By John Duke, Contributing Columnist
Twice a month the Medical Teams International mobile dental van comes to Outside In to treat homeless youths and other patients within our homeless youth services.
Even though the van has the ability to do cleanings and preventive care, they mostly do extractions and emergency care for our clients. For every homeless youth and low-income adult that gets an appointment, there are five who do not because the need is so great. Slots are so limited that we prioritize by intensity of pain and level of illness. It concerns me how many people I see in dental pain, especially when all dental disease and decay is preventable.
When I first started working in homeless medicine, a mentor of mine who worked with older homeless people told me that he could tell a lot about the general health of a homeless person by looking at their teeth. I think about my mentor’s words decades later as I see homeless youth packing a cavity with tobacco snuff to ease the pain.
There are thousands of people in our community with no access to dental care at all. Homeless youths often grew up poor and many have never had dental insurance or have ever seen a dentist. Sleeping on the streets, in squats and shelters, homeless youth have very little control over personal hygiene or what they eat.
At Outside In we see blackened and missing teeth all the time. It is a serious health problem. It is an employment problem. It is a barrier to getting off the streets and joining mainstream society.
When youth have untreated decay and are in pain they miss school, have trouble eating and speaking, deal with the embarrassment of tooth loss, and have life-long health issues and costs. Addressing dental decay is also remarkably expensive. A 10-year-old child who develops cavities will pay more than $2,000 over a lifetime to take care of just one of those decayed teeth —— a tremendous burden for all people but particularly lower-income and homeless youth and families.
Just this year Outside In opened a school-based health center at Milwaukie High School. I already knew the dental health crisis was bad but the biggest eye-opener for me was seeing how many children, from that beautiful school in a nice suburban community of Portland, also have bad teeth. Our dental health crisis isn’t just affecting Portland’s low-income communities, people are suffering across the board.
Our dental crisis is also telling when we compare Portland to other major cities in the Pacific Northwest. For example, we know that Portland kids have 40 percent more decay as compared to kids in Seattle, which is fluoridated. The solution is a combination of education, better access to dental care, and fluoridated water. For a crisis of this magnitude, we need to use all the tools available.
Brushing with fluoridated toothpaste is a start, but it’s clearly just not enough. Fluoridating our water ensures that every family has access to a safe, effective and affordable cavity prevention measure, regardless of income, ethnicity or education level. It’s time Portland makes a different choice, the community choice. It’s time to fluoridate our water as an investment in children’s health, educational success, and social justice.
Studies have shown that fluoridated water reduces dental decay by at least 25 percent percent. There have been more than 3,000 studies of its safety and effectiveness. Fluoridated water has been used for more than 65 years and over 200 million Americans currently have access to it. In fact, Portland is the largest city in the country yet to enact water fluoridation —— and our children’s teeth are paying the price.
To help with the dental health crisis new clinics are opening —— but they can’t keep up. We need to do more to prevent Portlanders from needing urgent care and painful extractions in the first place. The volunteer dentists on the Medical Teams International dental van and the dedicated staff at the new Multnomah County Billi Odegaard Dental Clinic are heroes. They are trying to help and heal people each day. The big problem is that they are fighting a fight that cannot be won one mouth at a time. There are too many barriers for low income people —— we are living in a society where there are extreme disparities in access to dental care. Education, access to more care, and healthier foods are all an important part of the comprehensive dental health program we need in Portland but it only makes sense that our community should take the precaution of fluoridating our water to give everybody a better chance at having healthy teeth.
Outside In has weighed the arguments for and against water fluoridation. We love the uniqueness of our community and our patriotic leaning toward what’s “weird,” but when weird ends up hurting children and those who can’t afford dental care, weird becomes “wrong.” This is one area where the public health data is irrefutable.
Every major health care organization in the country, from the Centers for Disease Control and Prevention to the National Institutes of Health, has come to the same conclusion: Fluoridation is safe and effective. It is time for Portland to embrace the norm when it comes to protecting our kids. It’s time Portland makes a different choice. It’s time to fluoridate our water as an act of social justice. Please join me, Outside In, the Coalition of Community Health Clinics, Medical Teams International, and over 80 other organizations in endorsing a YES vote on ballot measure 26-151 on or before May 21.
Visit www.HealthyKidsHealthyPortland.org to learn more.
John Duke is the Clinic and Health Services Director for Outside In.
Read the counterpoint argument on fluoride here.