Saving Beautiful Smiles

When I was living in Zimbabwe in 1999, I was intrigued by the beautiful smiles of the children. Despite our dismal surroundings — a remote AIDS hospital where medications were scarce and food even scarcer — these children had perfect, sparkling white teeth.

I found it so curious, in fact, that on my frequent visits to the surrounding villages, I started asking the mothers what, exactly, they did to keep their children’s teeth healthy. When the first mother pointed up at a tree and showed me how to snap off a twig and fray the ends to form a toothbrush, I was in disbelief.

But after months of witnessing this exact explanation from the villagers and seeing for myself the shining smiles of the children, I believed. This belief, coupled with the observation that sugary drinks and junk food were nearly nonexistent in rural Zimbabwe, forced a shift in my paradigm. Indeed, those African children had a surprising advantage over their American counterparts that I hadn’t expected. And it was the first time I pondered the connection between dental health and sugar.

Today, tooth decay is the most common preventable illness affecting American children. In other words, if we could target just one area of children’s health in our country, dental care is where we would get the most bang for our buck. This issue really hit home when I looked at how kids’ dental health in Santa Barbara, my own community, compared with the rest of the U.S. I was shocked.

Based on dental screening in Head Start programs, California children have higher rates of untreated dental disease than the national average. And Santa Barbara County rates are even worse. In our county, based on the Head Start surveys for 2011, 39 percent of the preschool children assessed had untreated dental disease (compared with 21 percent nationally).

Many of these children’s teeth were in poor enough condition to necessitate emergency procedures, such as tooth extractions and abscess treatment. One such story particularly caught my attention. Little Angelica, a 4-year-old in a local preschool, was being referred for speech therapy by an astute teacher who had noticed her worsening speech impediment. When a health advocate sent by the County Education Office visited Angelica in her classroom, she noticed that all four of her upper front teeth were rotten.

A closer inspection of the gums revealed that the front teeth had been reduced to near stumps, and a painful abscess was brewing underneath. Through the assistance of the health advocate, Angelica was referred to a dentist who extracted the remainder of her four upper teeth, treated the abscess, and returned Angelica to a pain-free childhood. Remarkably, what was thought to be a speech impediment turned out to be the sequela of painfully infected and decayed teeth.

According to a 2005 survey, a third of all children in Southern California have never even visited the dentist.

Since 1992, multiple programs in Santa Barbara County have coordinated their efforts to address this unmet dental need, especially targeting those who are uninsured or underinsured. The Children’s Oral Health Collaborative, formed by a broad range of stakeholders, is now working to solve the dental-health discrepancies in our community. It is supported by over 30 local agencies and leaders. They focus on prevention and screening, identification of children with disease, and successful treatment. Such preventions, including fluoride treatments and regular checkups, avert enormous costs down the road.

These costs are not just financial, they are societal. We share a collective community loss when our children’s education and self-esteem suffer due to untreated dental disease. The impacts to the individual child are considerable: abnormal speech development, poor academic performance, debilitating pain, behavior problems, and even an inability to chew.

But there is more to prevention than regular checkups. Sugar consumption, which has skyrocketed over the past 20 years, is the single most important contributing factor to dental cavities in children. Studies have shown that increased consumption of chips, candy, cookies, and sugar-sweetened beverages significantly increases a child’s risk of cavities. Sugar-sweetened beverages are the largest source of this sugar, according to the Centers for Disease Control, and the majority of added sugars are consumed at home. So it is not enough to petition schools to remove sweetened beverages from the menu or vending machines from the halls; change must happen in our own homes.

Every child deserves a beautiful smile. I am thankful to the 60 dentists who provided volunteer services to over 4,000 children in our county last year. For every devastating story, there are many more of hope and success. Remember that shocking survey from 2011 which found that 39 percent of Head Start children in Santa Barbara County had untreated dental disease? Every single child identified through that screening was referred for treatment, and health advocates assisted their parents in navigating the system. In the end, 94 percent of them ended up receiving successful dental intervention.

And that’s a number we can smile about.

For more information on the Santa Barbara County Children’s Oral Health Collaborative, call Dr. Betty Layne, DDS, at (805) 643-3762.