Children’s Dental Health
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Key Findings

• Dental disease is rampant among California children
• Many children in San Mateo and Santa Clara counties have cavities
• Many -- but not all -- local low-income children have dental insurance
• Dental insurance is not enough. Prevention and access matter, too
• Populations who need quality dental care have seen little progress
• State legislators are increasingly placing dental health on their agenda
• Mandating dental assessments is a starting point, not an ending point

Many Children in San Mateo and Santa Clara Counties Have Cavities

A substantial number of children in San Mateo and Santa Clara counties have cavities, and many experience pain and swelling from untreated dental problems, according to the most recent county oral health assessments.

Santa Clara County

In 2002, The Health Trust reported that 51 percent of children from poor families in Santa Clara County enter kindergarten with a history of cavities, and almost one-third had untreated decay. By the time they reached third grade, 72 percent had a history of tooth decay. The Health Trust estimated that there was only capacity to treat up to 20,000 of the county's 140,000 low-income children, and that approximately 35,000 county elementary school children experience pain or swelling in their mouths from untreated dental problems, though these figures may have changed since then. A significantly higher proportion of Latino, and -- to a lesser extent -- children of Asian background had a history of cavities and/or untreated decay compared to Caucasian children.

San Mateo County

In 2000, the San Mateo County Health Services Agency published a children's oral health assessment documenting excessive levels of dental problems among low-income school-age children, inadequate numbers of providers, poor service at county dental clinics, lack of service on the coast, insufficient access to fluoridated water, and under-use of sealants on molars (plastic coating to prevent decay).

Eighty percent of low-income children in the county had cavities before their 18th birthday (compared to 71 percent of low-income children statewide), making dental disease  the most common health problem among low-income children in the county. More than half of county children lived in areas with only partial or no fluoridation. In non-fluoridated areas, a sample of selected schools showed that only 16.8 percent of children in kindergarten through sixth grade were cavity-free in 1998. Almost half required restorative treatment. At the time, only 129 dentists in the county served pediatric Denti-Cal patients, 30 percent below the prior year. Some 17,000 children were living in poverty, many of whom would be Denti-Cal-eligible. Since no formal assessment has taken place since 2000, it is difficult to determine progress since then, although significant areas of the county did begin receiving fluoridated water in late 2005.