Two Decades of Persisting Income Disparities in Dental Caries Among US Children and Adolescents

Posted & filed under Children's Oral Health and Fluoride.

Guest Blog Post by Lourdes M. Secola, DMD, MScD, DDS, Cert.PH
West Maple Pediatric Dentistry. Omaha, NE

Dental caries – known to most of us as tooth decay – continues to be the most common preventable disease of childhood. And the poorer you are, the worse your dental disease is likely to be. When that is true for quantifiable subsets of the population, it is no longer an individual problem but a public health phenomenon.

Researchers at the University of North Carolina revisited National Health and Nutrition Examination Survey (NHANES) dental survey data beginning in 1988 and published their results in a study entitled, Two Decades of Persisting Income-Disparities in Dental Caries Among US Children and Adolescents. They observed trends in dental caries occurring in three age groups (2-5, 6-11, 12-17) and examined how these trends are associated with income disparities. Not surprisingly they found that the lower the family income, the more children suffered from tooth decay.

dental caries; children; adolescentsOur experience at West Maple Pediatric Dentistry in Nebraska encompasses nearly 24 years in practice, during which time we have served waves of people of different ethnic and national backgrounds. The families we serve represent over 23 countries and need everything from basic guidance on how to maintain oral health through home care and diet to extractions for badly decayed teeth. Every few months, we receive a new cohort of children with the same significant caries experience in a process that continues to repeat itself. Our experience mirrors the findings of the researchers: the younger patients are usually the most affected by dental disease.

The correlation between caries experience and income disparities persists, which should sound an alarm that current programs and practices have not been effective for all communities. In oral health care, a one-size-fits-all approach rarely works. People have different needs when it comes to their oral health, and different situations call for different responses. We are fortunate that community water fluoridation benefits everyone, regardless of income. However, when entire communities of people, as characterized by their income, continue to suffer from high levels of caries, we must be willing to support additional and targeted efforts that may be quite unlike approaches that have worked for those who have not experienced poverty.

I have faith that, by taking into account the greater circumstances in which people live, work and lean, we all can work for the betterment of the oral health of our children.