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Gabriela Pacheco
E. Parrish
English 1010
10 April, 2015
Teeth Wars
Children with healthy mouths have a better chance of general health because disease in
the mouth can endanger the rest of the body (DentaQuest). One in two children living in a low
income household receives no dental coverage. This increases the risk of other health problems
in children; not only does the lack of proper treatment and hygiene affect their dental health, but
many other parts of their bodies as well.
What is the effect of poor dental health on low income children? The lack of suitable
health care among low income families already tends to be a problem; however, the most
prevalent unmet health issue among low income children is dental care. It has been said that
tooth decay is the most common chronic illness among children. With that being said, poor
health care has also been linked to ear, sinus infections, weakened immune systems, diabetes,
and health and lung disease, among other conditions. Lack of treatment can affect a child's
speech, nutrition, growth and function and social development, as well as quality of life (Kaisser
Commission). This issue can make children grow up feeling self-conscious and make them have
low self-esteem leading to a negative image of themselves.
The importance of this issue was brought to the surface when in 2007, a 12 year old boy
from Maryland died after bacteria from an abscessed tooth traveled to his brain (Gretchen
Gavett). The cost to have the little boys tooth extracted would have been $80, with the right

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insurance. However, his family did not have insurance at some point they had Medicaid, but
his mother didnt return some paperwork and they were removed from the program and they
were not able to make an appointment for this procedure to happen. The bill for two weeks of his
care at Marylands Childrens Hospital was about $200,000; at the time of the boys death, only
about 900 out of Marylands 5,500 dentists accepted Medicaid and this also played a big factor
(Gavett). The reason for why many dentist are opposed to participating in any type of Medicaid,
is due to the fact that payment rates for dentist who participate is less than half of their normal
charges. However, those who do participate only take a limited amount of patients in, which still
proves to be a problem (Kaisser Commission). After this devastating incident, many states have
taken steps to increase the amount of dentist who are willing to participate by making some
changes, such as raising their payments.
Although its evident that this issue affects the head of the households at these low
income families with children the most, it can also affect the children themselves. It has been
said that poor children those with an income below federal poverty level (FPL) had twice the
prevalence of dental cavities than higher-income children do (Kaisser Commission, 2009). When
said child goes to the dentist after years of not going, they will most likely face being told that
they have many oral issues. This can then result in the child being scared of the dentist and the
procedures that they must endure. People, who have some knowledge of the topic of dental care
and low income families with children, probably dont think that this is really an issue. After
reading my paper, most readers will have a better understanding of policies focusing on
improving dental care and reducing unmet dental needs among low-income children.

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Children who receive low, or no dental care are more at risk for health issues than those
children who have access to the resources needed. Studies have shown that children from low
income families are less likely to receive dental care and more likely to have unmet dental needs
than children from higher income families. Roughly 1/3 of low income children ages 6-19 have
untreated tooth decay, compared to 15% of children above poverty level. 80% of the decay is
found in 25% of children ages 5-17, coming from mostly low-income and other vulnerable
groups (Kaisser Commission). Children who are under poverty level are less likely to visit the
dentist until they are much older and they only seek regular care until a problem gets to the point
that they need emergency treatment. On the other hand, a kid with the proper coverage has
regular checkups and does not have to worry about any serious infection, unless its not treated
as it should.
Its obvious that the children who are not able to afford the needed care are going to end
up with more problems, however, just because they cant afford regular checkups doesnt mean
they cant maintain proper hygiene. Proper oral hygiene refers to the daily preventive care, which
includes brushing roughly twice a day and flossing daily, as well as eating a balanced diet and
limiting snacks between meals. The use of the proper dental products that contain fluoride,
including toothpaste, is also a good preventive method. There are a few ways to attain these
materials, for example, plenty of dentist offices offer free tooth brushes and tooth paste for
people in need. If the children brush and floss regularly and maintain proper oral hygiene, even
without attending the dentist regularly, then the need for worry and infections should be
decreased.

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Another factor that is brought into play when it comes to children and poor dental care, is
that of psychosocial problems. These problems occur when a child does not have the proper care
and are tied back to the self-esteem factor, like talked about previously. Self-esteem relating to
body image is already a problem in this society, adding the factor of teeth and other health issues
into the picture can make it harder to accept and cope with. This issue can lead to long-lasting
effects throughout their teen years and even into their adult years. Something that can be done to
improve the problem would be by providing free or low cost clinics in more schools. Although
this would be aimed towards the children the most since they would be the ones receiving the
care it can also be aimed at their parents because it would make it easier on those who are
struggling with not only money, but also time. School based health clinics in New York City
administered by the Children's Aid Society, provided dental services to children regardless of
their ability to pay. The results support increasing the number of school-based dental clinics in
urban areas that serve children in need. Being based in schools, factors such as transportation
issues, parent availability, and missed appointments are greatly reduced (Journal of School of
Health). By providing a natural location, sources are more accessible and easier to reach.
Although this idea sounds great, there is also the factor of who is going to pay for all these
expenses? Where exactly would all the money come from to pay the providers and all other
costs?.
One of the biggest improvements to this issue would be by making parents more
informed of the oral health problems that can affect their children. The Ad Council and the
Partnership for Healthy Mouths performed a study that demonstrated progress in the effort to
improve childrens oral health habits and awareness in August of 2013. The program received

