Addressing Oral Health Inequities, Access to Care, Knowledge, and Behaviors (original) (raw)
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Academic Pediatrics, 2009
We examined progress in US children's oral health and dental public health infrastructure since the Healthy People 2010 Oral Health Objectives were issued. We summarize trends in the prevalence of dental caries and dental sealants on the basis of national and state-specific data. Trends in state oral health program activities, funding, and staffing were derived from annual surveys. The prevalence of dental caries in primary teeth of children aged 2-4 years increased from 18% in 1988-1994 to 24% in 1999-2004. Racial disparities persisted in that age group, with caries significantly more prevalent among non-Hispanic black and Mexican American children than among non-Hispanic white children. Caries prevalence in primary teeth of non-Hispanic white children aged 6-8 years remained unchanged, but increased among non-Hispanic black and Mexican American children. State-specific prevalence of caries among third-graders ranged from 40.6% to 72.2%. Caries in permanent teeth declined among children and adolescents, while the prevalence of dental sealants increased significantly. State oral health programs' funding and staffing remained modest, although the proportion of states with sealant programs increased 75% in 2000 to 85% in 2007 and the proportion with fluoride varnish programs increased from 13% to 53%. Progress toward improving the oral health of America during the past decade has been mixed. Greater attention to the oral health of young children is clearly needed, and child health professionals can be valuable partners in the effort. With continued high prevalence of a largely preventable disease, ongoing problems with access to basic oral health services, and increased national attention to health care reform, there is a clear need and opportunity for governments to make serious and sustained investments in dental public health.
The ongoing fight for population oral health
The Lancet, 2024
Oral diseases are the most widespread health conditions, with nearly half of the world's population living with one or more of them, spanning from young children to older adults. 1 Despite important progress made until the early 1990s, no clear improvement has been reported in the past three decades. 2 Behind epidemiological data, there are unheard personal stories of pain and suffering caused by oral diseases, especially in low-income and middle-income countries (LMICs) and among marginalised groups around the world. People report a wide range of negative consequences of oral diseases in their daily activities, physical health, and mental health
Oral Health and COVID-19: Increasing the Need for Prevention and Access
Preventing Chronic Disease, 2020
What is already known on this topic? Oral health is an important component of health and overall well-being. What is added by this report? Nonemergency dental care has been curtailed during the coronavirus disease 2019 (COVID-19) pandemic. Reopening dental practices involves unique challenges and provides opportunities to increase focus on prevention and nonaerosol-generating procedures. What are the implications for public health practice? Vulnerable populations are at high risk for COVID-19 and oral and other chronic diseases, and they also have less access to health care services. Removing policy, regulatory, workforce, and reimbursement barriers and incentivizing prevention would increase access to oral health care and improve population health.
Promoting Oral Health through Education and Prevention Programs
Revista de Cercetare si Interventie Sociala, 2020
Health education is a key element in health promotion and requires strong planning based on theories of medical behavior. The study was conducted over a period of three years, January 2015 - December 2017, by means of an 11 items questionnaire anonymous applied to dentists or medical staff. Seven questions were multiple choice to allow a broader discussion of the results and the rest were one answer. The time of dental practitioners is limited, so their view of the duration of a possible dental health program is essential. Hours per week volunteered, vary from one doctor to another: from 1-3 hours or less to 3-5 hours or as needed. Assessing the willingness to engage (82%) and the time allocated to the dentists surveyed (44% between 1 and 3 hours per week and 51% over 3 hours per week), we can say that we have human resources for implementing an oral health project. The workforce in the field of oral health would like to be involved in such a program and believes that it could benef...
Disparities in Oral Health and Access to Care: Findings of National Surveys
Ambulatory Pediatrics, 2002
In this background paper, sociodemographic variables, including age, race, family income, sex, parental education, and geographic location, have been used to characterize the dental status of US children and their access to dental services. Because tooth decay, or dental caries, remains the preeminent oral disease of childhood and national data is available on dental office visits, tooth decay has been used as the primary marker for children's oral health, and visits to the dentist is the marker for care. In general, children from low-income families experience the greatest amount of oral disease, the most extensive disease, and the most frequent use of dental services for pain relief. Yet these children have the fewest overall dental visits. Paradoxically, children in poverty-those living in households with annual gross incomes under 16500forafamilyof4−ornearpoverty−thoseinfamilyhouseholdswithincomesbetween16 500 for a family of 4-or near poverty-those in family households with incomes between 16500forafamilyof4−ornearpoverty−thoseinfamilyhouseholdswithincomesbetween16 500 and $33 000-also have the highest rates of dental insurance coverage, primarily through Medicaid and SCHIP. For those most affected, dental disease is consequential for their growth, function, behavior, and comfort. The twin disparities of poor oral health and lack of dental care are most evident among low-income preschool children, who are twice as likely to have cavities as are higher income children. Medicaid-eligible children who have cavities have twice the numbers of decayed teeth and twice the number of visits for pain relief but fewer total dental visits, compared to children coming from families with higher incomes. Fewer preventive visits for services such as sealants increase the burden of disease in low-income children. These disparities continue into adolescence and young adulthood, but to a lesser degree. Disparities in oral health status and access to dental care are also evident when comparing black, Hispanic, and Native American children to white children and when comparing children of parents with low educational attainment to children of parents with higher educational attainment. The fastest growing populations of children are those that currently have the highest disease rates and the lowest amount of dental care. If the strong correlation between these subpopulations and dental diseases continues, caries rates are likely to rebound after longstanding declines, and the stress on publicly financed dental care will likely increase.
Disparities in Access to Oral Health Care
Annual Review of Public Health, 2020
In the United States, people are more likely to have poor oral health if they are low-income, uninsured, and/or members of racial/ethnic minority, immigrant, or rural populations who have suboptimal access to quality oral health care. As a result, poor oral health serves as the national symbol of social inequality. There is increasing recognition among those in public health that oral diseases such as dental caries and periodontal disease and general health conditions such as obesity and diabetes are closely linked by sharing common risk factors, including excess sugar consumption and tobacco use, as well as underlying infection and inflammatory pathways. Hence, efforts to integrate oral health and primary health care, incorporate interventions at multiple levels to improve access to and quality of services, and create health care teams that provide patient-centered care in both safety net clinics and community settings may narrow the gaps in access to oral health care across the li...