Iowa scores right in the middle in a new report that grades states on preventing tooth decay.
The state was given a C grade for providing children with dental sealants, according to the report released Tuesday, Jan. 8, 2013, from the Pew Center on the States.
Those clear plastic coatings, applied to the chewing surfaces of molars, are shown to prevent decay at one-third the expense of filling a cavity. Sealants are typically first applied to children’s molars when they are in second grade, shortly after their permanent teeth appear.
"We believe Iowa is definitely moving in the right direction in improving oral health," said Suzanne Heckenlaible, executive director for the Delta Dental of Iowa Foundation.
Heckenlaible said the state also faces challenges, including improving access to oral health for people in nursing homes and the homebound elderly and increasing the number of children who receive sealants.
According to Delta Dental, the average submitted fee for a sealant by Iowa dentists in 2011 was $41.47. A study by the Colorado Department of Public Health found that every dollar spent on sealants saved $2 in costs for fillings and other dental treatments.
A survey last year by the Iowa Department of Public Health showed about 45 percent of third-graders had at least one dental sealant.
In Pew's "Falling Short" report, Iowa earned seven out of 11 points in four benchmarks scored by the group.
That included having 25 to 49 percent of high-need schools with a sealant program. The goal is 75 percent or above.
The Iowa Department of Public Health funds sealant programs at schools with at least 40 percent free and reduced lunch rates.
Programs are in Linn, Jones and Washington counties in Eastern Iowa, among 21 counties statewide.
According to Pew's report:
- Only five states earned an A, and just two - Maine and New Hampshire - received the maximum points possible.
- Although the eight states that received a B are performing relatively well, half did not have sealant programs in a majority of their high-need schools.
- Seventeen states earned C grades, and another 15 received a D.
- Five states—Hawaii, New Jersey, Montana, North Carolina, and Wyoming—earned an F, lagging far behind in prevention efforts.
The Iowa Department of Public Health notes that 80 to 90 percent of dental decay in children aged 5 to 17 occurs in the pits and fissures of teeth, mostly on the chewing surfaces, and that placing dental sealants on molars significantly lowers the probability that decay will occur.
Pew's report showed 19 states still have a regulation that restricts hygienists’ ability to provide sealants to children. The rule requires a dentist to examine a child before a hygienist can perform the service, making sealant programs less cost-effective.
In Iowa, a dentist’s exam is sometimes required in schools, though certain classifications of dental hygienists can place sealants without a dentist’s prior exam.
The report also showed that preventable dental disease is hurting state budgets.
Between 2010 and 2020, annual Medicaid spending for dental care is expected to climb from $8 billion to more than $21 billion.
Children account for about one-third of the program’s total spending on dental services.In 2009, American children made more than 49,000 visits to hospital emergency rooms for preventable dental problems. Many of those were made by Medicaid recipients or the uninsured, leaving taxpayers or others assuming a significant portion of the costs.