passed in 2008 , is to be implemented during the 2010-2011 school year and is regulated by Kentucky ’ s Board of Education . The law requires screening only once , upon entry into the school system . These screenings can be conducted by many people ranging from a dentist to a nurse practitioner . 2 The bill was initially introduced by Rep . Thomas Burch and supported by two interest groups , Blueprint for Kentucky ’ s Children and Kentucky Youth Advocates . It was unanimously passed in both houses and signed by Governor Steve Beshear . 5
There seems to have been very little controversy over the issue , so one would suspect that the law would have clear benefits for the oral health of the citizens of Kentucky . One of the main arguments that the Kentucky Youth Advocates used to help get the law passed was access to care . Parents were concerned for their children ’ s health because they could not find a dentist , and when they did , it was often inconvenient timing . 6 Although this law would still function as a medium through which dental education is increased , it would not address the problems related to access to care . If children and their parents are having a hard time making an appointment for regular treatment , it would make it all the more difficult for them to schedule an appointment for a screening . If the screenings were provided by the schools , it could slightly alleviate the access to care problem in regards to the screenings , but this is not the case for most of the states passing such laws , including Kentucky . Because the law was passed unanimously in both houses , 5 it leads one to believe that the governing officials did not take time to consider all of the implications of a program like this and unknowingly put an unproductive program into place that affects the majority of the children and their parents .
Evidence , Efficacy and Evaluation
Unfortunately , as much as these laws are trying to better the oral health of their respective communities , there is no evidence to prove their efficacy . A study was done analyzing the British screening system , which has been in place for almost 100 years . The study followed over 8,000 subjects aged six to nine years old . The screenings are similar to those conducted in the United States and whose purpose is to identify those children in need of more involved dental care . The results showed that less than half of those who were screened positive ( i . e ., in need of follow-up care ) went for a follow-up visit , and a quarter of those received treatment for their problems . The data showed that this was not significantly different from those who were screened
negative . What ’ s more is that income also played a significant role in deciding if treatment was received or not . Those children who came from more affluent families were more likely to receive treatment than their underprivileged counterparts . The authors of the paper suggest that due to this disparity , the inequality in dental care between children from different income levels will increase , which opposes one of the original intentions of the screenings . 7
In an article written in the British Dental Journal to question the current relevance and motives of the British dental screening system , KM Milsom has stated that many of the politicians involved in the passage and continuance of this mandate have been doing so under “ blind faith .” 8 The author suggests that the function of the screenings has changed over the last 100 years and needs to be re-evaluated to prove its current effectiveness . He points to the data that proves no benefit of these screenings , which have become such an integral part of the school systems in England and Wales . 8 Similarly , the Association of State and Territorial Dental Directors states that there is no scientific evidence proving the benefit of these screening programs in the United States and that the lack of evidence suggests that the purpose and process of the programs needs to be both identified and evaluated . 2 With these kinds of studies proving that these programs do not better the oral health of a community , one must question why these school dental screenings are becoming mandated .
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