UCSF Partners with San Francisco Community to Address Oral Health Epidemic

By Scott Maier

A UCSF dental resident gives dental screening to a child

A UCSF dental resident gives a free dental screening to a child during a Sunday Streets fair in the Bayview, one of several annual outreach events for the local community. Photo by Cindy Chew

In San Francisco, nearly 40 percent of children have experienced tooth decay by the time they reach kindergarten, and low-income kindergartners are eight times more likely to have untreated tooth decay, reports the San Francisco Children’s Oral Health Collaborative (SF COH).

Oral health disparities are specific to local neighborhoods, with the highest rates in Chinatown, where more than 50 percent of all kindergarteners suffer from cavities.

To inform and elicit community feedback about the importance of children’s oral health – and continue to learn why some ethnicities are more at-risk – the SF COH, which includes UC San Francisco, the SF Department of Public Health and community health providers and advocates, hosted a community stakeholder meeting on April 30 in Chinatown.

Attendees at the two-hour meeting at the Chinatown YMCA included City and County of San Francisco Supervisors Julie Christensen and Scott Wiener, and Health Commissioner Ed Chow.

Lisa Chung, DDS, MPH, gives a presentation during a meeting of the San Francisco Children’s Oral Health Collaborative.

Lisa Chung, DDS, MPH, gives a presentation during an April 30 meeting of the San Francisco Children’s Oral Health Collaborative. Photo by Laura Lane

“Good oral health is critical to the well-being of our city, and we need to expand access to dental care as well as healthy and nutritious food, particularly in our low-income communities,” Wiener said.

Similar stakeholder meetings are planned for Latino and African American communities in San Francisco.

“Because of this meeting, we were able to raise the level of awareness of children’s dental caries that is disproportionately affecting the Chinatown neighborhood,” said Lisa Chung, DDS, MPH, associate professor in the UCSF School of Dentistry Department of Preventive and Restorative Dental Sciences and SF COH co-director.  “We were able to bring together local health and child care providers and organizations and engage in a spirited discussion about what could be causing these Chinatown disparities, existing barriers to addressing them, and how we can collaborate and move forward.”

A Silent Epidemic

Tooth decay and periodontal disease are the two biggest threats to oral health and among the most common chronic diseases in the United States. In fact, former U.S. Surgeon General Regina Benjamin called oral diseases a “silent epidemic.”

Children with untreated cavities may experience pain, dysfunction, school absences, difficulty concentrating and low self-esteem, according to the SF COH.

“It is better to prevent tooth decay than to provide extensive dental treatment for a very young child,” said Dr. Steven Ambrose, director of Dental Services for the San Francisco Department of Public Health, a co-leading agency of the Children's Oral Health Collaborative. "If we can help parents understand how to keep their babies' teeth healthy, we can prevent unnecessary disease and pain, and promote and protect our children's oral health in a far easier and cost effective manner."

Dental caries is largely preventable through dental sealants, fluoride varnish, healthy eating habits, daily oral care at home and routine dental visits. However, many parents, medical providers and even dental providers do not fully understand their critical roles in preventing this disease.

Plan to Make San Francisco Cavity-Free

A cross-sector initiative designed to improve the health and wellness of all San Franciscans, the San Francisco Children’s Oral Health Collaborative coordinated the San Francisco Children’s Oral Health Strategic Plan 2014-2017 toward making the city cavity-free. The plan identifies the most effective, evidence-based actions each group can take to make the most impact. Target groups are children under 10, pregnant women, low-income communities of color, recent immigrants and other populations most at risk.

“Involving the community and collaborating with its members are essential in efforts to improve public health, and is at the core of SF HIP’s Children’s Oral Health Collaborative,” Chung said. “We prioritized this first meeting in Chinatown on public and private health professionals and Chinatown program planners, community leaders, and school administrators as they are working closest with the target population – young children and their caregivers. We look forward to working to have similar community briefings throughout San Francisco.”

The San Francisco Children’s Oral Health Collaborative is supported by the Hellman Foundation. The Chinatown community stakeholder meeting was sponsored by the Chinatown YMCA, the Asian Pacific Islander Health Parity Coalition, APA Family Support Services, NICOS Chinese Health Coalition and API Council.