Tooth decay rates among kindergarteners have decreased nearly threefold over the past seven years in every San Francisco ZIP code — except one that includes part of Chinatown.
City health officials and community service providers are pushing a plan to close the gap.
ZIP code 94108, which includes the southern portion of Chinatown, had 53 percent of kindergarteners living there report they experienced tooth decay during the 2013-14 school year, the highest percentage in The City, according to data from the San Francisco Unified School District’s Kindergarten Oral Health Screening Program, analyzed by the Department of Public Health. In addition, the northern portion of the neighborhood, included in ZIP code 94133, had the fourth highest level of tooth decay at 45 percent. The citywide average for the 2013-14 period was 30 percent.
Still, the tooth decay rate in southern Chinatown is down from a seven-year high of 64 percent in 2011-12, likely because an increasing number of people in the Chinese community are utilizing DentiCal, said Lisa Chung, an associate clinical professor at UC San Francisco’s School of Dentistry.
However, the percentage in southern Chinatown hasn’t improved since the data was first tracked in 2007-08, when tooth decay was 52 percent. The percentage decreased in every other San Francisco ZIP code, with more than a 10 percent dip in the Mission, Sunset and Inner Richmond.
To address the disparity, the San Francisco Children’s Oral Health Collaborative — made up of city, community, university and school district members and medical and dental providers — recently kicked off a series of community stakeholder meetings in Chinatown to inform, raise awareness and gather feedback on children’s oral health.
It’s the latest effort from a three-year strategic plan, the collaborative kicked off in November to drive down cavity rates citywide, particularly among ethnic groups affected disproportionately.
“Particularly in new immigrant families, Chinese may carry over their traditional beliefs and cultural practices, which might include seeking care only when needed, which is often too late, and overlooking the importance of preventive care,” Chung said. “One example is not considering baby teeth as important.”
But Yong Heng Situ and Mei Hong Situ, who immigrated from Kaiping, China and live in Potrero Hill, said difficulty accessing a dentist — not a lack of education — has contributed to the 10 cavities their 7-year-old daughter, Doris, has had. Last week, as a dentist at North East Medical Services, a nonprofit community health center on Stockton Street, applied sealant to protect Doris’ teeth, her mother Mei Hong Situ explained that would have her daughter rinse her mouth with saltwater when she had a toothache.
“It’s what Chinese people do so it doesn’t hurt too much,” Mei Hong Situ said in Cantonese. “When we know it’s a problem, then we come to the dentist, but sometimes it takes a month to get an appointment.” Doris’ father, Yong Heng Situ, added that they chose North East Medical Services because it is the cleanest health center serving the Cantonese-speaking population, but that they often can’t book an appointment earlier than one month out.
“The longer it takes, the more the decay builds up,” he said in Cantonese. The Affordable Care Act providing more dental access to children, combined with DentiCal returning for adults last May, “has put a lot more stress and demand on clinics that accept DentiCal, which are limited,” Chung said. The collaborative’s access team is working on how health centers might provide preventive dental care at sites frequented by children and families, like Head Start preschools. They’re also looking at how those centers can bill and be reimbursed for the work at nontraditional sites outside of a dental office. The actual services would begin no sooner than the fall.
An integration team is also working with the San Francisco Health Network to develop and implement protective fluoride varnish procedures at all the primary care clinics in the network. The service is slated to begin at the Chinatown Public Health Center early next year.