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Zulayka Santiago's picture

My values and perspectives on life have been heavily influenced by my mother—a woman of no formal academic education but whose wisdom surpasses that of many.  She was born and raised in the Dominican Republic, and as a single mother she fought hard to give her 2 daughters the opportunities that she did not have.   Mostly, she succeeded at achieving that aspiration:  my sister and I were able to get a good education through the public school system, and because of Medicaid we had the medical care we needed.  


But given that we didn’t have dental insurance, accessing oral health care was a more complicated endeavor.  The out of pocket costs for care were well-above what my mother could afford on her limited budget, and finding a dentist who she could communicate with (in Spanish) was challenging, to say the least.  These barriers to care continue to be all too common for families in North Carolina and across the nation. Even for families with dental care coverage (either through private insurance or Medicaid) issues of affordability, geographic access and cultural competence continue to be unsurmountable obstacles to care.


One of my mother’s favorite idioms is, “mejor es prevenir que lamentar”, which means “it is better to prevent than to lament”.  And in the world of oral health, this couldn’t be more true.  Tooth decay (aka cavities) is the most common chronic disease of early childhood. In fact, it's a condition that is 2-3 times more common than asthma or obesity. Dental care remains the greatest unmet health need among U.S. children. Children with untreated tooth decay not only suffer pain and infection, they have trouble eating, talking, socializing, sleeping, and learning, all of which can impair school performance. But the good news is that tooth decay is TOTALLY PREVENTABLE!


In NC we’ve done a great job of ensuring that young children have access to fluoride varnish treatments in their pediatric visits through the nationally-recognized Into the Mouths of Babes program. However, there is another essential aspect to prevention that we are not doing so great at: dental sealants: plastic coatings placed on the chewing surfaces of teeth.  According to the Centers for Disease Control and Prevention, dental sealants can reduce decay by 80 percent in the two years after placement, and continue to be effective for nearly five years (they have even been endorsed by the American Dental Association!). Dental sealants are one-third the cost of a filling, and  sealant programs based in schools are an optimal way to reach children—especially low-income children who have trouble accessing dental care.


Yet despite all of this compelling evidence, NC has not yet maximized access to and use of this preventive measure.  It is time for us to do everything within our power to ensure that as many children as possible can easily access this service that could have significant impact on children’s performance in school and their overall well-being.  This will require both a change of mindset and a willingness to address systemic barriers to progress. This is one of the main priority areas for the NCOHC in 2017, and of course we’d invite all of you to join us in this endeavor!

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