The silent epidemic in our mouths
IT HAS BEEN six years since the US surgeon general issued a warning about the ``silent epidemic" of oral disease and urged us to recognize oral health as a critical component of overall health. Despite the call to action in the nation's first-ever report card on the oral health of Americans, dental disease remains the most common, chronic disease of childhood -- affecting five times more children than asthma.
It doesn't have to be this way. By working to expand access to important preventive measures such as dental screenings and sealant programs in community settings, we can eliminate oral disease in thousands of children and adults.
Dental disease is caused by bacterial infection in the mouth. The effects of dental decay are serious and can be permanent. In children and adults, decay, pain, and infection can inhibit learning, speech, and eating, leading to problems in school and on the job, negative self-image, and poor nutrition.
Oral infection in children is a harbinger of future dental disease, and chronic oral infections are associated with an array of problems later in life, including heart and lung disease, diabetes, stroke, and premature births. The costs can be calculated not only in debilitating pain and suffering, but in the more than 51 million school hours and 164 million work hours that are lost each year because of oral health problems.
What is tragic is that these costs do not need to be borne. We have made great progress in our understanding of oral disease -- to the point where it is almost entirely preventable today. Together we can prevent this widespread disease.
As a first step, we need to ensure that children have access to preventive care. Dental sealants, a thin plastic barrier applied by a dental professional to children's back teeth, can prevent the majority of dental decay in children. While we have made great progress in expanding this treatment, nearly half of Massachusetts children do not have sealants. In Ohio and Illinois, every young child in school has access to sealants through school and community-based programs made available through partnerships between the state departments of public health and the public schools.
We need to expand the reach of fluoridated water to all possible communities in Massachusetts. As calcium strengthens bones, fluoride strengthens teeth and helps prevent decay. After 60 years of community water fluoridation in America, we know this important health measure benefits everyone in the community. Unfortunately, nearly 40 percent of Massachusetts residents live in communities without fluoridated water. Fluoridation costs very little (50 cents per person per year) to implement and saves thousands of dollars each year in prevented dental procedures.
We know that regular visits to a dental professional can stop early signs of infection and decay from degenerating into full-blown disease, but there are a number of barriers that exclude people around the state from dental care -- from a lack of dental professionals in many communities, to the very low number of dentists who accept MassHealth insurance for dental procedures. By expanding the capacity of school-based programs to treat children early in life and community health centers to do preventive and restorative care, we can reach and prevent this disease in many more people.
Last year, as part of the settlements in the Health Care For All v. Romney case, the state agreed to work to eliminate other barriers to provider participation in MassHealth: increasing MassHealth reimbursement rates for dentists, permitting dentists to cap the number of MassHealth patients they accept, and contracting with a third party administrator to manage the burdensome paperwork that is required in the MassHealth dental program. Combined with the Legislature's recent decision to restore MassHealth coverage of adult dental care, these three measures will dramatically increase access to care for both children and adults.
It is challenging to think about eradicating the most common, chronic childhood disease, and one that plagues thousands of adults as well. But there is no reason why any child or adult should suffer from tooth decay or any of the serious forms of oral disease. Join me in speaking up for better oral health. We have the solutions; we just need our local and state officials to act.
Dr. Kathy O'Loughlin is president and chief executive of Delta Dental of Massachusetts and a member of the Watch Your Mouth coalition. 
