Water Fluoridation in York County, Pennsylvania

List of fluoridated and non-fluoridated drinking water systems in York County

York Daily Record Calls for Fluoridation of York / 1995 Position of York Water Company on Why they Won't Fluoridate without a State or Federal Order (3/3/2002)

Source: http://ydr.com/history/ntbf/2ntbfH.shtml

1973: Hanover
Fluoridation still debated

The Hanover Water Commission opts to fluoridate its water after three years of study. The issue first came up in 1957 and was voted down. The issue has come before the York Water Company several times, most recently in 1996. The water company has repeatedly decided against fluoridation, unless mandated to do so. The company is concerned about legal challenges from those perceiving health risks.

Source: http://ydr.com/story/op-ed/10714/

Dentists doing their best to give care to the needy
Sunday, June 22, 2003

On June 8, an editorial appeared in the York Daily Record giving solutions to the nationwide dental health crisis that also exists on the local level. In May, a Healthy York County Coalition Dental Summit was held. The purpose of this summit was to increase awareness about the lack of access to dental care. Also, its purpose was to engage the community in finding solutions to these problems. The editorial mentioned many of the topics discussed at the summit.

I agree with two of three editorial ideas for improving the outlook for poor children. One, parents and their children must take ownership and responsibility for their dental care. An aspect of dentistry that creates an inherent problem is the fear associated with dentistry. A lot of people do not want to visit the dentist. The National Institute of Dental Research did a survey and found that 59 percent of adults have seen a dentist “within the last 12 months.” This means that 41 percent of adults elect not to visit a dentist. Consider the statistic that 80 percent of 800,000 state-funded (Medicaid) patients in Pennsylvania did not receive care. Is this due to difficult access or is it due to patients not showing up for their appointments?

A lot of patients will wait to see the dentist until it is an emergency. This situation makes a critical point that education and prevention of dental disease are important assets to reducing access to care problems. Prevent the disease before it happens. In the order of prevention, it has been shown that community water fluoridation is one of the most effective measures in reducing the incidence of dental caries. Furthermore, the fluoride exposure in the water, coupled with good oral hygiene taught through education and timely placement of sealants, can virtually prevent caries. This is in agreement with the editorial’s point that fluoride should be added to the York Water Company’s water.

However, I, as a dentist representing the York County Dental Society, dispute the paragraph stating that dentists should be more philanthropic and offer more pro bono dental care. Our dental society has had a long tradition in reaching out and being proactive in helping the community at large. The dental society is comprised of about 130 dentists who are compassionate and thrive on providing excellent dental care for compliant patients. Our society is unique in that it has a number of longstanding programs in place.

There is a scholarship program that we have supported over the last 35 years. The society annually donates to a reserve fund, which is used to support dental and dental hygiene education in the form of either a grant or a loan. Many members of our local dental community have been supported by this fund (myself included). The members have also been involved with the Head Start program, in which dentists volunteer their time and provide dental examinations for children. Essentially, this program has been in place for 25 years, and dentists examine about 500 children each year.

Over the past 16 years the Dental Society has sponsored “Dentists with a Heart Day.” This is a day where dentists open their offices to provide free dental services to needy patients. The Dental Society also administers the Hoodner Clinic. This unique program provides care for patients who are not in Medicaid and do not have the resources to obtain care. The system works in the following manner: The patient is screened for income level and financial need. Then, the dentist formulates a treatment plan that is reviewed by a panel of local dentists. If the work is approved, the dentist does the work at a significantly discounted rate. One problem, however, is that we need to increase the funding. The fund is tied to the performance of the stock market, and when the stock market does not do well, there are limitations on what care can be given.

In addition to volunteering with these programs, many dentists each year render care that is either free or discounted. We surveyed the society to get an idea on how much care was donated. Forty-four percent of the society participated in the survey, and we found that more than $600,000 of dental care was donated by those dentists for the year 2002. If we extrapolate these results to the society as a whole, one may hypothesize that the Dental Society donates more than a million dollars a year in dental care. This gives sound evidence that the society has been proactive in helping needy patients and the community.

We dentists know there is a problem, and we are doing our very best to help needy patients every day. However, there must be a collective effort between dentists, physicians, legislators, and community leaders to make a serious impact on this issue.

James D. Isett, DMD, MS, is the president of the York County Dental Society.

Source: http://ydr.com/story/opinion/10286/?PHPSESSID=1c95180bce9a99487a039a427b1c4851

York Daily Record

Poor children suffering in silence

There are solutions to the dental health crisis, especially an improvement in Medicaid funding.
Sunday, June 8, 2003

Asilent crisis is going on for Pennsylvania’s poorest children, and only those close enough to them can detect it at first.

Their teeth are rotting.

In fact, one in 13 poor American children suffers with at least one dental problem that hasn’t been corrected, according to the Centers for Disease Control. These kids can’t find a dentist to help them.

Medicaid, which funds dental care for poor families, is so inadequate in Pennsylvania that many dentists won’t accept it for payment.

