Feb. 20, 1998 By Connie Daughtry
GAINESVILLE, Fla.---Socioeconomic factors and education influence the outcome of children's dental care, said University of Florida College of Dentistry researchers who formed an important link with Manatee County (FL) groups to study oral health issues among students.
Their findings have influenced local public policy and may change it more, the researchers said.
UF researchers, under the leadership of Donald McNeal, professor and director of UF's division of public health services and research, presented local agencies in late November, with findings and recommendations from the yearlong study, which assessed the oral health of children in Manatee County.
The college launched the project at the request of Marco Alberts, dental director of Manatee County Rural Health Services Inc. and a UF dental alumnus.
"Our findings for Manatee are not that different from most Florida counties," McNeal said. "The bottom line is the level of care for children must be improved. Hence, there is a need to develop a program to improve children's access to care and to establish a regular source of care for each child."
Two Manatee County schools, Manatee Elementary and Palmetto Elementary, were selected for the study based on the high percentage of low-income children, including children of migrant workers, attending the schools. More than 52 percent of the 869 students enrolled in both schools received dental examinations and submitted information for the study.
The researchers found blacks and Hispanics, who each made up approximately one fourth of the study, had more decayed surfaces than whites (88.7, 59.3, 73.6 percent respectively); that children enrolled in free/reduced lunch and Medicaid programs had a 30 percent higher prevalence of decayed or missing teeth than those not enrolled in those programs; and children whose mothers had more than a high school education received better dental care than those whose mothers had no postsecondary schooling. They also found regular dental visits, professional fluoride treatments and fluoride supplements led to healthier teeth and gums.
Children with dental sealants also had fewer cavities. More importantly, the researchers found that 34 percent of the students needed routine dental care, and 2 percent needed immediate care.
"A key objective of the study was to use the existing academic-practice linkages to assess the oral health of special population groups in the community and to make recommendations," said McNeal.
UF recommendations include establishing: a system to track the children long term; preventive, educational and dental care programs targeting high-risk children; a school-based dental sealant program provided by private-public partnerships; professional fluoride treatments, toothpastes or supplements; and fluoridation of Bradenton's water.
The participants' credibility and their connection with other agencies strengthen the effort to provide better dental care for children, McNeal said.
As a result of the UF study and a Bradenton Herald article about it, the issue of fluoridating the city's water came to the forefront. A referendum indicated that most Bradenton voters supported the idea. In November, the Bradenton City Council voted to fluoridate the water. The state Department of Health will fund the program's initial costs -- about 50 cents per person a year -- to fluoridate the water.
Mary Campbell, a Manatee Elementary School nurse, has set into motion UF's recommendation to track her students' dental needs. Most Florida schools include proper dental care in their health curriculum or include programs supplemented by professions in the community said Gail Mitchell, a UF dental health researcher, but she and others said there is more to do. "A social marketing campaign, which points out the benefits of health services, needs to be targeted to parents so they can recognize the advantages for their children and act accordingly," Alberts said. "Manatee County also needs to focus on early intervention. This can be accomplished by reinstating the dental exam dropped from the routine health screening provided for at-risk children and children who receive free or reduced lunches."
If Florida's proposed Title 21 legislation is approved, it also will boost children's dental care. The plan is to help children whose family income is too high to qualify for Medicaid but too low to pay for needed medical and dental coverage. Money to support Title 21 is expected to come from the state's recent settlement with the tobacco industry. The study was funded by the U.S. Public Health Service.
The academic-community partnership includes UF's College of Dentistry, Manatee Rural Health Services, Manatee Technical Institute, University of South Florida's Gulfcoast South Area Health Education Center and the Manatee County Dental Society. Senior UF dental students and Manatee Parent Teachers Association volunteers also helped with the project.
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