Sabrina’s story: Needing dentures in high school
By Pam Chanter and Kirk Pappas, MD
Can you imagine going through high school with dentures? Sabrina is a 16-year-old sophomore at a Santa Rosa high school. Sabrina is a good student, with a B+ average, but she has already missed several days of class this school year because of severe toothaches she began to experience over the summer. Sabrina’s family has no dental insurance, and she hadn’t had her teeth examined or cleaned professionally in more than two years.
When Sabrina finally was able to get an examination at St. Joseph Dental Clinic, the dentist told her that three of her permanent molars are so badly decayed that she needs root canals – a procedure that removes the decayed nerve and central pulp, but preserves the exterior of teeth so that they can still do their crucial job of chewing food.
Unfortunately, due to insufficient funding and staff resources, the clinic is not able to perform root canals at a cost that Sabrina’s family can afford. The clinic can only offer her the less-costly procedure of removing the three teeth. It’s a short-term option with bad long-term consequences, as the extracted teeth will leave a gap that soon must be replaced with an expensive bridge or partial denture to maintain proper chewing and protect adjacent teeth.
It shouldn’t be like this. Dental disease is almost 100 percent preventable!
Sabrina’s story is a composite of what happens to way too many kids in Sonoma County. If we invest in prevention strategies and in strengthening our dental safety net, however, we can keep children like Sabrina and her younger siblings from the trauma of having to lose permanent teeth and other dental tragedies.
Low-income people are disproportionately burdened. Here are just a few of the alarming figures:
- There are only 15 dentists in all of Sonoma County serving the low-income population.
- A 2009 survey found that low-income kindergarteners and third-graders in Sonoma County had more than twice the level of untreated decay as more affluent children (21 percent vs. 9 percent). Over the last three years, more than 2,500 children under age 5 received expensive and potentially traumatic oral surgeries to treat cavities that were so severe that they could not be treated without general anesthesia at PDI, the Pediatric Dental Surgery Center in Windsor.
- Many more children experience constant dental pain due to lack of preventative dental care and unavailability of dental treatment.
- Children with dental problems miss more school days, have a harder time concentrating in class, and are more likely to have eating and speech disorders.
Research indicates that poor oral health is directly linked to major health conditions later in life, like cancer, diabetes, heart disease and stroke. Untreated dental problems during pregnancy can contribute to poor birth outcomes and neonatal mortality.
Responding to this grim picture, an Oral Health Task Force was convened in January, bringing together not only leaders from the medical, dental, and public health communities, but also business leaders and advocates for children, seniors, and people with disabilities. The task force analyzed gaps in the current system and developed five key recommendations to improve the oral health of children and adults throughout Sonoma County:
1. Increase Access to Basic Dental Care
2. Integrate Dental & Medical Care
3. Educate Pregnant Women About the Importance of Oral Health
4. Promote Innovative Models of Dental Care
5. Collect Data to Measure the Oral Health Status of Sonoma County
The recommendations focus on concrete, local strategies that will significantly improve the oral health of low-income children and adults. The goal is to implement the recommendations within three years using current resources or resources likely to be available within the near future.
We are seeing progress already. Santa Rosa Community Health Centers is raising funds to open a new dental facility in Santa Rosa. First 5 Sonoma County has committed to expand access to dental care for young children. St. Joseph Health System/Memorial Hospital is working to purchase a new mobile dental van. The Sonoma County Department of Public Health has committed to increasing the surveillance of the oral health status of our community. And Kaiser Permanente has awarded grants to Santa Rosa Community Health Centers, Alliance Medical Center and West County Health Centers so they can expand access to preventive dental care for low-income people.
By implementing the Oral Task Force recommendations, our community can significantly improve the dental health of low-income people, particularly children, in Sonoma County over the next three years.
Pam Chanter is vice president of Vantreo Insurance Brokerage in Santa Rosa and serves on the board of directors for Santa Rosa Chamber of Commerce and St. Joseph Health System’s Memorial Hospital. She is the vice president for the Sonoma County Oral Health Taskforce. Kirk Pappas, MD, is the physician-in-chief for Kaiser Permanente Medical Center of Santa Rosa and former president of the Sonoma County Medical Association. He serves as a member of the Sonoma County Oral Health Taskforce.
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