Unmet dental needs in children following suspension of school-based oral health services due to COVID-19

Abstract

Background: Children with dental caries (tooth decay), the world's most prevalent noncommunicative disease, face severe negative impacts on health and quality of life. Methods: The CariedAway trial is a study of the non-inferiority of WHO-sponsored essential medicines when used in a pragmatic, school-based caries prevention model. We present data on severity of disease, evidence of traditional dental care, and the impacts of the COVID-19 pandemic on urgent needs of low-income, minority children in New York City. Results: Of the 1398 children enrolled in CariedAway, approximately 30% had untreated caries on any dentition at baseline and only 11% of children presented with evidence of having received preventive dental sealants. When follow-up observations were performed after 24 months, 4% of children had developed fistula and nearly 10% presented with pulpal involvement. Conclusion: School-based caries prevention programs are attractive public health interventions to overcome access barriers to dental care and reduce oral health inequities. We show that there are severe unmet needs in minority urban children that are further exacerbated by a lack of access to care during disease outbreaks. School-based programs using essential medicines can provide lasting care during pandemic periods.

A school-based randomized clinical trial of silver diamine fluoride for dental caries incidence

“…Approximately 1 in 4 of children participating in CariedAway had untreated disease at baseline (1 in 3 for the COVID-19 sample), and we previously showed that only 11% had pre-existing sealants at their time of enrollment 42 . Following treatment, the overall odds of dental caries decreased by approximately 20% in both study arms.…”