The Pew Charitable Trust may want to start studying how Maine manages tooth decay in children. Our level of untreated tooth decay for third graders was 14.6 percent in 2011 — the second lowest in the nation.

Instead of looking at Maine, however, Pew is spending hundreds of thousands of dollars in a number of states around the country to influence elected officials to adopt a dental provider model similar to one in New Zealand.

Pew is so confident about the success of the New Zealand model that it recently published a brief, the latest in a series of papers and press releases, touting its success. But there’s a problem — the brief was based on incorrect data.

Pew’s brief asserts that in the United States, children between the ages of 5 and 11 have an untreated tooth decay rate of 20 percent in permanent teeth, compared to a rate of 3 percent in New Zealand.

Pew concludes that New Zealand’s lower rate of untreated tooth decay in this age group represents the positive effect of the dental therapist, and is the reason Maine and other states should adopt the dental therapist model.

The authors of the Pew brief derived the statistic of 20 percent untreated decay among U.S. children from a 2012 report by the U.S. Centers for Disease Control and Prevention. That 20 percent rate, however, was not for permanent teeth only, but for both primary and permanent teeth.


While New Zealand’s rate of 3 percent may be accurate for permanent teeth, the report referenced by Pew notes that 17 percent of baby teeth in New Zealand’s 5 to 11 year olds have untreated decay. That adds up to a total of 20 percent, the same in the United States.

Pew, therefore, is citing a disparity that simply doesn’t exist as a primary rationale for pushing a new provider type.

By simply affirming the accuracy of the data, Pew could have avoided publishing and disseminating misinformation to the public and policymakers.

Since Maine third graders have a rate of 14.6 percent for untreated tooth decay, it seems New Zealand should be learning from us, instead of Maine adopting New Zealand’s provider type.

Low levels of untreated tooth decay in children have no impact on their future disease risk as adults, whether they live in the United States or New Zealand

New dental providers, whether they are dentists or dental therapists, cannot significantly change risk of disease through surgical treatment.


Prevention lowers disease risk. which means we must:

* Continue programs that apply dental sealants and make available the right amount of fluoride.

* Encourage regular visits to oral health care providers.

* Keep reminding children and adults to brush for two minutes twice a day with a fluoride toothpaste and floss daily.

* Improve the oral health literacy of our most vulnerable populations, to ensure the outcomes that improve oral health for a lifetime.

Basic prevention of dental disease is something we should all be doing better. And, perhaps it’s where Pew could place its resources. The only way to live a life that is healthy and free from oral pain is through prevention.

Dr. Jonathan Shenkin is a pediatric dentist in Augusta, and on faculty in Health Policy, Health Services Research and Pediatric Dentistry at Boston University School of Dental Medicine.

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