When you think of a child missing school, you may not think of her oral health. But that is one of the most common reasons for missing school among elementary school children. In fact, the U.S. Surgeon General calls dental disease the most common preventable chronic childhood disease. It contributes to school absenteeism, difficulty learning, poor nutrition, poor self-esteem, and reduced overall well-being and development.

The American Dental Association, American Public Health Association and American Academy of Pediatrics recommend children have their first dental visit when the first tooth comes in or as a 1-year-old. However, a recent survey found that more than 10% of Marin kindergartners suffered from untreated dental decay. Not surprisingly, the majority of these children come from low-income families. We have the will and the resources to tackle this problem in Marin, to make sure no child falls behind because of poor dental health. The benefits go far beyond preventing toothaches and cavities.

Children from families who cannot afford dental care miss school twice as often as those from families who can afford care, widening gaps in academic achievement for low-income children. A study published in the American Journal of Public Health found that children with tooth pain were four times more likely to have poor test scores than those with good oral health. Childhood dental disease costs California school districts approximately $29.7 million annually due to lost reimbursement for average daily attendance.

One crucial way to address the recent findings in Marin is to assess the oral health of each child as they enter kindergarten. The Marin County Office of Education

and Dr. Connie Kadera of Marin Community Clinics are working with the county Department of Health and Human Services to bring oral health assessments to schools in Marin’s lowincome communities. The goal is to screen all kindergartners for tooth decay and offer access to affordable dental care.

In order to achieve universal oral health screening, we need the support of parents.

California Assembly Bill 1433 helps ensure that children with dental disease are identified so they can be treated. This law requires

that parents have their child assessed before the end of kindergarten. Unfortunately, only 68% of Marin parents submitted the assessment last year.

The impact of poor oral health on children and schools is entirely preventable. With the following preventive strategies,

Marin’s children can avoid dental disease.

• Parents of kindergartners fill out and return the Oral Health Assessment form.
• Limit sugary foods and drinks
• Brushing with fluoride toothpaste twice per day, drinking fluoridated water where available, and getting fluoride varnish applied 2-4 times per year
• Flossing once a day
• Parents assist children with brushing and flossing as at this age their manual dexterity is still developing.
• Children visit the dentist as a 1-year-old and have routine dental visits at least two times per year.
• Pregnant women access perinatal oral health care and education.
• We are fortunate to have partners who are ready to work together to provide school-based oral health assessments, education about oral health, and referrals to dental care in schools with the highest unmet need. We know that every child should have a dentist that they see routinely.

Poor oral health is often a sign of disadvantage in Marin County, and it further widens gaps in achievement and selfesteem. We owe it to ourselves and our future to guarantee all of Marin’s children good oral health, to help ensure that all children have the same chance for success.

To find out how you can support children’s oral health or to learn more about the Marin Oral Health Strategic Plan and efforts to improve oral health and reduce oral health disparities among our children, go to MarinOralHealth.org

Matt Willis, MD, is Marin County Public Health Officer. Mary Jane Burke is Marin County Superintendent of Schools.