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Poor Kids' Teeth In Poor State

Finding Renews Calls For Better State Coverage

By HILARY WALDMAN, Courant Staff Writer

September 19, 2007

An investigation into the oral health of Connecticut school kids has uncovered a particularly bleak picture for poor and nonwhite children.

The state Department of Public Health reported Tuesday that nonwhites experienced severe tooth decay at twice the rate of white children. And poor children - regardless of race or ethnicity - were three times more likely to have multiple cavities by third grade when compared to third-graders from families with higher incomes.

The findings came as no surprise to advocates for the poor, who have long complained that stingy state payments to dentists are keeping dental care off-limits to impoverished children.

Although dentists agree that poor nutrition and parental missteps such as putting babies to bed with a bottle or a sippy cup contribute to the higher rate of tooth decay among low-income children, the inability to find a dentist is by far the biggest factor.

Advocates said the health department report only confirms what they have known for years - that Connecticut's families are suffering because dentists cannot afford to treat them.

The problem in Connecticut is not a lack of dentists. About 2,237 dentists practice in the state, more than enough to take care of the state's 3.4 million residents. But only about 100 of those dentists - about 4 percent - make themselves available to treat large numbers of low-income patients whose care is paid for by the joint state-federal Medicaid program.

Seven years ago, legal aid lawyers representing 300,000 low-income parents and children covered by Medicaid filed a federal class action lawsuit that accused the state of violating the rights of poor people by denying them access to the same level of dental care enjoyed by the rest of the state's residents.

This spring, the state legislature agreed to spend an extra $20 million a year to boost payments to dentists who care for low-income children. The money is expected to be enough to get more children into dental chairs this year, said Jamey Bell, a staff attorney at Greater Hartford Legal Aid, who filed the suit.

"We know hundreds of families who have tried desperately to get help for their children," Bell said Tuesday. "And sometimes it takes months and months, and sometimes they give up."

The latest look at children's teeth was part of a national survey called Every Smile Counts. During the past school year, state investigators examined the mouths of Connecticut children enrolled in Head Start preschool programs for low-income children. They also looked at children in public school kindergarten and third grade.

Although Connecticut's decay rates were the lowest in the country, the results were otherwise not pretty.

One out of every three children in preschool had at least one filling or untreated tooth decay.

By third grade, 35 percent of white children and half of all African American and Asian children had either fillings or untreated decay. Hispanic children had the highest rate of tooth decay, with 63 percent having either fillings or untreated cavities, the study found.

Rampant decay, defined as five or more teeth with decay, was found in one out of 10 white children and one out of five nonwhite children.

"It's horrible and it's outrageous and not at all surprising," said Bell.

Bell said she hoped that rates would begin to go up and more dentists would agree to treat low-income patients within the next several months.