By Sarah Vidrine, Senior Policy Analyst Honestly, not many of us give much thought to children’s oral health. For some of us, oral health is perceived as a cosmetic or hygiene issue – are my kids brushing their teeth? Does my breath stink?? But what if I told you that tooth decay – otherwise known as dental caries – is the number one chronic disease among children? That it is more common than childhood obesity or asthma? Did you know that the infection from tooth decay can travel to other parts of the body causing significant and debilitating health issues, some of which are fatal? Or that cavity-causing bacteria can be transmitted from parent to child? Children with tooth decay have trouble eating, speaking, and learning and are consequently at risk of malnourishment, academic failure, diabetes, pneumonia, heart disease, and even death. Worst of all, there are clear disparities in terms of impact. Access to care depends on a range of factors over which children have no control: their family’s economic status, the community in which they live, whether they have insurance that covers dental care, and whether that insurance is accepted by a provider. You might ask how North Carolina plans to address this crisis in children’s health. The good news is that North Carolinians from around the state are working together to tackle the issue through the NC Oral Health Collaborative, in which professionals, community members, youth, advocates, and parents all have a voice. And there are bright practice spots, particularly through the work of the Oral Health Section within the NC Department of Health & Human Service’s Division of Public Health. They’re working to make sure that children have access to toothbrushing in child care facilities. They’ve partnered with Community Care of North Carolina and others to ensure that physicians can apply critical tooth varnishes to very young children at their well-child visits. They’re partnering with schools to offer preventive services like dental sealants. Sealants are low-cost and painless – they can be painted on children’s teeth in under 10 minutes and are enormously effective. Research indicates that children with sealants were 78% less likely to need fillings than children without sealants! And now for the bad news. Access to dental health services is severely limited. According to the UNC Sheps Center for Health Services Research, North Carolina rate of dentists per 10,000 people places us 47th in the nation. While some higher income and urban areas have lots of provider choice for those on private insurance, rural counties are drastically underserved; in fact, three counties have no dentists at all. And while almost half of NC’s children are eligible for Medicaid, only 27% of dentists accept child Medicaid patients, and some of those dentists aren’t accepting any new patients. So access to sealant programs and other cost-saving, preventive care in North Carolina is limited. In addition to lack of access to private dentists, the Oral Health Section has lost a critical number of field staff due to funding cuts. So what can we do to ensure that ALL North Carolina’s children have access to the best preventive dental care possible? After all, we know that for every $1 we spend on preventive services taxpayers save $50 in emergency and restorative procedures. There are a host of solutions being explored by the NC Oral Health Collaborative that could have enormous positive impact on children. These include: restoration of funds for the Oral Health Section to care for more children, addressing regulatory barriers that prevent providers from serving children, increasing the Medicaid reimbursement rate for providers, incentivizing dental practice in underserved areas, and innovative approaches to reach more patients at a lower cost. It’s particularly exciting that this process provides an opportunity for all of us to weigh in and become part of the solution. Visit oralhealthnc.org to learn more!