Matthew Whittle

In recognition of Public Health Week, April 7-13, SEANC will highlight areas this month where state employees are working to improve public health.

This week we are looking at North Carolina’s Oral Health Section of the Department of Health and Human Services.

Begun in 1918, North Carolina’s oral health program is the oldest dental public health program in the nation, and was created in order to combat the rampant oral health problems in the largely rural state.

Its goal, to teach elementary school children about the need to take care of their teeth, is an especially important one today as, according to DHHS, 37 percent of children entering kindergarten are already affected by tooth decay.

"Access to dental care is one of the biggest unmet health care needs in this state," said retired state oral hygienist Nancy Ferguson Brown.

Because of a justified fear of reprisal – DHHS Secretary Aldona Wos fired 14 dental hygienists after 14 of their peers spoke against cuts to the General Assembly last year – SEANC chose not to speak to current employees, but rather to Brown, who is an outspoken advocate for children’s oral health.

Brown, who retired in 2009 after 30 years with the state Oral Health Section, said the program is a crucial tool in reaching out to children and families, educating them about the need for improved oral health care. Traditionally, she explained, the program has assessed the condition of children’s teeth, helped parents find dental care, and worked with school systems to provide dental sealants and fluoride mouth rinses to students.

Today, however, she says, the agency has been greatly reduced – even though the need for its mission has not.  According to the state DHHS Oral Health website, “tooth decay is the most common chronic infectious disease of childhood, more common than asthma.”

“Access to dental care is one of the biggest unmet health care needs in this state,” Brown said. “Visiting the dentist has become a luxury. Where else can children learn about the importance of their teeth, but in school? I did. And every week in Burke County somebody stops me on the street and comments how the school dental program helped them keep their teeth. For many of them, us coming into the classroom was the first time they had ever been exposed to a toothbrush, much less told what to do with it.”

The challenge, she explained, is that not only are teachers not trained to teach students about dental health care in the classroom, they do not have time. However, she continued, if somebody else can come in and teach the children about their teeth in a helpful, fun and engaging way, the teacher can then reinforce that message through other subjects such as science.

But it’s about more than just a pretty smile and fresh breath. More and more, she said, doctors are finding out that the health of a person’s teeth, gums and mouth can be indicative of the health of the rest of their body – and therefore a crucial aspect to preventative health care.

“The mouth is the gateway to the body and we’re continuing to learn more about the role the mouth plays in the health of the rest of the body,” Brown said. “We’re finding more and more that poor oral health is associated with a number of chronic diseases.”

That’s why, Brown said, it’s important for children to begin learning about their teeth and learning how to take care of them early – to learn those good habits.

“Good dental health is a life skill,” she said. “It is something you carry with you for the rest of your life.”

Even the state agrees, stating on the DHHS Oral Health website that there is a problem with young children’s oral health in North Carolina.

“Currently, 37 percent of children entering kindergarten have already been affected by tooth decay. Most dental disease can be prevented with regular brushing and flossing, regular dentist visits, protecting teeth with sealants and flourides, and a healthy, low-sweets diet,” the website reads.

That’s why Brown can’t understand why the state is persisting in cutting funding and positions for the Oral Health Section.

“It’s already a small program, but they only seem to want to cut prevention,” she said.

She admits that unlike some areas of public health, the oral health program generate little, if any, revenue. But, she said, it more than pays for itself by keeping children out of emergency rooms because of serious and acute oral health problems and away from more expensive dental treatments.

And by keeping children from having to deal with such dental emergencies, she said, not only does the oral health program save money in the long run, it also encourages education and economic development.

“Unhealthy children cannot learn. Education today concerns the whole child. Our future citizens must be healthy to meet the demands of the workplace. Employers want people with teeth in their smile, literally,” she said. “We had 30 years of such great progress. When I retired, my position wasn’t filled and my community has floundered. It’s very disheartening. If this program goes unfunded, progress will take a huge step backward. North Carolina is not a progressive dental state. School nurses are not taught dental science. We cannot leave it up to the dentists in private practice. We need to fund our state dental program.”