Posted on: Friday, February 1,2002

State gets grade of B-minus in dental report

By Alice Keesing
Advertiser Health Writer

Hawai'i scored a B-minus on a national report card on oral health released this week, although the report ignores the fact that Hawai'i's children have some of the worst rates of dental decay in the nation.

The second annual report by the nonprofit group Oral Health America provides a snapshot of the nation's oral health by looking at everything from the use of sealants to prevent cavities to the percentage of elderly with no teeth.

The nation earned a "C" grade. Hawai'i, Connecticut, Iowa and Utah scored the highest grade of B-minus. Hawai'i had the highest cumulative score and improved from a C-plus last year.

Despite Hawai'i's good showing, some professionals say the report does not paint an accurate picture of oral health in a state where cavities are rife and many have no access to care. The report also comes at a time when the Legislature is considering cutting the state's public dental health program.

"The state doesn't deserve a B-minus," said Beth Giesting, executive director of the Hawai'i Primary Care Association, the umbrella organization for the state's 10 community health centers that serve uninsured, poor and homeless people.

While the report rated Hawai'i high for its access to dental care, Giesting said too many people are falling through the cracks. More than 427,000 people — 37 percent of the population — have no access to dental care, she said.

"If you are talking about the areas that have unmet needs, that would be pretty much every rural area or the areas that have a large proportion of poor people or people who are uninsured," she said.

Where Hawai'i falls down in the report — scoring a "D" — is in prevention. Most notable was the lack of fluoride in Hawai'i's public water system, which the health department has been unsuccessfully pushing at the Legislature. The department has not introduced a fluoride bill this session.

Dr. Mark Greer, chief of the state Department of Health's dental health division, also noted that the report does not take into account Hawai'i's rampant rate of tooth decay, which is among the highest in the country.

"The highest rate of tooth decay that we've seen among children is on the island of Lana'i, where it's three times the national average overall," Greer said. Ethnic groups that suffer the most from poor oral health include Filipinos, Native Hawaiians, Pacific Islanders and South East Asians. "We certainly have problems. We have things that we need to work on. But what the report reflects is that we're far better off than many states."

The report gives Hawai'i an "A" for its oral health leadership, which Greer attributes to the system spearheaded by the dental health division. It is that system that health department officials believe is under threat at the Legislature by a bill that would cut the division from 26 to three people and eliminate the state's dental health clinics.

The clinics are a "last resort" for many, Greer said, including the aged, blind and severely disabled.

State agencies, dentists and clients testified in opposition to the bill this week, saying the clinics fulfill a vital role.

Giesting, however, supports the idea and believes the community health centers or other private groups could provide the services more economically.

The health committee deferred its decision on the bill to today.

The report, "Filling the Gaps: Oral Health in America," can be found at www.oralhealthamerica.org.

Reach Alice Keesing at akeesing@honoluluadvertiser.com or 525-8014.