A research team at New York University’s College of Dentistry is studying the cost effectiveness of cavity prevention programs using children in New Hampshire schools.
Last year, the team was awarded a $3.6 million, five-year grant to fund research in six rural New Hampshire counties. The goal is to reach 12,000 children from preschool to sixth grade in 40 schools.
The team will compare traditional sealants and fluoride varnish against a simpler treatment of silver diamine fluoride and fluoride varnish.
Silver diamine takes six minutes to apply, compared to sealants, which typically take 20 minutes per child. If silver diamine is found to be a better fit for school-based dental programs, that could initiate changes throughout the state.
NYU’s Richard Niederman is a professor and chair of the Department of Epidemiology & Health Promotion at NYU Dentistry. He is one of the lead researchers in the study.
Niederman said national statistics show that up to 30 percent of children have untreated cavities. That number is even higher in rural areas, where experts estimate more than 35 percent of children have untreated cavities.
“Cavities are the most preventable disease in children,” Niederman said.
Niederman said children with cavities are more likely to be missing teeth as adults, and in the meantime they suffer great pain.
“A toothache is excruciating. You can’t think. You can’t work. You can’t concentrate in school,” Niederman said.
Ray Orzechowski is part of the Concord Dental Sealant Coalition. He explained why schools are a great place to reach children for preventive work.
“We’re able to take away the barriers as far as transportation and cost,” Orzechowski said. “We can get sealants placed on the teeth of those people who aren’t going to be in a dental office.”
Orzechowski said silver diamine fluoride treatments are not yet covered by Medicaid, but the hope is the quicker application will allow trained professionals to treat more at-risk children. Silver diamine has been used in Europe for many years, and is as effective as traditional sealants, he said.
Hope Saltmarsh is the oral health program director at New Hampshire’s Department of Health and Human Services. She said the department serves in an advisory role for the study.
Saltmarsh said DHHS is interested in learning more about what the researchers find because it could lead to more children getting cavity protection.
Through already-established school dental programs, the percentage of third graders in New Hampshire with sealants increased by 15 percent. Those with untreated dental decay decreased by 14 percent from 2001 to 2014.
Saltmarsh said in New Hampshire there are dental programs that have developed over time independently from each other which help to provide sealants in schools, instead of a state-based program.
“We’re not reaching every school that has higher needs, but we’re reaching almost all of the higher-need schools,” Saltmarsh said.
Partners for the NYU study also include Northeast Delta Dental, New Hampshire Dental Society, Alice Peck Day Memorial Hospital’s Community Health Department, Concord Dental Sealant Coalition, Coos County Family Health, HealthFirst Family Care Center and Sullivan County Oral Health Collaborative.
Niederman said money for the NYU study comes from the National Institute on Minority Health and Health Disparities, part of the National Institutes of Health.
NYU College of Dentistry is the largest dental school in the United States, educating nearly 10 percent of the nation’s dentists, according to its website.