Gavin Uchida has seen a lot of teeth in his life while working as a pediatric dentist and an administrator for the Hawaiʻi Keiki - HDS Dental Sealant program.
He said the rate of dental decay in the state is currently "off the charts."
"We have more cavities than almost every other state," Uchida told HPR.
The Hawaiʻi Keiki - HDS Dental Sealant program began in 2019 as a partnership among the state's Department of Education, University of Hawaiʻi at Mānoa Nancy Atmospera-Walch School of Nursing and the Hawaiʻi Dental Service Foundation.
Dentists and a team of nurses visit schools on Oʻahu, Maui and Kauaʻi once a year to perform free oral exams to second and third grade students. If necessary, the team will then provide free dental sealants to prevent cavities.
The program is partly driven by the results of a 2015 state health department report. It found that 70% of Hawaiʻi third graders are affected by tooth decay — compared to the national average of 50%. This is more prevalent in Title I schools, where more than half of the students are from lower-income families.

Uchida told HPR local dentists have known for decades cavities have been an issue among children.
"The data regarding the rates of cavities is remarkably consistent in Hawaiʻi, even over the past 10 years," said Uchida. He explained how there was a statewide report done in 2015 from the Department of Health, and the data that they are seeing now is nearly identical.
According to Uchida, while tooth decay affects lower-income families the most, it's also "unnecessarily high" among wealthier households.
"We have a lot of sugar in our lifestyle," said Uchida. "Aunties and uncles, everyone likes to share and give sweets and give juice and give candy. But dental decay is often just the result of too much sugar, and not enough brushing."
The program also hopes to address dental issues that impact the learning outcomes for students.
"Keiki often miss school due to dental pain, which not only limits their ability to eat and speak, but also reduces their overall quality of life," said Debroah Mattheus, director of the Hawaiʻi Keiki-HDS dental sealant program.
Since 2019, the program has held 90 events at DOE schools, conducting nearly 2,000 screenings and providing more than 1,100 sealants.
However, the program was paused during the last two school years due to the COVID-19 pandemic. While they made minor changes for safety, officials are concerned about the students they missed in those two years.
"During this challenging couple of school years, a lot of them probably have not seen the dentist," said Gerraine Hignite, a dental hygienist and Hawaiʻi Keiki program manager.
"It's very important that at least we can access them. There's a lot of barriers," Hignite said.

Barriers could include parents working, transportation or availability of dentists in community health centers.
"If we can provide this service in school while the kids are in school, that would be a benefit for everybody. And if they do need to have dental needs addressed, we can refer them to a dental home in the community," said Hignite.
Kauluwela Elementary is one of dozens of DOE schools that holds the dental sealant event in their cafeteria. Principal Sonja Samsonas told HPR that students and families are often put on a waitlist in nearby health centers for dental needs.
"I see it as a benefit for everyone involved," Samsonas said. "That's one less person taking up a seat at the health centers. And then it keeps our students in school, which then helps our teachers be able to teach and instruct them on a daily basis."
Looking forward, program administrators want to expand the program to reach more schools — particularly in Maui and Hawaiʻi Island.