EXECUTIVE SUMMARY

From Hawaii DoH, August, 2016

With Hawaii Smiles, the Hawaii State Department of Health takes its first in-depth look at the oral health status of a representative sample of third grade children throughout the state. During the 2014-2015 school year, a total of 3,184 third grade children in 67 public elementary schools on six islands received a dental screening. Third grade children were screened because third grade is the target elementary school population for the National Oral Health Surveillance System. The findings presented in this report support the need for culturally appropriate community-based prevention programs, screening and referral services, and restorative dental care to improve the oral health of Hawaii’s children.

The results of Hawaii Smiles confirm that Hawaii’s children have the highest prevalence of tooth decay in the United States. The results also demonstrate that the burden of oral disease is significantly greater in certain segments of the population. For example, tooth decay is disproportionately experienced by low-income children, defined as those who are eligible for the National School Lunch Program (NSLP). About 31% of children eligible for NSLP have untreated tooth decay compared to 13% for those not eligible. The disparities gap is even more pronounced when looking at urgent dental needs due to pain and/or infection. The need for urgent dental care is more than five times higher in low-income children compared to their higher-income peers (13% vs. 2% respectively).

There are also oral health disparities based on race/ethnicity with Micronesian and Other Pacific Islanders (Guam, Samoa, Tonga and Other Pacific Islands) having the highest prevalence of untreated decay. About 56% of Micronesian and 41% of Other Pacific Islander children have untreated decay – four times higher than the prevalence among White (13%) and Japanese (11%) children. As with income, the race/ethnicity disparities gap is more pronounced when we look at the need for urgent dental care.  Thirty percent (30%) of Micronesian and 23% of Other Pacific Island children have dental pain and/or infection compared to only 3% of White and 2% of Japanese children.

With this report, the Hawaii State Department of Health builds upon the oral health data in the 2015 Oral Health Key Findings report to inform policy development and program planning. Based on the findings of this study, Hawaii must strengthen oral disease prevention efforts and implement strategies that lead to improved access to both preventive and restorative dental care for all children. Everyone has a role in improving and promoting the oral health of Hawaii’s children.

Several key strategies have been identified to improve the oral health of children in Hawaii.  The strategies are grouped into three general categories highlighted in the key findings: community-based prevention programs, screening and referral services, and restorative dental care. Teeth develop before birth and start to appear in the mouth when a child is about 6 months of age. Therefore, the strategies listed below demonstrate efforts to prevent tooth decay starting from the prenatal period all the way through childhood.

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HNN: Report: Hawaii has highest prevalence of tooth decay among kids