Tooth decay seems to be higher among youth in Plymouth County than the state average.
Dawn Ericson, coordinator for I-Smile, a state program that helps connect youth with dental services, shared the statistics at a community health meeting Friday.
A state survey showed 15.5 percent of kindergarteners and ninth graders across Iowa had some areas of tooth decay or cavities this past year.
About 18 percent of ninth graders at Le Mars Community School had some area of decay or cavities in their teeth, according to preliminary results from the audit in May.
Among LCS kindergarteners, 16 percent had decay or cavities, the audit showed.
"Since we started doing this in 2008, every year we've been above the state average," Ericson said. "We don't know why it is."
She suggests that one contributing factor may be the amount of fluoride, or lack thereof, in drinking water.
"Some people aren't getting as much fluoride as they used to, with the different reverse osmosis systems and bottled water," she said.
Some filtration systems like reverse osmosis can remove significant amounts of fluoride from water.
Also, state requirements for amounts of fluoride in water don't apply to bottled water people purchase, Ericson said.
"And we have a lower amount of fluoride added to our water in the rural water systems of northwest Iowa," Ericson said. "It's about the only part of the state that doesn't have fluoride added in those rural water systems."
The American Dental Hygienists' Association states that community water fluoridation helps prevent tooth decay for both children and adults.
According to state numbers, Brunsville, Craig, Oyens and Struble have less than .7 parts per million of fluoride in drinking water -- which state officials label "deficient."
Le Mars has 0.9 parts per million of naturally occurring fluoride in its water.
Other communities, including Kingsley and Hinton, have added fluoride to the community's drinking water supply.
Whether fluoride or other issues are the culprit in higher percentages of decay and cavities in Plymouth County's youth, more challenges may be ahead for dental health, Ericson said.
Attracting and keeping dentists in rural areas is becoming more and more difficult, she said.
While Iowa has a dental school, many new dentists leave the state, Ericson said.
That means the remaining population of dentists in Iowa has a higher average age and is moving toward retirement.
"We're going to lose 50 percent of our dentists in the next five years," she said.
Dentists that do serve in Iowa keep very busy, making them less likely to accept patients with Medicare, which offers a lower reimbursement rate for the dentist's care, Ericson explained.
"Some people travel one or two hours to get dental care," she said.
Iowa does offer programs to help connect youth with dental care -- especially those whose families may not be able to afford it.
Ericson said she'll be offering a dental sealant clinic at Clark Elementary this year. These clinics offer free dental sealants for students.
The sealant is a plastic material that is applied to the chewing surfaces of back teeth.
This protects the pits and grooves of back teeth from germs and food that can cause cavities, according to I-Smile information.
Ericson said the free sealant clinics are offered at schools which have at least 40 percent of students receiving free and reduced-rate lunch.
She said I-Smile is looking into offering dental screenings at the LCS high school for students who don't receive them elsewhere.
There is also a dental insurance offered for people younger than 19 through Iowa's hawk-i program.
The insurance is free to families who are under certain income limits and is also available for a small premium for families who are within a higher income range.
The dental program covers cleanings and check-ups, fluoride treatments, sealants, fillings and crowns and some medically necessary orthodontia.
For more information about the hawk-i dental program, call 1-800-859-2025 and ask about the dental only plan or visit the hawk-i website at www.hawk-i.org/en_US/dentalonly.html.