By Katie Strachan
The Oshawa Express

After taking a bite into the world of childhood oral health, it seems the city is decaying. Oshawa elementary schools are the most atrisk for tooth decay and cavities, says Dr.
Patricia Abbey, the director of the oral health division for the Durham Region Health Department.“Oshawa has the highest rate of tooth decay and cavities,” she says.“This can be an excellent indicator of poverty.” The study looked at kindergarten students from the past school year in various schools across the region. The data was then charted and separated by municipalities to determine the most high-risk schools and areas.“You can see a large grouping of red dots here,” says Fangli Xie, an epidemiologist with the health department as she points to the south end of Oshawa. Xie was one of two people who worked on the study.

The city had 13 red dots, outlining highrisk schools, on the chart; the second highest
municipality for poor oral health was Ajax/Pickering with just four red dots. Although the chart outlined statistics from the 2003 school year, Dr. Abbey says the trend is absolutely continuing. “In Oshawa last year we saw a total of 43 schools and 11 of those were high-risk,” she explains. To be deemed a high-risk school, more than 14 per cent of the junior kindergarten and senior kindergarten students must have two or more cavities when screened by the oral health division. In total, 186 schools were screened and only 25 of them were deemed high-risk - 11 of those were in Oshawa, says Dr. Abbey, adding that is 44 per cent.“We’re looking at a big problem.

They (the high-risk schools) are concentrated in Oshawa around the 401, in South Oshawa,” explains the doctor. While the study was completed as an education tool for parents and schools, it also serves as helpful knowledge for health department staff.“We have portable equipment. We go to schools in south Oshawa where we provide dental care right in the school because a lot of parents don’t have means of transportation to get their kids to the dentist,” explains Dr. Abbey.“Our high-risk schools are our priority.” The oral health division visits schools every year and screens students in junior kindergarten, senior kindergarten and Grades 2, 4, 6 and 8. Typically cavities and tooth decay are caused from lack of access to dental care, poor oral health and diet says the doctor, adding Oshawa’s problem is a socio-economic issue.

“Too frequent of sugar consumption and soft drinks etc. That will cause tooth decay and
cavities,” Dr. Abbey says. Dental care can be expensive which is why a number of lowincome families cannot bring their children to the dentist or oral hygienists for proper cleanings and fluoride applications. These are necessary for a healthy mouth, says Dr. Abbey. So families end up going to see health care practitioners for tooth problems, she adds.“A lot of families cannot go to the dentist because it’s very expensive, so they go to see a doctor for swelling but that is further burdening because some people don’t have family doctors,” she explains, adding emergency rooms become even busier places. Emergency room visits are usually for toothaches, swelling, falls or salivary gland issues, says Xie.

The region has two programs, which help families who cannot afford dental care for their children or teens – the Children In Need of Treatment (CINOT) program and Ontario Dental Works program. The CINOT program will treat children under the age of 17 who are in need of urgent treatment. They will receive one course of treatment for free. sThey must have no insurance and demonstrate the need for financial assistance.

The health department sees about 900 kids annually at an average cost of $356 per child. While 900 kids seems like a lot, Dr. Abbey says about 1,239 kids are told they need urgent care through the school screenings and that 31 per cent of those kids live in the city. “Not everybody takes advantage of it. We do have parents who find it difficult to find a dentist that accepts the CINOT program,” she says, adding dentists are not forced to accept the program.

The CINOT program used to only treat children until they reached Grade 8 but it was recently changed to include teens up to 17.“This year we’re already up to 1,000 (kids) because of the increase to age 17,” explains Dr. Abbey of the CINOT program.“The kids would be in pretty good shape when they finished elementary school but then they would go downhill in their teenage years.” The Ontario Works Program differs because it allows young patients
to receive treatment on an on-going basis for free.

The health department treats more than 1,600 kids per year at an average cost of $225 each. The fee for a child using the CINOT program is significantly more because they typically require more extensive work and anesthetic procedures.

“It’s not uncommon to see that they (a child through CINOT) would have 10 or 15 cavities at a time that need to be treated compared to one or two on the Ontario Works program,” Dr. Abbey explains.“It’s not uncommon for a child in the two or three-year-old range to need $3,000 worth of work on their teeth.”

The Oral Health Division has a clinic that is located in the Whitby Mall where CINOT kids are treated, says Dr. Abbey.“There’s no reason for a child to not get proper care,” she explains,
adding there are five full-time hygienists and nine full-time dental assistants working in the clinic. The clinic typically sees about 1,500 patients per year.

The health department travels to six different locations, like high-risk schools, where they spend two full weeks completing treatments for free, says Dr. Abbey.“A lot of the kids that we see are in rough shape. They really are in pain, we try to get them access to the treatment that they need,” she explains. The full report on the ‘Snapshot of Oral Health’ will be published in the fall.