University of Minnesota
In Minnesota, 80 percent of tooth decay in children is found in just 30 percent of the population.
Toward healthier teeth
U pediatrician Deinard makes the rounds promoting fluoride varnishing for children
By Rick Moore
Around the country, he’s known as the fluoride varnishing guy. Granted, that’s not as catchy as the cable guy, but Amos Deinard produces smiles that last longer, in a manner of speaking.
Deinard, a faculty member in the University of Minnesota’s Department of Pediatrics since 1969, has been on a decade-long quest to improve the teeth of low-income children by teaching health care providers (other than dentists) how to provide them with fluoride varnishing treatments.
That might seem like a relatively unimportant procedure, but consider this: In Minnesota, 80 percent of tooth decay in children is found in just 30 percent of the population. That 30 percent is largely comprised of some of our society’s most vulnerable—children of families who can’t afford routine dental care and those on Medicaid and MinnesotaCare.
One report showed that in the previous year, 51 million hours of school time were lost nationwide because kids needed to stay home due to tooth pain.
In extreme cases, lack of dental care can mean much more than a poor smile. In 2007, 12-year-old Deamonte Driver of Maryland died when bacteria from an abscessed tooth spread to his brain.
While Deamonte’s story is not the norm, it illustrates some of the issues standing in the way of children receiving proper dental care. Deinard points out that since the mid-1990s, there has been a dearth of dentists willing to see patients on Medicaid, leaving those families unable to afford preventive care.
The fluoride varnishing treatments, which take only a few minutes to apply, are a cheap and easy way to help stave off tooth decay in children.
Taking up the challenge
Deinard’s quest to improve the dental health of Minnesota children began at a Surgeon General’s conference in 2000 when he met a retired pediatrician from North Carolina named Olson Huff. Huff had started a program called “Into the mouths of babes” through which he was training medical personnel how to provide the fluoride varnishing.
“He challenged me to come back to Minnesota and replicate what he was doing in North Carolina,” Deinard says.
So, the following year he created a web-based training for providers, and since then his efforts have gained momentum. “In the last two years we’ve trained [personnel in] at least 130 clinics around the state—urban and rural,” he says.
In addition to pediatricians and family physicians, the treatments can be applied by nurse practitioners, physician assistants, public health nurses, and other healthcare providers.
“If you can put polish on your nails you can put fluoride varnish on teeth,” Deinard notes. “It takes about three minutes.”
And as the years have passed, more states have come to realize the benefits of the treatments; it’s now a reimbursable procedure in 44 states.
“It’s as basic primary care as immunizations, in my mind,” says Deinard. “It’s not in lieu of having comprehensive dental care, but absent that care, you might as well get a little primary prevention. An ounce of primary prevention is worth a pound of fillings.”