WHY IT’S TIME FOR SCHOOL ENTRANCE ORAL HEALTH
SCREENINGS IN THE STATE OF OKLAHOMA
By Tim Fagan, DDS, MS
President, Oklahoma Dental Association
Member, Governor’s Task Force Focus Group
In 2007, the Oklahoma Dental Association and 12 other state agencies recognized that there were several populations of Oklahoma residents (especially children) who did not receive even basic oral health care due to financial and/or logistical challenges. These groups understood the effect of this imbalance on children and they asked Governor Brad Henry to create a special task force that would study the status of children’s oral health in the state. Governor Henry concurred and by Executive Order 2007-30, established the Governor’s Task Force on Children and Oral Health to study and make recommendations concerning the oral health of children in Oklahoma, and to develop a State Oral Health Plan.
This task force released their findings in August 2009 and made a total of 16 recommendations. The recommendations included establishing several programs aimed at reducing dental disease in all Oklahoma children, ensuring all children have dental homes, and educating the public and parents of children on oral health. In order to implement the recommendations of the Governor’s Task Force, the ODA in 2010 formed the GTF Focus Group, charged with working to implement the Governor’s Task Force recommendations through the creation of programs, legislation, planning, raising awareness, etc.
One goal of the GTF Focus Group is to introduce legislation that would require or establish some form of certification of a dental screening or assessment prior to entry into elementary school. Currently, 12 other states in the country have dental screening laws. Dental screenings prior to school entry could improve a student’s school readiness by providing a timely opportunity for diagnosis and treatment of oral health problems. Screenings would help identify children with previously undetected dental disease so that their parents/guardians could be made aware of the need for treatment. Additionally, these screenings would help children establish a dental home.
The World Health Organization has suggested that school dental screenings could “enable early detection and timely interventions towards oral diseases and conditions, leading to substantial cost savings”.(1) The American Dental Association and the American Academy of Pediatric Dentistry support the concept of school entrance oral health examinations.(2, 3)
Most of us are aware of the fact that tooth decay is the most common chronic childhood infectious disease in the United States.(4) Did you also know that more than one-quarter of US preschoolers (28%) have experienced visible cavities before entering school?(5) And according to the 2007-08 Oklahoma Oral Health Needs Assessment, the statewide prevalence for dental cavities was 71.5% in Oklahoma third graders.
We know that untreated tooth decay causes pain and infections that may lead to problems that affect eating, speaking, playing and learning. (4) Children with dental pain may be irritable, withdrawn, or unable to concentrate. Pain can affect test performance as well as school attendance.(6) More than 51 million school hours are lost each year because of dental-related illness.(4)
Oral health is an integral part of overall health, and as such, oral health assessments should be given the same priority as other health assessments for children.(3) Just as Oklahoma children are required to have immunizations and vision screenings to attend school, it makes sense that they should also have an oral health evaluation.
With these facts in mind, the GTF Focus Group is now proposing that the Oklahoma Dental Association seek state legislation to implement “School Entrance Oral Health Screenings in the State of Oklahoma.” Draft legislation has been written and is modeled after the very successful State of California Oral Health Assessment as a Condition of School Entry Program. Principally, the requirement is that a designated form is completed that demonstrates that a screening has taken place within a designated time frame of a child entering kindergarten or first grade, whichever comes first, for the first time. Dental examinations/evaluations completed on children that already have an existing dental home would suffice as long as the exam occurred in a dental office of a licensed Oklahoma dentist, within the designated time frame, and the appropriate information is transferred to the designated form. The GTF Focus Group is hoping that many of the dentists and dental hygienists in Oklahoma will volunteer to perform screenings at no cost on children that do not have an existing dental home so that all children entering kindergarten or first grade will benefit. Further, the GTF Focus Group anticipates that the Oklahoma Dental Foundation Mobile Unit can be used to conduct screenings as it travels the state. Additionally, volunteer dentists and hygienists can conduct the screenings during the annual ODA Oklahoma Mission of Mercy. It is also hoped that local dental societies and/or individual dentists might offer free screenings at least once a year as a public service.
The GTF Focus Group understands that new “mandates” will have little support by our current State Legislature, so the bill has been written so that parents may elect to opt out of the school entrance screening for religious or financial reasons, or they lack access to a dentist or hygienist to perform the screening. The California program works the same way and has experienced a very small “opt out” rate.
A screening form will be developed that will be downloadable from several websites to ensure the form may be easily accessed by everyone. Once the screening has been conducted, there will be a minimal amount of information to be entered onto the form, taking only a few minutes to complete. And finally, the form will then be submitted by the parent/guardian to the child’s school, just as they do with the child’s immunization record.
Much time and effort has been devoted in creating and planning this program so that it is simple and straightforward, and in these challenging economic times, low or no cost. Now, we need your help and support to see that this program comes to fruition. Let’s see to it that the children of Oklahoma start school with good oral health! Please support the children of our state and your Oklahoma Dental Association as we seek passage of this important legislation. Let’s do it for the betterment of our kids!
1. World Health Organization. Oral Health Promotion: an essential element of health-promoting school. WHO Information Series on School Health. 2003
2. Policy on Mandatory School-Entrance Oral Health Examinations. 2009-2010 American Academy of Pediatric Dentistry Reference Manual.
3. Oral Health Assessment for School Children (2005:323). Current Policies. American Dental Association
4. “Oral Health: Preventing Cavities, Gum Disease, and Tooth Loss.” Centers for Disease Control and Prevention. 2009
5. Trends in oral health status: United States, 1988-1994 and 1999-2004. National Center for Health Statistics. Vital Health Stat 119(248), 2007.
6. Fact sheet: Oral Health and Learning. National Center for Education in Maternal and Child Health & Georgetown University. 2001