Oral health is essential to the general health and well-being of individuals and the population. Yet significant oral health disparities persist in the U.S. population because of a web of influences that include complex cultural and social processes that affect both oral health and access to effective dental health care. This paper introduces an organizing framework for addressing oral health disparities. We present and discuss how the multiple influences on oral health and oral health disparities operate using this framework. Interventions targeted at different causal pathways bring new directions and implications for research and policy in reducing oral health disparities.

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Reducing Oral Health Disparities: A Focus on Social and Cultural Determinants

Background Scientific advances in cariology in the past 150 years have led to the understanding that dental caries is a chronic, dietomicrobial, site-specific disease caused by a shift from protective factors favoring tooth remineralization to destructive factors leading to demineralization. Epidemiologic data indicate that caries has changed in the last century; it now is distributed unequally in the U.S. population. People who are minorities, homeless, migrants, children with disabilities and of lower socioeconomic status suffer from the highest prevalence and severity of dental caries. Results Scientific advances have led to improvements in the prevention, diagnosis and treatment of dental caries, but there is a need for new diagnostic tools and treatment methods. Conclusions and Clinical Implications Future management of dental caries requires early detection and risk assessment if the profession is to achieve timely and cost-effective prevention and treatment for those who need it most. Dental professionals look forward to the day when people of all ages and backgrounds view dental caries as a disease of the past.

https://jada.ada.org/article/S0002-8177(14)63469-3/pdf

The Biology, Prevention, Diagnosis and Treatment of Dental Caries: Scientific Advances in the United States

This article reviews the caries profile for children in Nigeria and proposes an appropriate framework for addressing the silent caries epidemic. We reviewed the caries prevalence among children in Nigeria, assessed the existing responses to the caries epidemic including the national oral healthcare delivery situation in the country and discussed the current caries management in children. We then proposed a response framework for Nigeria. We argue that successful interventions will require the adoption of a socio-ecological model. This would ensure that the micro-, meso-, exo- and macrosystems required to support the behavioural, structural and biological interventions for promoting caries prevention are addressed. National oral health surveys are required to help understand the epidemiology, social determinants of and factors that undermine the ability of children to access oral health care. A global caries prevention agenda for children would help get the government’s support for a national response agenda. Currently, there is no global call for action on the caries epidemic in children. This lack of an agenda needs to be urgently addressed. A combination of approaches for the prevention of caries in children in Nigeria is needed. A national survey is needed to generate the needed evidence for the planning of community relevant responses to the national caries epidemic in children. The design of a global health agenda for children is an important first step that can facilitate the development of a national oral health programme for children in Nigeria.

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Appraisal of the national response to the caries epidemic in children in Nigeria.

https://www.dental.theclinics.com/article/S0011-8532(09)00029-9/pdf

How dental care can preserve and improve oral health.

Epidemiology of early childhood caries: clinical application.

Children from low-income families are more likely to have dental disease and less likely to have regular dental care. Children's dental-related illnesses are responsible for more than 880,000 lost school days each year. The lack of reliable state-level data often makes monitoring the oral health of children a challenge. By conducting oral health screenings, school nurses could promote prevention and early identification of dental problems and could aid in the collection of data. This innovative project used a convenience sample of students to test a caries detection device. Children in Grades 3 and 6 (n = 2,622) received oral health screening by the school nurse using a noninvasive laser fluorescent dental device. Findings revealed that 82% of students referred to the dentists received dental care. School nurses can contribute to improving the oral health status of the school-age population by early detection of dental caries and referrals for a dental evaluation.

Theresa M. Tetuan

Papers

Oral Health Screening Using a Caries Detection Device.