“I think the perception of a lot of the dentists in private practice is they’ve participated in the program in the past and been disillusioned with it,” Dr. Craig Pate told the Rotary Club of York in February. Dr. Pate is the program director for York Hospital’s Dental Center, which does provide dental care for Medicaid patients.

While other states are finding funding to improve Medicaid for dental health, Pennsylvania has been slow to change. State lawmakers must find a way to improve funding.

The cost for caring for long-term oral health problems is more staggering than check-ups for children. Treatment for cavities and gum disease cost thousands of dollars, and if the patient is using state aid, those lifelong issues will cost taxpayers more than early prevention would have.

Dr. Burton Edelstein, a pediatric dentist, spoke at a York and Adams Counties’ Dental Summit held in May. He is the founding director of the Children’s Dental Health Project and a renowned speaker on the subject. In a study done by the Dental Health Project in 2000, hundreds of children during the one-week study landed in the dentist’s chair because of toothaches. Almost half of them were younger than 6 years old.

One local Head Start caseworker tried to find a dentist for three York County children who each had at least five cavities. The dentist she found agreed to examine one of the children for free but wouldn’t be available for follow-up care.

Realistically, Medicaid — if it increases — still won’t be acceptable enough for most dentists, but here are other ideas for improving the outlook for these kids:

A chronic toothache should be treated like a recurring stomach ache. Most people believe that irritation in the belly could be a sign that something serious is happening or is about to happen. A tooth that hurts should sound the same alarms because it won’t stop hurting, and the problem won’t go away on its own.

It’s a terrible pain to live with, especially when you’re too young and too helpless to find someone to help you.

Source: http://ydr.com/story/business/9663/

Dental summit held
Residents of York and Adams counties discussed possible solutions to problems caused by poor dental care.

Daily Record staff
Saturday, May 17, 2003

Caseworkers at Head Start of York County are familiar with the problems that result from a lack of access to dental care.

When they look into the mouths of low-income children, they see the result of public policies, business interests, a lack of education about oral health care and the American sweet tooth.

They see cavities - lots of them.

Head Start uses area dentists to screen the 3- to 5-year-olds involved in its program, then matches the children with services in the community.

Caseworkers struggle with finding enough dentists in the county who accept Medicaid patients. Some of the dentists don't accept clients with Medicaid because the government reimbursement for services is less than what is paid by private insurers.

Maryann Kornbau of Head Start recently worked on the cases of three children from different families. Each of the children had between five and 11 cavities.

One dentist from the East York area volunteered time to help one of the children, but said he wouldn't be able to provide follow-up care because he doesn't accept medical assistance, Kornbau said.

The other two children were put on a waiting list because the seriousness of the work they need demands a hospital setting. The wait can be months, Kornbau said.

"It makes us look bad because we can't find the follow-up dental work," she said. "Sometimes, you find you are out there begging to find a dentist."

The problem of access to dental care in York County is not something that can be pinned on any one group. Each year, many dentists provide free care days for children and adults. Also, the state has a system in place to get children access to dentists and oral health education programs are available to teach people how to care for their teeth.

To address dental issues, several organizations and businesses held the first York and Adams Counties' Dental Summit on Friday morning at the Holiday Inn-Holidome in West Manchester Township.

About 120 people - dentists, dental hygienists, insurance company representatives and employees of agencies that work with groups such as special-needs children and low-income families - attended.

Dr. Burton Edelstein, a pediatric dentist and founding director of the Children's Dental Health Project, a Washington D.C.-based group that works on access and education issues, was the keynote speaker.

Edelstein talked about the possibility of creating a coordinated system in which, if a place such as the York Hospital Dental Center became overwhelmed with Medicaid patients, private dentists could be contracted to handle cases.

That would expand the capacity of the center and also give private dentists the opportunity to help but allow them to individually decide how many reduced-pay and charity cases they could handle financially.

He urged the audience to narrow its focus - by tackling easier issues first or limiting work to certain areas of concern, such as children or those with special needs.

Those attending the summit later broke off into smaller groups to discuss possible solutions.

Dr. Craig Pate, director of the York Hospital Dental Center, said the purpose of the summit was to give direction to a task force started under the Healthy York County Coalition.

Pate sees many of the problems caused by poor dental care, as well as the effect of not having fluoride in most of the county's water. Studies have shown that fluoride is effective in reducing cavities in both adults and children, but it has been a controversial issue in this county.

Water suppliers are not required by law to insert fluoride into the water, and the largest one in the county, York Water Co., does not use it.

Dr. John Bush, a dentist who serves on a committee of the Head Start program, told the audience at a panel discussion that the cost of fluoridating one person's water for 60 to 70 years would be less than the cost of one filling.

It remains to be seen what actions will come out of the summit, Pate said. "I'm hoping this is a starting point for us to move forward," he said.

Reach Jennifer Nejman at 771-2026 or jnejman@ydr.com

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Last modified: 28 June 2003