Survey reveals alarming dental decay rates in Kentucky preschoolers

The University of Kentucky College of Dentistry’s 2023 Kentucky Early Learners’ Oral Health Surveillance Project survey found dental decay rates for Kentucky children ages 2 through 5 are significantly higher than the national average. 

The survey, funded by the Kentucky Department of Public Health, evaluated the prevalence of dental decay and treatment needs among children and identified populations most at-risk in the Commonwealth. This is one of the largest state-level oral health surveys of children in Pre-K and Head Start programs ever conducted. 

Pamela Stein, D.M.D., M.P.H., a professor in the Division of Public Health Dentistry, served as a co-investigator on the surveillance project. 

The oral health of young children is essential to health equity as it not only sets the trajectory for oral health across the lifespan but also influences an individual’s overall health and development.”

Pamela Stein, D.M.D., M.P.H., Professor, Division of Public Health Dentistry, University of Kentucky

Project team members screened 6,660 kids across 106 Kentucky counties. Local dental hygienists were hired to serve as screeners and coordinate project efforts at the regional levels. Screeners contacted daycares and Head Start programs in their area. If the daycare or Head Start facilities agreed, screenings were scheduled for the children.  

The screeners were trained to standardize their identification of treated decay (cavities that already had fillings) and untreated decay. If a child was identified to have untreated decay the screener classified the severity of decay and determined the urgency of when the child should receive treatment. 

Each child’s screening results were documented on a report card and sent to their parents/guardians. All report cards contained referral information for local dentists and contact information for the regional coordinator for parents to contact for assistance if their child was identified as needing dental care. 

The project team concluded that dental decay rates for Kentucky children ages 2 through 5 are considerably higher than the national average and were comparable to the highest risk group in the U.S. which is children living at or below 100% poverty. 

Multiple, interconnected demographic, geographic and social factors influence tooth decay rates among the children screened. Region was the strongest association for untreated decay followed by age, facility type and rural location.  

Additional findings show race, ethnicity and fewer economic resources compounded risk for dental decay. Higher decay rates were found in children attending rural Head Start facilities and Black children in poor ZIP codes in Jefferson County. 

The data from this survey should impact the dental care of young Kentucky children in the future. At a state-wide conference to discuss survey findings on Nov. 1, community and health leaders from across the state discussed strategies to reduce the level of dental decay in our youngest Kentuckians. 

“The University of Kentucky College of Dentistry has a statewide mission to increase oral health care access for all Kentuckians,” said Jeff Okeson, D.M.D., professor and dean of the College of Dentistry. “The survey’s findings can help guide and refine our continued efforts in reducing dental disease in children as a part of that mission. It’s just as important to educate everyone about good oral health practices as it is to improve access to oral health care.” 

The American Academy of Pediatric Dentistry (AAPD) recommends that children see a pediatric dentist and get established when the first tooth appears, or no later than their first birthday, and continue every six months with preventive care. 

However, most children start going to the dentist too late, and it usually is due to complaints of pain associated with decay. Although dental decay is a preventable disease, it remains the most common chronic childhood disease, approximately four times more prevalent than childhood asthma. 

Other data collected from UK Dentistry’s mobile programs for preschool-aged and school-aged children have seen tooth decay rates decline over the years and could be an effective early intervention toward improved oral health that necessitates further examination.