Health Commission endorses citywide children's oral-health plan, sets target for kindergarten cavities

The San Francisco Health Commission voted to endorse a citywide strategic plan to reduce dental caries in children and to request periodic updates on implementation.

Pediatrician Susan Fisher Owens, a leader of the SFHIP Children's Oral Health Collaborative, said the plan'building process engaged community partners, academic institutions, clinics and funders with the stated goal “to make San Francisco children caries free.” The plan sets three-year targets for caries experience, untreated decay and disparities and proposes tactics across access, integration, promotion and evaluation.

DPH'dental director Dr. Steven Ambrose presented local data showing progress but persistent disparities: in a 2012 kindergarten screening, 37% of San Francisco public-school kindergartners had at least one decayed, filled or missing tooth, above the Healthy People 2020 goal of 30%; some neighborhoods reported rates above 50%. Dr. Ambrose also noted low sealant coverage (about 19% of 6'8 year olds in 2013) and racial/zip'code variation in untreated decay.

Plan recommendations include integrating fluoride varnish into primary'care clinics, increasing access to sealants (contingent on sustainable Medi'Cal billing), bringing preventive services into nontraditional settings (schools and community sites), and building an ongoing population'based surveillance dashboard to track indicators.

Commissioners discussed wording to call out sealants and patient access. DPH presenters said Hellman Foundation contributed $400,000 for the planning phase and that the collaborative would pursue billing and sustainable funding mechanisms to scale sealant delivery. The commission approved the resolution endorsing the strategic plan as amended and requested periodic implementation updates.

Next steps: DPH will work with SFHIP partners on billing feasibility, expand varnish and sealant pilots and report progress to the commission.