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Association challenges Pew issue brief

Washington—The Pew Children's Dental Campaign acknowledged "errata" in a posted issue brief challenged by the Association as using "erroneous calculations to buttress its arguments that New Zealand's use of dental therapists is responsible for better oral health among New Zealand children than those in the U.S."

The issue brief, "Dental Therapists in New Zealand: What the Evidence Shows," asserts that "among 5- to 11-year-olds, the treatment disparity is the most dramatic. In New Zealand, 3 percent of children in this age range have untreated tooth decay, compared with 20 percent of U.S. kids."

While New Zealand's 3 percent rate may be accurate for permanent teeth, the report referenced by Pew (2009 New Zealand Oral Health Survey) notes that 17 percent of baby teeth in New Zealand's 5- to 11-year olds have untreated decay, the Association said in a May 6 press release. That adds up to a total of 20 percent, which is a reading of the data confirmed by the Centers for Disease Control and Prevention, the ADA said.

"Ultimately, a 20 percent rate of untreated decay in children is unacceptable in any country," ADA President Dr. Robert A. Faiella said. The ADA press release said Pew's "significant error" is "unfortunately glaring… in assuming that the 20 percent figure represented permanent teeth only (originally reported by the CDC in May 2012; corrected in June), when in fact the CDC reports the statistic is for both primary and permanent teeth."

"Unfortunately, debates about midlevel providers have threatened to drown out discussions of how to extend known, proven solutions to greater numbers of Americans who lack access to dental care, many of them suffering with untreated disease," Dr. Faiella said.  A separate Association letter to the Pew Charitable Trusts chief executive officer pointed to "highly flawed interpretations of data."

An "errata" statement posted May 7 at pewstates.org said, "Pew has been made aware of an unpublicized revision to a report by the U.S. Centers for Disease Control and Prevention (CDC) which was used in the analysis and preparation of the…issue brief" and said two charts "appear to have been mislabeled, one referring to the rate of untreated tooth decay in permanent teeth and one referring to the rate of tooth decay in permanent teeth among children of varying income levels."

The "errata" statement said Pew is "working with the CDC to gain a fuller understanding of the unpublicized revision that was apparently made last summer and how it impacts the findings of the report, as well as analyzing any additional relevant data or data that have been released since the brief was issued." The addition of an "errata" statement was the only observable change in the issue brief posted online May 8.

In response to an ADA News request for comment,  Shelly Gehshan, director of the Pew Children's Dental Campaign, said, "We support states in seeking a variety of evidence-based solutions. And the debate about increasing access to dental care, including the idea of expanding the dental team with midlevel providers, should be a fact-based dialogue. That's why I appreciate the ADA bringing a data discrepancy in our 'Dental Therapists in New Zealand' brief to our attention. Pew takes accuracy and data analysis seriously, and we plan to fully evaluate the revised data from the U.S. Centers for Disease Control and Prevention."

The Association said in a May 3 letter to Ms. Rebecca Rimel, president and CEO of Pew Charitable Trusts, "We hope you agree that it is in everyone's interest that the [Pew Center on the States' Children's Dental Health] Campaign takes steps to correct this error as intently and purposefully as it did in promoting the [issue] brief.

"Because the Campaign has made the New Zealand comparison a centerpiece of its advocacy for dental therapists in the media, state legislatures and elsewhere, we too will work to correct the record publicly through those same channels – with the media, lawmakers and others who share our larger goal," said the letter signed by Dr. Faiella, ADA president, and Dr. Kathleen O'Loughlin, executive director.

The letter noted that ADA and Pew "share an overarching common goal, improving the oral health of our nation's children" and said in closing, "We are grateful that Pew has lent its powerful presence to this effort, and we look forward to continuing our work together through the many strategies on which we agree."