Tooth decay: New study explores the impact of increasing dental health programs in middle schools

 

Kennesaw State University researcher Christina Scherrer’s studies on school-based dental health programs have shown how effective they can be in reducing tooth decay in elementary-aged children. Now, through a grant from the National Institutes of Health (NIH), Scherrer is expanding her research to see if similar programs can also help children in middle school.

“Dental problems are a significant contributor to children being out of school for pain and discomfort,” said Scherrer, professor and department chair of industrial and systems engineering in the Southern Polytechnic College of Engineering and Engineering Technology. “Data also shows that children who do not receive good oral healthcare can have diminished health later in life.”

According to Scherrer, who is working with Shillpa Naavaal, associate professor in Virginia Commonwealth University’s School of Dentistry, school-based dental programs are important, especially in low-income areas where parents may not have the means to take their children to a dentist. The researchers will use the more than $400,000 NIH grant to survey school sealant program directors and state oral health directors around the United States to determine how they are using school-based sealant programs and then dive into data on children’s teeth.

“We know sealants work, and we know that school-based sealant programs work,” Scherrer said. “However, most of these programs are in elementary schools and what we don’t know is how it looks different in a middle school. Our hypothesis is that perhaps children’s first molars are in better shape because they’re more likely to get sealed in these school-based programs and the second molars, those that typically come in between the ages of 11 and 13, are not.”

Scherrer and Naavaal will use data from the Centers for Disease Control and Prevention (CDC), which details children’s teeth including those that have sealants, have decay, and that are missing, in addition to demographic data. Once the research team has analyzed the CDC data and survey results, they will build a simulation model to see what the likely benefit would be of increasing school-based sealant programs for middle schoolers.  

Once the simulation model is built, the team will be able to estimate the impact of increasing the number of middle-school-based sealant programs on children’s teeth. If their results support the belief that more school-based sealant programs will improve children’s oral health in a cost-effective way, the goal is to apply for funding to help implement more programs.

“Dr. Scherrer continues to impress us with her community-focused and impactful research,” said KSU's Engineering College Dean Ian Ferguson. “It is an incredible honor to receive three NIH grants within the past year. It is clear that she and her research teams are making a difference in children’s lives. We look forward to continuing to follow her projects over the next several years.”

Earlier this year, Scherrer started work on her first NIH grant for a project aimed at assessing and reducing barriers associated with primary care doctors applying fluoride varnish on children’s teeth. She has been researching children’s oral health for more than a decade.

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Medicare coverage of medically necessary oral and dental health therapies in physician fee schedule

The Gerontological Society of America (GSA) — the nation’s largest interdisciplinary organization devoted to the field of aging — commends the Biden-Harris Administration for finalizing regulatory policy that will have a direct and meaningful impact in the lives of many Medicare beneficiaries. The Medicare program is taking an important step towards much-needed coverage of medically necessary oral and dental care.

Specifically, the final Physician Fee Schedule for 2023 codifies Medicare coverage for dental services that are inextricably linked and substantially related and integral to organ transplant surgery, cardiac valve replacement, valvuloplasty procedures, and head and neck cancers. The final rule also creates the opportunity for further coverage expansion by establishing “a process to identify for [the Medicare program’s] consideration and review submissions of additional dental services that are inextricably linked and substantially related and integral to the clinical success of other covered medical services.” Finally, the rule codifies Medicare coverage for the wiring of teeth related to covered medical services, the reduction of jaw fractures, the extraction of teeth in preparation for radiation treatment of neoplastic disease, dental splints for covered treatment of certain medical conditions, and oral or dental examinations relating to renal transplant surgery.

GSA members contribute to the evidence base as it relates to the importance of oral health as an essential element of healthy aging. The Society has a long-standing commitment to oral health, which includes multiple collaborations over several years. Guided by its Oral Health Workgroup, GSA works to increase awareness of appropriate oral care and strengthen the impact that all members of health care and caregiver teams have to ensure good oral care for older people. Additionally, GSA’s Oral Health Interest Group is an interdisciplinary network that provides an active opportunity for persons interested in the issue of oral health to meet and exchange information and resources.

Starting in 2016, GSA has developed and actively disseminated several relevant publications. Among them are a white paper from an interprofessional convening that included more than 20 national aging and oral health organizations titled “Interprofessional Solutions for Improving Oral Health in Older Adults: Addressing Access Barriers, Creating Oral Health Champions,” and two issues of GSA’s What’s Hot newsletter, “Oral Health: An Essential Element of Healthy Aging” in 2017 and “Interrelationships Between Nutrition and Oral Health in Older Adults” in 2020.

GSA has been a strong advocate for the inclusion of coverage of medically necessary oral and dental care in Medicare and has worked as a member of the Consortium for Medically Necessary Oral Health Coverage to advocate for Medicare coverage of medically necessary oral and dental treatment. GSA has joined roughly 240 colleagues in signing the consortium’s Community Statement to urge Congress and the Administration to explore options for extending evidence-based coverage to all Medicare beneficiaries. As a member of the consortium, GSA will now turn to the important process of expanding coverage of medically necessary oral and dental services to all medical conditions for which such services are documented to be of clinical, fiscal, and human value.

GSA thanks the administration for recognizing these facts and taking this important step to extend Medicare coverage to dental services that are integral to the delivery of covered medical services. By broadening coverage of medically necessary dental services and opening an important opportunity for stakeholders to suggest clinical scenarios to which medically necessary oral and dental services should be extended in the future, the Physician Fee Schedule makes meaningful progress to improve the clinical success of covered medical services.