Child specialists suggested for kids' dental care

By Beverly Creamer
Advertiser Staff Writer

In this 1920s photo from the collection of philanthropist and dental health activist Helen Strong Carter, children line up to brush their teeth at a school in Honolulu. Strong Carter collection

"We currently bring in children from Project Head Start," said Carolyn Kuba, chairwoman of the Department of Dental Hygiene at the university. "We do some cleaning, and we'll place sealants on the teeth of some of the children. The sealants are a preventive measure in terms of cavities."

Helping the Head Start children also helps the dental hygiene students, Kuba said. "It gives the students a good chance to learn to handle young children. Sometimes you need to coax them," she said.

The American Dental Association recommends sealants and topical fluoride treatment to fight tooth decay in children.

Hawai'i has one of the highest rates of dental decay in the nation, said Yoshi Koga, program consultant and former director.

State Department of Health statistics show that Hawai'i elementary school children have more than twice the cavities of their counterparts on the Mainland. The Health Department blames the lack of fluoridation, and is advocating the water treatment. While Moloka'i is close to making a decision on fluoridation, a legislative bill calling for statewide fluoridation is dead for this session.

"The Centers for Disease Control have put that as one of the top public health priorities," said Karen Hu, head of the Health Department's hospital and community dental services branch. Hu said studies show fluoridation can reduce cavities by 60 to 70 percent. Children on Hawai'i military bases - which have fluoridated water - have a 61.9 percent lower rate of tooth decay than others.

But while the clinic will provide fluoride treatment to children who have experienced tooth decay, patients are referred to a dentist for more extensive work, such as filling cavities. Periodontists and dentists on the staff act as consultants to the students.

"Good hygiene is the next best thing to prevent tooth decay in young children," said Dr. Mark Greer, chief of the dental health division of the Health Department. "We grew up hearing (brush) 'three times a day,' but for young children once a day is easier to sell. We recommend bedtime, and suggest they even do it in the bathtub or shower, for those who can't deal with the mess."

Helen Strong Carter, a philanthropist and wife of a territorial governor, started the first dental hygiene program here in 1921, and inspired the first dental clinic as an outreach to the community. In the program's first years, the graduating hygienists were all student teachers and took their message into the schools with them.

One old photograph from Koga's collection shows a 1920s lineup of elementary schoolers bending over an outside trough brushing furiously after school lunch.

The photo is dated and charming but points to a truth that still holds: The start children get in dental hygiene is important.

It begins with protecting those first baby teeth. "They should stop the bottle by age 1," said Kuba. "If the child sleeps with the bottle, the milk or juice pools around the front teeth and causes cavities. Many children have stainless steel caps on their baby teeth (because of cavities)."

The first trip to the dentist, said Kuba, should be just about the time the child's first teeth come in. At least annual visits for cleaning and check-ups are recommended thereafter.

The UH clinic may not be the best choice for small children, however, because of the length of time it takes for the student dental hygienists to perform the check-up and cleaning. If your dental plan provides, it's best to choose a dentist who specializes in children's care.