Half of third-graders across the state have cavities, the Minnesota Department of Health reported last week.
That finding -- and the fact hospitals treat non-traumatic dental emergencies to the tune of $49 million every year -- prompted the department to launch the Minnesota Oral Health Plan: Advancing Optimal Oral Health for All Minnesotans. The plan identifies the populations most at risk for oral disease, their obstacles to routine care and strategies for improvement.
Red Wing is ahead of the game, local dentists said. That's thanks in part to the CARE Clinic and because professionals help elementary schools teach children about dental health every February.
"For that age, I see some decay. But one out of two every two kids? I wouldn't say it's that high here," Dr. George Noesen said.
Tooth decay is nearly 100 percent preventable, but it remains a common chronic childhood disease. For 2010, 55 percent of third-graders surveyed experienced tooth decay. The national rate is 53 percent for children 6 to 8 years old.
However, the survey found that just 18 percent of Minnesota third-graders had untreated tooth decay. That's lower than the national target of 26 percent set by Healthy People 2020.
Low-income children bear the greatest burden of oral diseases. Children eligible for free or reduced lunch were almost one and a half times more likely to experience tooth decay and almost three times more likely to have the decay go untreated than more affluent peers.
The CARE Clinic reaches this population locally with free medical exams every Tuesday evening. A dental care program was added in 2011, and on Wednesday nights, dentists and hygienists clean and repair teeth in the clinic, ironically accessed through the former St. John's Hospital emergency room, 1407 W. Fourth St.
Some patients' mouths are in terrible shape, but by addressing decay and gum disease at the clinic, these people don't end up the emergency room, Noesen said.
The savings are huge, based on Minnesota Department of Health numbers. Minnesota emergency rooms saw patients rack up $148 million in dental-related charges between 2007 and 2010 for preventable, non-traumatic conditions. Noesen said this should have been treated by a dental provider in a more appropriate setting.
Treating dental care has broader, long-term health effects. Mayo Clinic states that the body's natural defenses and good oral health care, such as daily brushing and flossing, keep bacteria under control. However, harmful bacteria can grow out of control. Left untreated, bacteria go beyond tooth decay and gum disease, breaching the body's protective barriers and perhaps entering bloodstream.
People who have money or dental insurance also sometimes wait until they're in pain. They don't understand that a healthy mouth is fundamental to overall health, Noesen said.
"A lot of people say, 'If it doesn't hurt, I don't want to fix it.' Well, if you wait until it hurts, that's not a good sign either," Noesen said. "Then you play catch up."
The state oral health plan calls for a range of solutions, such as providing dental sealants, increasing water fluoridation, enhancing the dental workforce, increasing use of public insurance programs, implementing a statewide dental health tracking system, and improving the integration of medical and dental care.
"We have to do a better job investing in public health and access to routine dental care. If we do this, we can significantly reduce oral disease and health care costs in Minnesota," Dr. Ed Ehlinger, Minnesota commissioner of health, said in a statement.
Noesen likes many things in the state plan, but he added that the state should have and could have addressed this 10 or 15 years ago. Dentists collect a 2 percent provider tax -- just as all health professional do -- and that money was supposed to raise the level of reimbursements to dentists treating people on Medical Assistance. Instead, lawmakers years ago redirected those monies into the general fund.
"If that money would go back to reimburse dentists for seeing Medical Assistance and those types of patients, I don't think we'd have this problem," Noesen said.