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tremendous media exposure through widespread TV, radio and print. Over 50% of parents
surveyed had heard of the new Kids Healthy Mouths PSAs. This resulted in a significant
improvement; after the study parents reported that their children brushed at least twice a day
compared to before the campaign. There was an increase of 55% (English-speaking parents) in
2013 to a 48% in 2012. An increase of 77% (Spanish-speaking parents) in 2013 compared to a
69% in 2012. This study helped to raise awareness of the issues involved when proper care is not
taken. However, campaigns such as Kids Healthy Mouths are not being promoted everywhere. It
would make sense that they should be since they are showing significant results. This research
proves that when parents are better informed, they are more likely to comply with what is being
said, in order to keep their children healthy and disease free. No parent wants their child to
suffer once they know of the things they can do to prevent any suffering.
Another factor at play is that not every health plan/insurance is taken by every dental
office particularly. As has already been mentioned, dentists tend to limit their Medicaid patients
to a small amount or don't accept the insurance at all because the rates they are paid when
treating these patients are lower than what they would otherwise receive from other clients. In
turn, those who do accept it are harder to find and not easily accessible to low income families.
Dr. Steve Slott, a Burlington dentist, who works with Medicaid recipients, thinks that Medicaid
rates still need to be raised higher to attract more dentists. He called the current way of
administering Medicaid "false economics" because it doesn't focus on preventive care (Emily
Howenwarter).
A small, yet very real effect of poor dental health on children is the parental guilt that
surfaces. A parent can feel guilty due to the fact that they have to see their children face all of the

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problems that come with this issue. This guilt can lead to other issues in the household, such as
marriage issues. A way for this to be fixed could be by reassuring the parents that its not their
fault and that there are things that can be done and resources available for them. One thing that is
for sure is that the effect of poor dental health on low income children can be harmful to their
growth. First off, poor dental health in general is not something to be challenged. From your
basic cavities to harmful infections such as periodontal disease it is important to take care of your
teeth. Untreated dental disease can turn a childs bright future into a minimum wage blind alley
(Schuyler Center for Analysis and Advocacy). Also, bad oral health in children can result in poor
social outcomes for their present and their future.
What is the effect of poor dental health on low income children? People, who have some
knowledge of the topic of dental care and low income families with children, probably dont
think that this is really an issue. After reading my paper, most readers will have a better
understanding of policies focusing on improving dental care and reducing unmet dental needs
among low-income children. The effects of poor dental health on low income children are:
children who receive low, or no dental care are more at risk for health issues than those children
who have access to the resources needed, psychosocial problems occur when a child has poor
oral health, this can lead to long-lasting effects throughout their teen years and into their adult
years and the issue of parental guilt also surfaces. Free or no cost clinics and the awareness of
the issues that can result from poor dental health would be ways to better the issue, however
more needs to be done. Its important to know of the right measures that need to be taken in order
to insure that a kids smile is as bright as their future.

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Works Cited
Gretchin Gavett. Tragic Results When Dental Care Is Out Of Reach. KEUD7 June 2012
<http://www.pbs.org/wgbh/pages/frontline/health-science-technology/dollars-anddentists/tragic-results-when-dental-care-is-out-of-reach/ >
Kaisser Commission. Oral health coverage and care for low-income: The Role of Medicate and
Chip. The Henry j. Kaiser Family foundation, 2009
http://www.hdassoc.org/pdf/OH_coverage__care_for_low_income_children__Medica.pdf
Manski, Richard J. Investing in Preventive Dental Care for the Medicare
Population:Preliminary Analysis American Journal of Public Health 2010
<http://web.b.ebscohost.com/ehost/detail/detail >
Dr. Steve Slott. Thinks that Medicaid rates still need to be raised higher to attract more
dentists. Times-News (Burlington, NC). 2008
http://web.b.ebscohost.com/ehost/detail/detail?

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Emily Hohenwarter. Dental care limited for Medicaid patients: Only 12 dentists in the county
accept recipients Times-News (Burlington, NC). 2008
http://web.b.ebscohost.com/ehost/detail/detail?
Childrens Oral Health Untreated dental disease can turn a childs bright future into a minimum
wage blind alley Schuyler Center for Analysis and Advocacy