical challenge.

Medicaid-covered Dental Preventative Services

Many Mississippians also lack the income and coverage to receive proper dental care. Since extractions are the only dental procedure for adults with Medicaid coverage in the state, removing the whole tooth becomes the logical choice for people that are unable to pay to restore an otherwise perfectly good tooth.¹³ In states such as Kansas, Medicaid covers preventative services such as cleanings.¹⁴

Studies have shown that missing teeth can increase the chances of discrimination in an individual’s social interactions and workplace success.¹⁵ It’s also been shown that multiple tooth extractions can impact an individual’s mental and overall health over time.¹⁶ Medicaid-covered preventative programs, such as regular cleanings, could reduce this negative effect to our state’s workforce.

Fluoridated Water Treatments

On average, communities with fluoridation experience 25% fewer cavities, saving $32 per person annually by avoiding dental treatment costs.¹⁷ Fluoride is a naturally occurring mineral that has been proven to prevent teeth from decay.¹⁸ Currently, 61% of the Mississippi population receives fluoridated water treatments.¹⁹

According to the CDC’s “2018 States Ranked by Fluoridation Percentage”, Mississippi ranks at 36. States with stricter fluoride water mandates, such as Georgia, Ohio, and Kentucky, rank in the top ten of highest percentage of fluoridated water.^{20, 21}

Conclusion

Preventative oral care should receive the same priority and promotion as routine physical examinations, nutrition education, and regular screenings. With Mississippi’s current health obstacles, preventative oral care is both economical and necessary. By initiating more dental health programs and policies, we can improve the future of our children, our workforce, and our state’s overall health.

References 

1. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Oral Health. Oral Health Data [online]. 2015. [accessed Jun 07, 2022]. URL: https://nccd.cdc.gov/oralhealthdata/
2. Sai Kurmana, MD, MPH; Angela Filzen, DDS; Lei Zhang, PhD, MBA; Every Smile Counts, The Oral Health of Mississippi Children 2018, the Office of Oral Health and the Office of Health Data & Research. Mississippi State Department of Health, Jackson, MS, November 2018.
3. Oral Health. World Health Organization [online]. March 15, 2022. [accessed Jun 07, 2022]. URL: https://www.who.int/news-room/fact-sheets/detail/oral-health
4. Baiju, R. M., Peter, E., Varghese, N. O., & Sivaram, R. (2017). Oral Health and Quality of Life: Current Concepts. Journal of clinical and diagnostic research : JCDR, 11(6), ZE21–ZE26. https://doi.org/10.7860/JCDR/2017/25866.10110
5. Razeghi, S., Amiri, P., Mohebbi, S. Z., & Kharazifard, M. J. (2020). Impact of Health Promotion Interventions on Early Childhood Caries Prevention in Children Aged 2-5 Years Receiving Dental Treatment Under General Anesthesia. Frontiers in public health, 8, 6. https://doi.org/10.3389/fpubh.2020.00006
6. Perkins, Teresa. 2012. UMMC School of Dentistry – Survey Measuring Absences Related to Toothaches: The SMART Survey. IADR Abstract Archives.
7. The State of Little Teeth Report. America’s Academy of Pediatric Dentistry. 2021. https://www.mychildrensteeth.org/state-of-little-teeth-report/
8. Collaborating to Improve Oral Health in Oklahoma. May 16, 2018. Office of Disease Prevention and Health Promotion. https://www.healthypeople.gov/2020/healthy-people-in-action/story/collaborating-to-improve-oral-health-in-oklahoma
9. Healthy Teeth. Healthy Baby. Minnesota Department of Health. Updated Wednesday, 13-Oct-2021 07:48:39 CDT. https://www.health.state.mn.us/people/oralhealth/programs/healthybaby.html
10. Return on Investment: School Sealant Programs. Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion Page [online]. Centers for Disease Control and Prevention. Last reviewed: August 25, 2020. https://www.cdc.gov/oralhealth/infographics/roi-school-sealant.html [accessed June 7, 2022]
11. Ibid.
12. Casamassimo PS, Chin JR, Conte CE, et al. Treating Tooth Decay: How to Make the Best Restorative Choices for Children’s Health. Chicago, IL: Pediatric Oral Health Research and Policy Center, American Academy of Pediatric Dentistry; 2020.
13. Mississippi Medicaid Covered Services for Beneficiaries Eligible for Full Medicaid Benefits, the Following Services are Covered. Mississippi Division of Medicaid, Medicaid Factsheet. 2019. https://medicaid.ms.gov/wp-content/uploads/2019/03/Covered-Services-for-full-Medicaid-benefits.pdf [accessed June 6 2022]
14. Benefits & Services. Kancare, Medicaid for Kansas. https://www.kancare.ks.gov/consumers/benefits-services
15. Moeller, J., Singhal, S., Al-Dajani, M., Gomaa, N., & Quiñonez, C. (2015). Assessing the relationship between dental appearance and the potential for discrimination in Ontario, Canada. SSM – population health, 1, 26–31. https://doi.org/10.1016/j.ssmph.2015.11.001
16. Yolanda Smith, B. Pharm.; Reviewed by Dr. Liji Thomas, MD. Tooth Extraction Risks. News-Medical, Life Sciences [online]. Last Updated: Apr 12, 2021. [accessed June 7,2022] https://www.news-medical.net/health/Tooth-Extraction-Risks.aspx
17. Return on Investment: Optimally Fluoridated Water. Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion [online]. Centers for Disease Control and Prevention. Page last reviewed: August 25, 2020. https://www.cdc.gov/oralhealth/infographics/roi-fluoridated-water.html [accessed June 7,2022]
18. Water Fluoridation Basics [online]. Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion. Page last reviewed: October 1, 2021. Centers for Disease Control and Prevention. https://www.cdc.gov/fluoridation/basics/index.htm [accessed June 7,2022]
19. Community Water Fluoridation, Water Fluoridation in Mississippi. Mississippi Department of Health. 2018. https://msdh.ms.gov/msdhsite/index.cfm/43,8104,151,280,pdf/Oral_Health_-_MS_Water_Fluoridation_2018.pdf
20. 2018 Fluoridation Statistics. Community Water Fluoridation [online]. Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion. Center for Disease Control and Prevention. Page last reviewed: September 8, 2020. https://www.cdc.gov/fluoridation/statistics/2018stats.htm [accessed June 7,2022]
21. Ellen Connett. Mandatory Fluoridation in the U.S. [online] 2020. FluorideAlert.Org. https://fluoridealert.org/content/mandatory-fluoridation-in-the-u-s/ [accessed June 7,2022]