2024 Session: Oral Health

HB1777, SB2476

Why are dental sealants important?

Dental sealants are a proven method to prevent tooth decay in children. Placing sealants can reduce tooth decay by as much as 80 percent. As the importance of oral health on overall health has become better understood by general audience, there is also an understanding that many places are failing to provide dental health services.

For children, lacking access to dental services can have a lifelong impact.

What is the problem?

According to the report “Falling Short: Most States Lag on Dental Sealants”, Hawaiʻi is one of five states who received a grade of “F” in prevention efforts on oral health. Dental caries can cause children pain, problems with self-esteem, and can interfere with schoolwork and daily activities of living. The Centers for Disease Control and Prevention (CDC), The American Academy of Pediatric Dentistry, and American Dental Association (ADA) cite sealants as the most effective preventative strategy in tooth decay., According to the Hawaiʻi Smiles 2015 report, more than 60% of Hawaiʻi children do not have protective sealants and recommends community based prevention programs such as school based oral health programs.

School-based sealant programs are efficient and cost-effective. School sealant programs can reach children who are most at risk for developing cavities, including low-income children and children in rural areas. Children in Hawaiʻi have the highest prevalence of tooth decay among third graders in the United States. More than 7 out of 10 third graders (71%) are affected by tooth decay; substantially higher than the national average of 52%. The 2016 report, Hawaiʻi Smiles 2015: The oral health of Hawaiʻi’s children, suggested expanding access to school-based sealant programs to improve the oral health in children.

How is Hawaiʻi doing nationally?

33 states, including DC, (65%) have school based sealant programs, a preventative and cost effective dental program that meets children where they are. Hawaiʻi is not one of them. 

Hawaiʻi also has the most severe restrictions on dental hygienists, hindering the increased application of sealants in schools. Archaic professional boundaries prevent dental hygienists from being a powerful contributor to improving children’s oral health. Improving access to care is dependent on having the workforce to provide said care, and therefore, these changes are critical.

What is the goal?

The aim of this legislation is to allow a dental hygienist to screen and apply dental sealants in a school-based oral health program without requiring a treatment plan from the dentist. This proposed bill would remedy this procedural set back by allowing dental hygienists to make the determination to seal a molar without the treatment plan of a dentist.

Oral health and physical health are no longer two distinct categories. The impact of poor oral health is felt for a person’s lifetime. Hawaiʻi must turn the tide of poor outcomes for children’s oral health.

Changing key policies will allow for the expansion of school-based oral health programs will result in healthier, happier keiki.

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