Dental sealants make grade with CPS

At the Nathan Davis Elementary School library on a recent Wednesday, Angela Worth, a dental hygienist, brushed cloudy white goo onto a second-grader's molars. Twenty seconds under a bright blue light and the cavity-preventing substance — called a dental sealant — hardened like nail polish.

Worth was there as part of a Chicago Public Schools-based oral health program working to combat the consequences of untreated dental decay in students. Key to that success is providing dental sealants — coatings on healthy molars — to students, especially to poor ones who might not otherwise get much preventive dental care.

Although Illinois has had middling success connecting students with dental sealants, scoring a C in a recent Pew Center on the States assessment, Chicago's program has been lauded for providing more than 100,000 CPS students with the preventive dental care each year.

Experts say programs like Chicago's help children have healthier teeth, which then keeps them from missing school and falling behind.

Dr. Susana Torres and her crew spent more than a week at Davis Elementary in January. Torres said she has seen several students in her time working in CPS schools with abscessed teeth, a painful infection caused by untreated tooth decay.

"You can't learn when you have an abscess," Torres said. "It's extremely painful."

Nearly every CPS and Chicago charter school now participates in the city's oral health program. For the first time this school year, CPS expanded the program to high schools, adding 106 campuses to the roster, bringing the total number participating to 667.

The program is contracted by the Chicago Department of Public Health, and dentists bill Medicaid for their services. Still, the dentists are required to see every student with a signed permission slip, even if they aren't on Medicaid. Some dentists look for grants to help cover dollars lost, said Mary Pat Burgess, the director of the program, but payment concerns haven't deterred dentists from applying for the program — nearly 30 applied this school year, and the city chose 17.

Students with signed consent forms get a free dental exam, cleaning and varnish. As soon as a child has a healthy adult molar, usually by second grade, a dental sealant can be placed on the tooth to keep cavity-causing bacteria at bay. Dentists seal the molars because those are the teeth most prone to decay.

Although some dental professionals raised concerns in the past about bisphenol A, commonly called BPA, which sometimes is present in dental sealants, experts say the amount of BPA present today is insignificant. Sealants have been used in school-based programs since the 1980s, but today only half of 13- to 15-year-olds nationwide have them.

"Sealants are a prevention measure," Burgess said. "You go in and you are able to seal a perfectly clean, healthy tooth. You have given that child's tooth and mouth the ability to fight decay and keep it pristine."

Preventing cavities from a young age can have huge benefits for students, CPS Chief Health Officer Stephanie Whyte said. Dental problems can affect ability to learn, interact in social groups or even land a job down the line, she and Pew researchers said.

"The mission of our office is to reduce health-related barriers to learning," Whyte said. "We're an academic institution. We want to make sure our kids are in school and learning."

Dentists in the program, which began in March 2000, see tens of thousands of students with cavities and more severe problems every year, Burgess said.

About 71 percent of all students seen last school year had dental problems that couldn't be treated at the dentist's school visit — 80,000 out of the 113,000 students seen. With the high volume of students, dentists don't have time for more involved procedures like filling cavities. Instead they refer parents to other dentists who take Medicaid for follow-up care.

But that's had limited success. Too often, parents never get the memo, Torres and Burgess said.

Dentists tuck an evaluation form in each student's "goody bag" — filled with items such as butterfly and soccer ball toothbrushes — hoping they'll make their way home. But the papers sometimes do not get to parents, Torres said.

To better communicate with parents, Burgess said she hopes to soon have a system in place to call parents of students with cavities or worse problems to ask if they have sought additional care for their children.

But the CPS program is still a huge leap above most of the country, and much of the rest of the state.

The Pew Center said the country overall lags in providing dental sealants as a preventive health care measure, especially to low-income students.

Less than half of Illinois' third-graders — 42 percent — had dental sealants in 2012, while the national health goal set in 2010 is 50 percent, according to the recent Pew Center report. The Pew Center also criticized Illinois for a state law that requires dentists to perform an exam before a dental hygienist can place a sealant. The center says hygienists are qualified to determine which teeth need sealants, and the law is unnecessary.

But Illinois performed better than most other states in providing sealant programs to high-need schools, scoring higher than 36 other states, the report said.

Burgess said she feels as though she makes a difference in children's lives, especially those who are most needy. She remembers a time when a little boy had a cleaning and came back to his dentist the next day, asking for another toothbrush. His brother took his.

"We provide a service that is so valuable to these kids and in many cases is not available for them," Burgess said. "Something as simple as a toothbrush is that important, and it was that important to (the little boy) to go and ask for another one. That's why we get up in the morning and go to work."

Copyright © 2018, CT Now