Dental health key to curbing other costly illnesses

"Sailors with toothaches sink submarines."

Dr. Steve Davis, interim commissioner, Kentucky Department of Public Health

While state and local leaders hail the importance of the ongoing $900 million expansion at the University of Kentucky Chandler Hospital, a lower-key visit to the UK College of Dentistry Aug. 26 should not go unnoticed. It promised the long-term possibility of preventive health care that may keep thousands of young Kentuckians from ever being patients at UK Hospital.

The visitors were Gov. Steve Beshear and wife Jane. Joined by UK's new president, Eli Capilouto, who is a dentist and public health professional, and Sharon Turner, dean of the dental school, Beshear announced the second phase of his initiative to cut the horrific rate of cavities in the teeth of the state's children.

A new pilot program called Smiling Schools will provide preventive oral health services for 25,000 children in Appalachian Kentucky. The children will receive protective tooth varnish in a program funded through a $1 million grant from the Appalachian Regional Commission and $250,000 from the state General Fund.

A child with a toothache is too distracted to learn, says Jane Beshear. The failure to master class lessons in early years is the beginning of failure to keep up in the workforce in later life, she added.

Staggering statistics about Kentucky kids' poor oral health were brought to the governor's attention when he was running for office four years ago. The Institute for Rural Journalism and Community Issues at UK sent the Beshears an assessment of the state's dental health, showing that half of Kentucky's children had decay in their baby teeth and nearly half of children ages 2 to 4 had untreated dental problems. This is more than twice the national average.

Untreated, these cavities help bring on the problems in later life that are associated with Kentucky being one of the unhealthiest states, a leader in diseases that send patients to that $900 million hospital — heart disease; cancer (including a dramatically higher incidence of deadly pancreatic cancer); pre-term birth; obesity; stroke and diabetes.

Kentucky youths who seek to join the military with a mouth full of cavities and gaps where teeth had been are turned away in high numbers, says Dr. Steve Davis, the state's interim commissioner of public health. The Navy, particularly, takes seriously the warning that a sailor stricken by a toothache in the depths of the sea could mishandle a task on a sub and send the craft plunging to the bottom.

Over the course of the 2011-12 school year, two protective fluoride tooth varnish treatments and educational materials for healthy dental practices will be offered to children in the first through the fifth grades at selected schools in 16 Appalachian Kentucky counties: Bell, Breathitt, Clay, Elliott, Floyd, Harlan, Jackson, Knott, Knox, Lee, Magoffin, Menifee, Owsley, Perry, Russell, and Wolfe.

The UK dental school will examine a sampling of the children before and after the varnish treatments to assess the effectiveness of the program. Dr. Rankin Skinner, a Clark County dentist, predicts a very positive outcome, based on a project that he started and that served as a pilot for the latest effort. Results of three years of treatment of 3,000 children in Clark County showed decay rates fell from 50 percent to 14.5 percent, Skinner reported at the UK meeting. Davis said the return on dollars invested in the low-cost varnish is very favorable.

The Clark program was financed by the Clark County Community Foundation. Its impetus was a front-page story in The New York Times which was inspired by Al Cross, director of the Institute for Rural Journalism. The Times story helped inspire a segment on ABC's 20/20, "A Hidden America: Children of the Mountains," which included Kentucky native Diane Sawyer's account of Barbourville dentist Edwin Smith's struggle to discourage parents from overfeeding kids sugared drinks.

The national news coverage also helped spur the Governor's Healthy Smiles Initiative which was rolled out two years ago with another ARC grant, of $2 million. This was to train rural dentists in pediatric services, noted Tony Wilder, the state commissioner of local government. Beshear, the current governors' co-chair of the 13-state commission, will preside this week over the agency's annual conference at Prestonsburg, which will focus on health issues in Appalachia.

Obviously, the bricks and mortar at UK's new hospital go to serve extremely important life-saving and healing purposes, but the pilot treatments of children's teeth in Appalachia should persuade all Kentuckians that this care is essential for every county.