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Changes in the Oral Health of US Children and Adolescents and Dental Public Health Infrastructure Since the Release of the Healthy People 2010 Objectives

University of Florida College of Dentistry, Department of Community Dentistry and Behavioral Science, Gainesville, Florida 32610-3628, USA.
Academic pediatrics (Impact Factor: 2.23). 11/2009; 9(6):388-95. DOI: 10.1016/j.acap.2009.09.018
Source: PubMed

ABSTRACT 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.

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    • "Among US children aged from 2 to 5 years of age, more than 25% have caries, a prevalence which appears to be on the rise [2]. Yet, young children, particularly those who are low-income, encounter substantial barriers accessing dental care for prevention or treatment of dental caries. "
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    ABSTRACT: Objective. (1) To describe an innovative program training US pediatricians to be Chapter Oral Health Advocates (COHAs). (2) To provide insight into COHAs' experiences disseminating oral health knowledge to fellow pediatricians. Patients and Methods. Interviews with 40 COHAs who responded to an email request, from a total of 64 (62% response). Transcripts were analyzed for common themes about COHA activities, facilitators, and barriers. Results. COHAs reported positive experiences at the AAP oral health training program. A subset of academic COHAs focused on legislative activity and another on resident education about oral health. Residents had an easier time adopting oral health activities while practicing pediatricians cited time constraints. COHAs provided insights into policy, barriers, and facilitators for incorporating oral health into practice. Conclusions. This report identifies factors influencing pediatricians' adoption of oral health care into practice. COHAs reported successes in training peers on integrating oral health into pediatric practice, identified opportunities and challenges to oral health implementation in primary care, and reported issues about the state of children's oral health in their communities. With ongoing support, the COHA program has a potential to improve access to preventive oral health services in the Medical Home and to increase referrals to a Dental Home.
    International Journal of Dentistry 10/2013; 2013:498906. DOI:10.1155/2013/498906
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    • "Among US children aged from 2 to 5 years of age, more than 25% have caries, a prevalence which appears to be on the rise [2]. Yet, young children, particularly those who are low-income, encounter substantial barriers accessing dental care for prevention or treatment of dental caries. "
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    ABSTRACT: Objectives. We determined the number of state Medicaid programs adopting initiatives to support preventive dental services provision by nondental health care professionals, their perceived attributes, and implementation barriers. Methods. We used Qualtrics to conduct a cross-sectional survey in 2008 of Medicaid dental program managers to determine organizational stage of adoption classified according to the Transtheoretical Model of Behavior Change with 3-year follow-up. We assessed perceptions of the influence of 18 initiative attributes on the decision to adopt, drawn from Roger's diffusion of innovations theory. Stage and date of adoption are presented descriptively. Attributes and barriers were analyzed by stage of adoption by using analyses of variance or χ(2) statistics. Results. By 2011, 42 states had adopted a policy. Only 9 states included a comprehensive set of preventive services, the most common being fluoride varnish. Adoption was affected by perceived initiative simplicity and its compatibility with other Medicaid programs. Administrative barriers were the most common among the 15 studied. Conclusions. State Medicaid policies to reimburse nondental providers for preventive dental services are becoming widespread. Interventions are needed to ensure oral health services delivery at the practice level. (Am J Public Health. Published online ahead of print June 13, 2013: e1-e8. doi:10.2105/AJPH.2012.301138).
    American Journal of Public Health 06/2013; 103(8). DOI:10.2105/AJPH.2012.301138 · 4.23 Impact Factor
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    • "National and state surveys have been conducted to determine untreated caries prevalence over the past 3 decades [2,6,7]. Tomar and colleagues recently reported that although some progress has been made in the oral health of our nation’s children, the objectives of Health People 2010 have largely not been met [8]. They reported that from 1988–1994 to 2004 untreated caries in children aged 6–8 years increased nationwide from 28% to 29%. "
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    ABSTRACT: Background Untreated dental caries afflicts almost one third of school-aged children in the United States and many of them are from disadvantaged families. This cross-sectional study was undertaken to investigate the prevalence of untreated caries in north central Kentucky, USA and to examine the relationships between the available demographic variables and untreated childhood caries as reported on the forms from the Smile Kentucky! program. Methods During the fall of 2008, caries status was assessed during the visual oral screening examination component of “SmileKentucky!”– a model of the American Dental Association’s Give Kids A Smile program. Parents had completed brief surveys concerning 3,488 elementary school children aged 5 to 13 years who participated in the program. A secondary analysis was conducted using univariate, bivariate and multivariate statistical methods. Results Untreated caries was reported in 33% of children. Bivariate and logistic regression analyses found that the most significant risk factors for having untreated caries were living in the metropolitan Louisville, Kentucky area, not having had a dental visit in the previous 3 years and not having any form of dental insurance. Conclusions Untreated caries in elementary school children is prevalent in north-central Kentucky despite efforts to improve access to care. The results suggest that additional family and community preventive initiatives are needed to reduce the development of childhood caries in this area of the United States.
    BMC Oral Health 09/2012; 12(1):38. DOI:10.1186/1472-6831-12-38 · 1.15 Impact Factor
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