Disparities in Children's Oral Health and Access to Dental Care

Abstract

Dental caries can be prevented by a combination of community, professional, and individual measures including water fluoridation, professionally applied topical fluorides and dental sealants, and use of fluoride toothpastes. Yet, tooth decay is the most common chronic disease of childhood. Dental care is the most prevalent unmet health need in US children with wide disparities existing in oral health and access to care. Only 1 in 5 children covered by Medicaid received preventive oral care for which they are eligible. Children from low income and minority families have poorer oral health outcomes, fewer dental visits, and fewer protective sealants. Water fluoridation is the most effective measure in preventing caries, but only 62% of water supplies are fluoridated, and lack of fluoridation may disproportionately affect poor and minority children. Childhood oral disease has significant medical and financial consequences that may not be appreciated because of the separation of medicine and dentistry. The infectious nature of dental caries, its early onset, and the potential of early interventions require an emphasis on preventive oral care in primary pediatric care to complement existing dental services. However, many pediatricians lack critical knowledge to promote oral health. We recommend financial incentives for prioritizing Medicaid Early and Periodic Screening, Diagnostic, and Treatment dental services; managed care accountability; integration of medical and dental professional training, clinical care, and research; and national leadership. JAMA. 2000;284:2625-2631.

Effectiveness of Preventive Dental Visits in Reducing Nonpreventive Dental Visits and Expenditures

“…8,27 Our findings indicate that children require fewer nonpreventive dental services when they have more preventive visits, indicating that preventive services do improve oral health. Thus, although we did not find that preventive dental visits resulted in overall program cost savings to ALL Kids, these visits may be beneficial from a societal point of view when taking into account potential improvements in quality of life of the child enrollees due to fewer oral health problems.…”

Caries dental en niños de 0-5 años del municipio de Andes, Colombia. Evaluación mediante el sistema internacional de detección y valoración de caries - ICDAS

“…La relación entre caries dental y equidad ha sido planteada por varios autores y representa un reto para el propósito de alcanzar mejores condiciones de salud bucal durante la primera infancia [23][24][25]; este aspecto debe ser contemplado al momento de plantear políticas, planes y programas en el territorio específico de Andes, a la luz de las condiciones particulares y de los grupos sociales y modos de vida a los cuales pertenecen los niños, las niñas y sus familias, en tanto la salud, la enfermedad y la atención están socialmente determinados.…”

Dental X‐rays and the risk of intracranial meningioma

“…We had no other good measure of socioeconomic status (SES) during the participant's lifetime, a factor known to be related to dental care. 32,33 Because control subjects received more education than case patients did, we suspect that the control subjects also had higher SES and that, if present, a bias would diminish associations with dental X-rays. Nonetheless, uncertainty remains concerning the effect of this lower-than-expected participation.…”