Daily Archives: March 5, 2012

Dr. Ian Clark: CO2 is not a significant climate driver

Dr. Clark’s prepared statement, including slides shown, before the  December 15, 2011, Canadian Senate Standing Committee on Energy, The Environment, and Natural Resources. Uploaded by International Climate Science Coalition, http://www.climatescienceinternational.org/ .

Elementary school dental screenings deemed effective in Tarrant County, Texas

Should dental screenings in elementary schools be mandatory? Is this more government intrusion?

Devine, B. Reaching the Texas dental goals of healthy people 2010. Tex Dent J. 2011 Dec;128(12):1255-9.

Background: The U.S. Department of Health and Human Services has promoted Healthy People 2010, which is a set of national health objectives for the nation to achieve over the first decade of the new century (1). Texas has not yet met its target of 50 percent of 8-year-old children with dental sealants having been placed on their 6-year molars, which is one of the Healthy People 2010 goals. An assessment of the dental needs of children in Tarrant County, Texas, was initiated by the JPS Health Network (named after John Peter Smith). The JPS Health Network established the Healthy Smiles program to address the dental needs of the students in this county because a school based dental sealant program would be effective in reducing dental decay.

Methods: Approved Title One elementary schools in Tarrant County were scheduled for dental screenings, education, and fluoride and dental sealant applications. Students were given visual dental screenings and classified as to future dental needs. First grade students received fluoride varnish and second and third grade students received fluoride and dental sealants.

Results: For the 2010-2011 school year: A total of 28,322 students were seen by dental professionals from the JPS Health Network; 8,348 dental sealants were placed; and 11,825 fluoride applications were given by dental staff.

Conclusions: The JPS Health Network Healthy Smiles Program proved to be an effective way to deliver oral preventive care and dental education to a large number of low-income students.

Clinical Implications: Dental caries prevention programs such as Healthy Smiles could help Texas reach its goals for improved oral health for the children of Texas.

Simulation model for fluoridation is misleading…

Using Colorado as an example, this paper proposes a simulation model for interventions in early childhood caries. The first simulation assumes that community water fluoridation is expanded to 24.6% of Colorado’s population not currently served. Based on prior CDC studies, the study also assumes that fluoridation will reduce cavity prevalence by 25.4%.

The study states:

“This study of Colorado’s young children provides evidence that may be immediately applicable to policy making within and beyond the state. Expansion of community water fluoridation (1.1) was found to be cost-saving even in an environment where most of the population receives fluoridated water, and additional savings are projected from reduced treatment and retreatment costs for children older than 6 years who are not considered in the model.”

There are several problems with this study. First, it does not acknowledge and consider the cost of harmfull effects of water fluoridation on childrens. Don’t fool yourself, there will be some children who experience harmfull effects. It does not consider other exposures of children to fluoride in addition to drinking water.

This type of high-brow policy study is usually politically-motivated…..which in this case is to prop up support for community water fluoridation. However, there is no additional supporting data provided to justify the assumptions made.

Hirsch, G.B., Edelstein, B.L., Frosh, M., and T. Anselmo. A simulation model for designing effective interventions in early childhood caries. Prev Chronic Dis. 2012 Mar;9:E66. Epub  2012 Mar 1. DOI: http://dx.doi.org/10.5888/pcd9.110219

Introduction: Early childhood caries (ECC) – tooth decay among children younger than 6 years – is prevalent and consequential, affecting nearly half of US 5-year-olds, despite being highly preventable. Various interventions have been explored to limit caries activity leading to cavities, but little is known about the long-term effects and costs of these interventions. We developed a system dynamics model to determine which interventions, singly and in combination, could have the greatest effect in reducing caries experience and cost in a population of children aged birth to 5 years.

Methods: System dynamics is a computer simulation technique useful to policy makers in choosing the most appropriate interventions for their populations. This study of Colorado preschool children models 6 categories of ECC intervention – applying fluorides, limiting cariogenic bacterial transmission from mothers to children, using xylitol directly with children, clinical treatment, motivational interviewing, and combinations of these – to compare their relative effect and cost.

Results: The model projects 10-year intervention costs ranging from $6 million to $245 million and relative reductions in cavity prevalence ranging from none to 79.1% from the baseline. Interventions targeting the youngest children take 2 to 4 years longer to affect the entire population of preschool-age children but ultimately exert a greater benefit in reducing ECC; interventions targeting the highest-risk children provide the greatest return on investment, and combined interventions that target ECC at several stages of its natural history have the greatest potential for cavity reduction. Some interventions save more in dental repair than their cost; all produce substantial reductions in repair cost.

Conclusion: By using data relevant to any geographic area, this system model can provide policy makers with information to maximize the return on public health and clinical care investments.

Click here for the full article (free).