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children avoid early caries they could prevent the pain and suffering that many of these same parents experienced as young children. If parents could have the dental I.Q. to know not to give a bottle of juice to an infant while falling asleep, or make a point of getting to a dentist for an exam, they could be giving their children an invaluable gift. If parents could help their children make good food choices and brush regularly so much pain and suffering could be avoided. More importantly, if these communities had better oral health literacy there would not be such an outcry for public monies for the treatment of dental disease. The Saskatchewan government paid First Nation more than $500,000 during 2011 for sedation and dental care for 800 children. If the childhood caries rate was significantly lower, the monies could be used for other health initiatives and there would be less pain and suffering for the young children. The problems facing families of these northern tier territories of Canada are really just snapshots of what’s going on in the United States. Maybe the problems are not as severe in our large cities and rural communities as those described above, but just imagine what is going to happen as funding is cut further for federal and state programs for dental care. Imagine what old dental problems are going to resurface as many communities opt to discontinue water fluoridation. Imagine what is going to happen as fewer people are offered work- related dental insurance and imagine what is going to happen as the cost of dental care continues to rise. Children are once again going to have rampant caries at an early age. Parents will feel the pain of economic decision making. Choices like what foods to buy and when to see the physician or the dentist become difficult choices. When a child complains of a toothache, will the parent make an appointment with the dentist or tell the child that they can't see the dentist because they can’t afford it? Will the parent settle for store-bought Ambesol to relieve the symptoms? Lawmakers argue that there is not enough money in the public pot to cover the cost of dental care. In October 2011, Pennsylvania and other states stopped offering the few dental services it did offer to adults and limited the dental care covered for children. All across Pennsylvania adults that were previously covered under state medical assistance were no longer eligible for many types of dental care. 2 What do you see as the end result of denial of benefits? More pain, more suffering, more infections, more hospitalization, more medications more emergency procedures. What if we could get a do-over? Not just in Pennsylvania, but across the country. What if we could bring oral health literacy to the current generation of young parents? Teach them how important it would be to start their children caries free. Don’t share utensils and spread oral disease, learn to brush and floss, seek care for early dental problems, all of the basic building blocks of oral health literacy. This type of education is expensive and requires many years to get a foothold. It seems to have worked with smoking. Fewer adults and adolescents smoke now than in recent history. The message got to this generation. The message of oral health literacy can also reach a generation, but it requires effort on the part of dentists and dental organizations. It also requires no more negative comments from lawmakers and anti- fluoride activists. Our message must get through in order to combat this plague. We must yell and shout louder than anyone else around us. —BRT Read more: 1. http://www.thestarphoenix.com/health/ lost+children/6171844/story.html#ixzz1n4VAjOfH 2. http://www.dpw.state.pa.us/provider/doingbusinesswithdpw/ dentalcareproviderinfo Dr. Bruce Terry of Wayne served as editor of the Pennsylvania Dental Journal from 2008-2016. JAN UARY/FEBRUARY 2018 | P EN N SYLVAN IA DEN TAL JOURNAL 27