NC Budget – Denying the Dentist

I grew up with painful memories of visits to the dentist – and my mother was a bear about me brushing my teeth. I wasn’t even a big candy eater or soda drinker. Yet I still suffered. Today in North Carolina my experience doesn’t have to be repeated. We have basic public health strategies and techniques that are cheap, effective, and, properly applied along with parental involvement in diet and brushing habits, mean that no kid needs to suffer a cavity again.

What’s happened in the last 40 years or so? Easily applied dental sealants, fluoride mouth rinses, a statewide screening program – especially in rural areas — and a system of referral to dentists for treatment when all prevention fails. North Carolina still has a ways to go since nearly one in five kids entering kindergarten has untreated dental decay. But with near last-in-the-nation accessibility to dental services in our state, prevention preserves teeth much better than hard-to-find treatment can fix them.

Unfortunately, the entire NC public health system that has been so successful at contributing to the drop in dental disease in children in on the table for elimination during the current budget crisis. It’s just one of a long line of critical services we depend on that’s up for being cut. Just a few of the other possible cuts include closing to new kids the state’s affordable health insurance program for children of working parents, cutting teacher assistants, eliminating prosthetic devices for poor diabetics, and cutting back on services for the elderly.

Elimination of the public health system’s Oral Health Section is emblematic of many of the serious service cuts now being considered in the NC House budget. Public health programs of this sort operate largely below the radar with effects that can only be discerned over the longer term in a healthier and more productive state. The sort of cuts North Carolina is considering will fundamentally change our health care system for the worse. They will mean our commitment to improving the health and education of our people will be set back years.

The focus may be on higher-profile budget-cutting proposals like shortening the school year or drastically reducing state salaries – but cuts like elimination of our oral health program will have consequences just as far-reaching.


  1. nyscof

    May 26, 2009 at 9:56 am

    Everything public health officials have done so far to curb tooth decay has failed, they should be eliminated. What needs to be done is to require dentists to treat more people for reasonable prices and require them to accept Medicaid patients.

    Public health officials haven’t had the backbone to do that so the dental health crisis persists. Someone with backbone, and who doesn’t rely on organized dentistry’s PAC money has to do the inevitable.

    Public health officials also could have ushered in Dental Health Therapists who work in areas and mouths where dentists refuse to go.

    Instead the focus on fluoridation which science has proven is a failed concept. Of course, organized dentistry loves fluoridation – because it doesn’t hurt their bottom line and gives the illusion of caring for the low income Americans they won’t allow in their dental chairs.

  2. Steve Jackson

    May 26, 2009 at 10:25 am

    “Fluoridation …is a failed concept”? Since when?

  3. Adam Searing

    May 26, 2009 at 11:25 am

    I’m all for more dental health professionals out there – we really do have one of the worst supplies of dentists for our population in the country. We’ve suggested innovations before like the DHPs too.

    However, things really have changed in the prevention side of things – as anyone with kids should know. Dental varnish and sealants are clinically proven to drastically reduce the incidence of cavities and we need to do this along with major reforms to improve the supply of dental professionals of all types – especially in rural areas.

  4. Single Payer Action

    May 26, 2009 at 11:28 am

    Im all for more psych techs at the state hospitals and higher pay for them too!

  5. nyscof

    May 27, 2009 at 7:29 am

    No one in America is or ever was fluoride deficient, Applying fluoride varnish to middle income children will not stop the dental health crisis occurring in low-income children.

    Besides, fluoride varnish contains a hugely toxic 22,600 parts per million fluoride, some of which gets absorbed and involuntarily swallowed upon application. What happens to the rest of it – it doesn’t stay on the teeth forever. Then you wouldn’t be able to charge for a second fluoride treatment.

    Modern science shows that ingesting fluoride does not reduce tooth decay, according to the Centers for Disease Control.

    After 60 + years of water fluoridation and 50+ years of fluoridated toothpaste and with a huge number of fluoridated dental products on the market, both Over the Counter and used in dental offices (e.g. cements), and with fluoride containing pesticide residues remaining on many foods – tooth decay is still a growing epidemic in the US where 6.5 million children have untreated tooth decay.

    However, the CDC reports that up to 48% of school children sport fluoride overdose symptoms – dental fluorosis (discolored teeth)

    Adverse health effects of fluoride http://www.FluorideAction.Net/health

    Bad diets create bad teeth and fluoride can’t fix that.

    However, consuming a fluoride-free diet, if that was possible, will not cause tooth decay.

  6. Kim

    May 28, 2009 at 1:20 pm

    The state budget proposal to eliminate the NC Oral Health section would effectively eliminate what few dental services are currently available to children in many rural communities. Several NC counties,have no dentists. The only dental providers seeing the children are the NC OHS public health hygienists. In NC, they are currently the backbone of the dental public health safety net, the dentist “extenders” who provide school based screenings for decay, provide education to the public and professional communities, and make the necessary and often complicated referrals for children who need urgent treatment,but don’t have the resources to access care. Elimination of this program will eliminate the annual oral screenings essential to tracking the oral health status of children across our state,and decrease the ability to provide early intervention and avoid costly emergent dental care of these children.

  7. Mary

    June 8, 2009 at 10:37 am

    I respect your comments about this subject and realize that you have legitimate concerns about fluoride. Your statement…
    “Bad diets create bad teeth and fluoride can’t fix that” is true to a certain extent. That is another reason that the NC Oral Health section must not be eliminated. They CONTINUOUSLY educate the public about their diet and attempt to motivate people to implement proper oral health techniques to prevent cavities.

    I agree wholeheartedly with the other point I you made – “What needs to be done is to require dentists to treat more people for reasonable prices and require them to accept Medicaid patients.
    NC is one of two states in the US that have the strictest Practice Acts. Studies have proven that dentists with very strict practice acts have the highest income. I continually wonder why our NC dentists are not helping to cure this crisis by doing exactly what you have suggested. If you know how to accomplish your suggestion, my hat is off to you.

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