CHAPEL HILL -- In an effort believed unique in the United States, University of North Carolina at Chapel Hill dentistry and public health experts are teaming with state dental health staff to try to cut tooth decay among the state's youngest children.
UNC-CH faculty are starting a project in nine western N.C. counties that will involve painting fluoride varnish on the teeth of children as young as 9 months. Those counties are Avery, Burke, Cherokee, Graham, McDowell, Mitchell, Polk, Rutherford and Yancey. Others likely will follow.
"Dental health of North Carolina children has, in general, improved dramatically over the last three decades," said Dr. James W. Bawden, Alumni Distinguished professor of pediatric dentistry. "However, 20 to 25 percent of young children in the state still suffer from severe dental decay."
Inappropriate and prolonged use of nursing bottles causes some of the disease, said Bawden, former UNC-CH dentistry dean. The rest is caused by poor diet and oral hygiene and by a lack of fluoride in local water supplies.
"By age 2 or 3, most of these children have suffered considerable pain and often have swelling and fever from dental infections," he said. "They have several teeth that need to be extracted and require extensive treatment to retain the rest of their teeth. Because of their young age, few general dentists can treat these children, and they are referred to pediatric dentists who have the training and experience to do so."
Because of an acute shortage of pediatric dentists in most of North Carolina and other factors, access to care for children with early, severe tooth decay remains a significant problem, Bawden said.
"Fluoride varnish is effective in reducing dental decay and has recently become available in the United States," he said. "The varnish can be applied easily and safely to the teeth of infants and young children and provides a new preventive tool to help control dental decay."
N.C. Department of Health and Human Services employees will help with the project, which is chiefly funded by the Appalachian Regional Commission. The N.C. Partnership for Children, also known as Smart Start, will administer it.
Drs. R. Gary Rozier, professor of health policy and administration, William F. Vann, professor of pediatric dentistry, and Bawden are working with N.C. dental health section staffers to design and implement the program.
"The project will provide valuable experience in conducting such an intervention and will allow careful evaluation of the extent to which decay is reduced in the target group of children," Bawden said. "It is the first project of its type in the United States designed to reach such young children with a decay preventive measure. We expect that implementing the program statewide would achieve a significant improvement in the dental health of North Carolina children."
Dental hygienists will apply the fluoride varnish every six months until the children reach age 3, he said. The North Carolina program should begin in early summer.
Funding is being sought to expand the effort to all 100 counties. Comparable fluoride varnish programs have been in operation in Europe for about 25 years.
Note: Bawden can be reached at 919-966-1165, Rozier at 919-966-7388 and Vann at 919-966-2739.