Dental Health Program

Oral health in children directly correlates with overall health. An oral health professional, hygienist or dentist, can identify dental health conditions but also may be able to identify other health concerns. Many diseases exhibit symptoms in the mouth prior to symptoms becoming noticeable in the body.

"When focusing on public health and health of children, the importance of early and regular dental screenings is clear," says Vicki Nolton, coordinator of the Mother Child Wellness program. "Our goal is to assist families in having access to quality healthcare and that includes oral health."

The Mother Child Wellness Program serves families in Mahaska, Poweshiek, and Jasper Counties who have household income of 200 percent of poverty level or under. One component of Mother Child Wellness health services is assistance in finding dental care and screenings.

"We have a list of dentists who will see Title XIX or Women Infant Children program clients. In Mahaska County, a dental hygienist provides screenings. She can identify cavities or dental problems, educate patients and parents on dental hygiene and health, and make referrals to dentists when additional care is needed, " Nolton says.

"I recently attended a dental summit with hygienists, dentists, and various human services agencies to investigate ways to deal with the crisis of limited dental health options in the area. Regular six-month check ups should be the norm, however, this may not always be the case if access to a dentist is limited. We work with families and dental care professionals to bridge the gap," Nolton says.

Nationally, four out of five Title XIX children receive medical care, however, only one out of five receives dental care. According to the SCHIIP Enrollment Report, March 2002, in Poweshiek, Mahaska, and Jasper Counties, an estimated 1,654 children are eligible for the hawk-i and Medicare Expansion programs and have limited assess to dental care. Therefore, they rely on the Mother Child Wellness program for assistance.

A 2000 article from the American Family Physician notes that even in the age of preventive dental health, many children have dental caries in baby (primary) teeth. It is one of the most common health problems affecting young children. A 1996 report found 38 percent of children ages 2 to 9 had dental caries. On a national basis almost 4.2 million children in the United States were unable to obtain dental care.

Another caution is the incidence of baby bottle caries, caused by sucking on a bottle of milk or juice as the infant or toddler falls asleep. Dental public health professionals are also seeing an increased rate of caries associated with sipper cups when children continually suck on juice or milk in them. To avoid higher risk of baby bottle caries, dental professionals recommend that parents do not put a baby down to sleep with a bottle or use water. If sipper cups are used excessively, use water.

Early Intervention
A number of children's health problems appear in the mouth. Here are just a few conditions that may be noticed in the mouth before or in conjunction with other symptoms.

• Signs of nutritional problems
• Niacin deficiency (pellagra) is accompanied by: an inflammation of the tongue surface. The tongue appears enlarged and red, and is painful.
• Vitamin B6 and vitamin B12 deficiency is accompanied by: inflammation of the tongue surface, canker sores, and an inflammation inside of the mouth.
• Caries in primary teeth Signs of respiratory problems
• Asthma is accompanied by dry mouth, which poses an increased risk for caries development. The decreased salivary flow is caused by the action of B-2 agonists on salivary gland function. The gums are usually red.
• Halitosis in children may be caused by enlarged tonsils and respiratory infections. Signs of hormone disorders
• Addison disease is accompanied by the appearance of bluish-black patches in the mouth.
• Diabetes mellitus is accompanied by an increased risk of gingival infections, periodontal infections, dental infections, and yeast infections of the mouth. Children with poorly controlled diabetes are at increased risk for periodontal disease due to a number of factors. Signs of behavioral disorders
• Bulimia is accompanied by the loss of dental enamel due to acidic stomach contents. Swelling of the salivary glands is due to frequent vomiting.
• Psychiatric medications can cause a decreased flow of saliva, which increases the risk for dental caries. A dental health professional can evaluate for these and many other sign of health concerns.

"The overall health of a community begins at an early age. At the Mother Child Wellness Program, we strive to give children assess to overall and dental health evaluations and improve health of all children," Nolton says.