Dental sealant program kicks off

Gocio Elementary School second-grader Xavier Del La Cruz is all smiles while getting dental sealant at the school on Friday. Herald-Tribune staff photo/Dan Wagner.

Gocio Elementary School second-grader Xavier Del La Cruz is all smiles while getting dental sealant at the school on Friday. Herald-Tribune staff photo/Dan Wagner.

SARASOTA - Xavier De La Cruz was not nervous. He'd been to the dentist before. Sure, his feet wiggled a little bit, but the 8-year-old sat patiently in a portable dental chair set up at Gocio Elementary as he took part in a pilot program that will provide free dental sealants to all second-graders in Sarasota County.

The program, a partnership between the Department of Health in Sarasota County and four local foundations, is an effort to improve school success by targeting one of its enemies: tooth decay.

Decay, which leads to cavities if left untreated, is a leading cause of school absences, and the most common chronic childhood illness. By some estimates, more than 50 million hours of school time are lost each year due to dental-related illnesses.

"The research shows that kids with dental pain do significantly more poorly in school," said Kimberlee McCarren, dental sealant program coordinator for the Department of Health in Sarasota.

This story comes from SPIRE CoLab, a partnership between philanthropy and journalism meant to inspire communities to take action on relevant social issues. It is led by the Herald-Tribune and funded by The Patterson Foundation. 

Children start to miss school, they're distracted by the pain, they don't sleep well and they don't eat well, eventually falling behind in class, McCarren said.

A dental hygienist for 36 years, McCarren says that dental pain in children is usually not acute. The vast majority of times it's chronic pain that they deal with on a daily basis. "But we expect little kids to learn despite that pain," she said.

Dental hygienist Kimberlee McCarron. Herald-Tribune staff photo/Dan Wagner.

Dental hygienist Kimberlee McCarron. Herald-Tribune staff photo/Dan Wagner.

More sealants, fewer fillings

Dental sealants can help. The liquid sealant is funneled into the grooves of permanent molars and then hardened. The sealant creates a protective barrier around the molar, preventing decay and cavities.

Sealants can last up to five years, and have been shown to protect against 80 percent of cavities in the first two years. The program targets second-graders because by then, children typically have four permanent molars.

The procedure is quick and painless. Children are out of McCarren's chair in 10 minutes, meaning they don't have to miss almost any class time. She talks to them about the "sugar bugs" that invade their teeth, quizzes them on brushing and flossing, and throws them a compliment on their pearly whites. At the end, the kids take home a brand new toothbrush and mini tube of toothpaste. McCarren's instruments are sterile and disposable, in a flash, she's on to the next child.

"Part of the goal is to leave kids with a very positive dental experience," said McCarren, who is applying all the sealants herself. By the time she's done in May, she will have visited all 17 Sarasota elementary schools.

In Florida, around 65 percent of the state's 67 counties now have dental sealant programs in schools. Investing in programs like this, McCarren said, saves families and taxpayers a lot of money down the road.

Sealants cost around $45 per tooth. One single filling hovers around $200.

"If you can prevent the filling by investing in sealants, the cost savings are huge," McCarren said.

Despite their effectiveness, dental sealants have gone underutilized. Only 20 percent of children at poverty-level get sealants, according to the Centers for Disease Control and Prevention. For children in higher income homes, the rate sits at 40 percent.

Children in low-income homes are particularly vulnerable. Research shows they're more than twice as likely to have tooth decay than children in more affluent homes, but far less likely to receive dental care. A Herald-Tribune series revealed that in 2015, only one third of Medicaid-enrolled children received any dental care at all, and just 18 percent of the state's dentists accept Medicaid patients.

Beyond the dental chair

Gocio Elementary School second-grader Summer opens wide for dental hygienist Kimberlee McCArron, who applied dental students for students on Friday. Herald-Tribune staff photo/Dan Wagner.

Gocio Elementary School second-grader Summer opens wide for dental hygienist Kimberlee McCArron, who applied dental students for students on Friday. Herald-Tribune staff photo/Dan Wagner.

The sealant program is free for all second-graders. While the initiative is funded through the Department of Health, the program will bill Medicaid when applicable. The portable dental chair and equipment were gifted by the Patterson Foundation, the Community Foundation of Sarasota County and the Rotary Club.

The program has also received backing from the Suncoast Campaign for Grade-Level Reading, an initiative that aims to get all children reading proficiently by third grade. The organizations see dental sealants as key to helping children stay healthy and focused in school.

For her part, McCarren sees her role as part dental hygienist, part caseworker. A goal of the program is to educate parents on the importance of dental health, and, when needed, help guide them through the Medicaid maze. After each procedure, McCarren sends a letter home to parents. If a child needs follow-up care, she lets the caregivers know.

At Gocio, where McCarren worked on Friday, only 22 students had parents who signed the permission slips for the sealants. There are 127 second-graders at the school. Administration is hoping that more parents will come on board by next week. Gocio Principal Steve Royce said he's not sure why the response rate was so low. Next year, he said, they might send the permission slips home sooner.

The Department of Health has its eyes set on Manatee County next. In Manatee, the need is even higher than in Sarasota. There, children are chronically absent at double the rate, and low-income children make up a higher percentage of enrolled students.

Back in the dental chair, Xavier is done in just 10 minutes. Did it hurt? "Definitely not," he says. Toothbrush in hand, he raced back to class smiling.