Michigan Fights Tooth Decay With Kindergarten Dental Screenings

Childhood caries is the most common chronic disease among kids ages 2 to 11.¹ But it is, in most cases, preventable. To address this prevalent problem, the Michigan Department of Health and Human Services (MDHHS) recently launched the Kindergarten Oral Health Assessment Program (KOHA), which offers no-cost dental screenings to young children and then refers those with tooth decay for treatment.²

EFFECTS OF CARIES ARE WIDE-RANGING

The importance of KOHA is all too clear to Christine Farrell, RDH, BSDH, MPA, who serves as the oral health director for the MDHHS Oral Health Program. “If children have dental pain, they cannot sit still and listen, learn effectively, or speak or eat well. They may exhibit behavioral issues, inattentiveness, poor overall health due to dental decay and tooth pain. It’s a matter of keeping children healthy so they can learn,” she explains.

In fact, according to the latest findings, unplanned, acute dental issues are responsible for 34.4 million missed school hours annually nationwide.³ It is hoped that KOHA can help remedy this. “The intent of the program,” says Farrell, “is to make sure that children have the opportunity to have a good education free of dental decay and pain.”

ROADBLOCKS TO CARE

The need for such a program is evident when considering the numerous barriers to adequate oral healthcare in the United States. As of 2024 approximately 57 million Americans reportedly live in areas with a shortage of dental health professionals — 67% of those areas are in rural communities.⁴

Farrell counts among those barriers a lack of understanding that dental caries is a public health issue. She also laments a lack of education of parents, caregivers, school personnel and other medical professionals by dental professionals on the importance of oral health in young kids and primary teeth starting at age 1.

Farrell explains, “Seeing a child at age 3 or 4 is too late to prevent early childhood caries. The dental profession needs to do a better job of promoting the age 1 dental visit within its own domain so that children can be seen early and preventive measures taken.”

TACKLING CHALLENGES

To date, KOHA has screened 35,000 kids, referring one in four for treatment.² Conducted by dentists or local health departments, the no-cost screenings are widely available. Yet, program implementation has proven challenging, especially in areas with dental workforce shortages. But through outreach into underserved communities, raising awareness on the value of dental care for children early on, and expansion of access to care, the state hopes to resolve these issues.²

Farrell relates that, in 2023, the Medicaid Program implemented major dental reforms that included expanded services and reimbursement rates comparable to commercial rates.

KOHA requires that assessments be conducted by a dentist, dental hygienist, or dental therapist. In fact, Farrell says that dental hygienists play an important role in performing assessments and preventive services without direct supervision.

The screenings, which began in 2021, were originally optional but will now be required before the start of kindergarten.⁴ Farrell notes that by October 2025, all 45 local health department jurisdictions should have coverage for the KOHA program.

REFERENCES

1. National Institute of Dental and Craniofacial Research. Data & Statistics.
2. Health and Human Services. Kindergarten oral health assessment program (KOHA).
3. Naavaal S, Kelekar U. School hours lost due to acute/unplanned dental care.
4. Spartan Newsroom. Michigan Kindergarten Oral Health Program Faces Implementation Struggles.