AUTHOR: DR. SHIRLEY SPATER, SKYGEN CLINICAL DIRECTOR OF BENEFITS MANAGEMENT
School closures and socioeconomic factors present complexities that further limit access to oral care; contributing to existing disparities in children's oral health.
The slogan for 2021’s National Children’s Dental Health Month is "Water: Nature's Drink". According to the CDC, tooth decay is four times more common than asthma among adolescents aged 14-17 years1, and is the most common chronic disease of children, even though largely preventable. The beneficial effects of water fluoridation, regular dental care, tooth brushing habits and consumption of nutritional food may combat the harmful effects of sweets. Regular dental visits help children set the lifelong path to healthy teeth and gums.
a national crisis
Unfortunately, the current COVID-19 pandemic has brought to light many existing disparities in access to healthcare and dental care in children. Limited access to school-based oral health programs and nutritional school lunches due to school closures nationally has contributed to an already-prevalent crisis. Children whose dental problems might have been addressed in an office setting or school-based program now may have to wait to see a dentist. Over time, in a less structured environment, those problems can get worse and may lead to more treatment—sadly at the nearest emergency room.
Even prior to the pandemic, children receiving no dental care were disproportionately children of color, with the highest prevalence found in Hispanic children.2 Both non-Hispanic Black and Hispanic children were significantly more likely than non-Hispanic White children to lack a preventive dental visit in the prior year.2 Racial and ethnic disparities in children’s oral health status and access were found to be largely attributed to factors such as socioeconomic and health insurance status.2 In addition, there is evidence that some racial and ethnic minority groups are being disproportionately affected by COVID-19, which makes efforts to decrease disparities all the more imperative.
the path to oral health equity
The expansion of equitable access to oral health care for children with disabilities, vulnerabilities, and other high risk populations is also of paramount importance. The dental workforce should reflect the same community, culture and language of those being cared for. Providing culturally relevant care, mitigating barriers, and creating stronger connections to family and community will improve oral health for all.
“To achieve health equity, barriers must be removed so that everyone has a fair opportunity to be as healthy as possible.”3
The elimination of racial and ethnic disparities in health has become a major national goal. Efforts to decrease disparities should be targeted at the social, economic, and other factors associated with minority racial/ethnic groups. Addressing the circumstances experienced by racial and ethnic minority children, their families, and communities and focusing on safely opening school-based and mobile oral health programs will contribute to our nation’s goal of eliminating children’s oral health disparities.
- Centers for Disease Control and Prevention, Hygiene-related diseases
- An Examination of Racial/Ethnic Disparities in Children’s Oral Health in the United States, J Public Health Dent. 2013 Spring; 73(2): 166–174.
- Centers for Disease Control and Prevention, COVID-19, Health Equity
- The ADA at 30: the Importance of Law and Health Policy in Expanding Equity, Healthy People 2020, July, 2020.