Here’s a quiz:
1. What health professional can help to reduce the number of premature, low birth-weight babies born in Colorado?
2. What person can “give” a child tooth decay?
3. What activity did your elementary teachers hate that can help prevent cavities?
And the surprising answers, according to recent scientific research, are: 1) dentists; 2) a mother; and 3) chewing gum.
The new research is changing the way two metro-area nonprofits provide dental care to low-income children and families in the suburbs. Instead of the old focus on “drill and fill,” Kids in Need of Dentistry and Dental Aid are providing care based on scientific evidence and the prevention of dental disease, according to Mary Allman-Koernig, executive director of KIND. “We want to catch kids before problems start,” she says – and “catching them” can extend even to before birth.
Karen Cody Carlson, chief executive officer of Dental Aid, says, “Studies show that if a pregnant woman has dental disease, the bacteria which cause that disease may travel though the blood stream, cross the placenta and contribute to the birth of a premature or low birth-weight baby.”
From 2003 to 2005, Dental Aid implemented a pilot program called Bright Smiles for Bright Futures, which provided dental care for low-income, uninsured mothers-to-be in Boulder County with the goal of reducing the number of infants with low birth weight. While the countywide rate for small babies in 2003-04 combined was 8.3 percent, the rate among Bright Smiles patients was only 7.6 percent.
New research findings also show that dental decay can be transmitted from mother to child. “The bacteria that causes dental disease in the mother can cause cavities in the child,” Cody Carlson says. But transmission isn’t through the blood; instead, it comes when a mom tastes the baby’s food or “washes off” a pacifier in her mouth after it falls to the ground.
To prevent such transmission, KIND and Dental Aid are educating parents about sanitation as well as the importance of brushing. Allman-Koernig says their efforts are complicated by the fact that an estimated 20,000 Colorado children don’t have a toothbrush, many live in families where one toothbrush is shared by everyone (more bacteria!) or where there is no toothbrush at all.
Dentists working with KIND and Dental Aid are also using such new preventive techniques as applying a plastic sealant on children’s molars when they first appear. The sealant prevents bacteria from fixing onto the teeth and thus prevents cavities. In addition, the nonprofits are telling parents about an artificial sweetener, Xylitol, which actually kills harmful bacteria in the mouth and helps prevent transmission to other family members, thus preventing cavities. Dental Aid is developing a program to provide Xylitol gum to new mothers immediately after delivery, with instructions to chew it four times a day to prevent transmission of bacteria to their infants.
KIND sees uninsured children up to age 18 at clinics in Adams and Jefferson counties and Colorado Springs, as well as in a 36-foot Miles for Smiles traveling van. With 5,500 patient visits a year, KIND receives little government funding and relies heavily on more than 300 volunteer dentists.
Dental Aid, with clinics in Boulder, Longmont and Louisville, has more than 16,000 patient visits each year, and “the tide is rising,” Cody Carlson says. Since 2001, Dental Aid’s numbers have increased by 128 percent. Like KIND, Dental Aid charges patients a flat fee, but must seek additional support from foundations, fundraisers and caring individuals.
Unfortunately, the grant that funded Bright Smiles has ended; Dental Aid is seeking funding to continue the program.
Like many health organizations serving the poor in Colorado, both Dental Aid and KIND face the constant, grinding challenge of raising funds to keep the doors open. Given the many problems associated with dental disease – including low birth-weight babies, school absence because of dental pain, and poor nutrition resulting from pain and inability to chew – state policymakers should look hard at their funding priorities. It would be good to see more Bright Smiles among the poor children of Colorado.
