TAILIEUCHUNG - Topical Fluoride Recommendations for High-Risk Children Development of Decision Support Matrix

New financing strategies can go only so far if existing constraints are not ad- dressed. System transformation will require a major reorganization of the cat’s- cradle of federal funding streams: Title IV (ChildWelfare); Title V (Maternal and Child Health); Title XIX (Medicaid); Title XXI (the State Children’s Health Insur- anceProgram,orSCHIP);HeadStart;WIC;andevenfundsfromNoChildLeft Behind, the Individuals with Disabilities Education Act (IDEA), and other pro- grams that are allocated from the Department of Education. This will not be an easy task. Like Social Security, many of these categorical funding streams are sac- rosanct among their respective advocacy constituencies, so any attempt to reorga- nize and reform how they function will meet with enormous. | Topical Fluoride Recommendations for High-Risk Children Development of Decision Support Matrix Recommendations from MCHB Expert Panel October 22-23 2007 Altarum Institute Washington DC Background While there has been a decline in the prevalence and severity of dental caries tooth decay in the . population overall dental caries continues to be the most common chronic childhood disease five times more common than asthma in children ages 5-17 Among young children the prevalence of early childhood caries ECC has increased. Recent national survey data show that among all 2- to 5-year-old . children 28 percent exhibited evidence of dental caries tooth decay an increase from 24 percent 10 years Despite increased prevalence rates dental caries is largely preventable. The use of fluoride administered both systemically and topically has been shown to be effective in preventing and controlling dental caries. Community water fluoridation is considered an important factor in the reduction of dental caries and contributes to reduced caries experience among children who live in optimally fluoridated 4 Although community water fluoridation is considered the foundation for sound dental caries prevention programs there are populations of children that experience higher rates of dental caries. Research shows that 33 percent of children experience 75 percent of the dental caries The highest disease burden is among low-income children and children from racial- and ethnic-minority groups in particular American Indian Alaska Native AI AN African-American and 7 8 9 In fact AI AN children experience the highest dental caries rates with 68 percent of AI AN preschool children having decay in their primary Children most affected by oral health disparities could benefit from additional fluoride exposure beyond water fluoridation. A growing body of evidence supports the benefit of frequent exposure to topical fluorides and .

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