The Surgeon General’s report on Oral Health indicates there have been efforts to improve oral health and decrease the severity of dental decay and other oral diseases. Unfortunately, oral health disparities still exist. Most notably these differences are evident amongst racial/ethnic groups, influenced by socioeconomic factors such as status, gender, and geographic location. The Center for Disease Control has found that people with lower levels of education and income, as well as specific racial/ethnic groups, have higher rates of oral disease. Research has shown that there has been a rise in tooth decay in low-income and minority children aged 2-5 years old. As documented by the CDC, there are more adult, black, non-Hispanic and Mexican Americans with untreated tooth decay than white, non-Hispanics. Concerning disparities that exist between educational levels, adults 35-44 years old, with less than a high school diploma, presented with untreated tooth decay as well as periodontal disease nearly three times that of those with at least some college education. It has been noted in the Missouri Oral Health Plan 2015-2020 that Missouri has lower dental visit rates and more missing teeth among adults than what is observed nationally. Conversely, more Missourians with access to community water systems receive an optimal level of fluoridated water compared to the national average. Community water fluoridation greatly reduces the percentage of tooth decay when compared to well water or other sources. The single- most nutritional factor influencing cavities is dietary sugar. Unfortunately, people living in low-income areas also have limited options as it relates to making “healthy food choices.” Limited access to preventive dental care is also related to whether there is a dental care provider in the area in which they live, reliable transportation and if the practice accepts Medicaid. Other barriers that could hinder a person from receiving quality care may include: limited access to and availability of dental services, lack of awareness about the state of their oral condition, the cost of dental treatments as well as a sense of fear related to dental procedures. The result of these inequalities often leads to pain, dental complications, lack of concentration, time missed at school and / work, an increased risk of infection and higher costs for treatment that could have been prevented if treatment were recognized, identified and rendered sooner.
In an effort to improve quality of life and eliminate oral health disparities, proven interventions such as community water fluoridation, school based dental fluoride and sealant programs have been implemented. School-based sealant programs provide sealants (thin coating on the chewing surfaces of the teeth to prevent cavities) to children who may not receive routine dental care. Increasing state and community dental health and preventive oral health services are also potential strategies. Although major improvements have occurred in the nation’s oral health, we still face many challenges. Governmental agencies and professional organizations are continuing to evaluate and address the disparities that exist.
Candace Wakefield DMD
Pediatric Dentist
The Children’s Dental Zone
Florissant, Mo.
