Date of Defense:
July 11, 2013
Dental caries is the most common childhood chronic disease. Scientific evidence shows that children are more vulnerable than any other age groups for oral diseases, which can jeopardize their physical growth, self-esteem and capacity to socialize. Disparities in disease, health outcomes, and access to health care across racial, ethnic and socioeconomic groups exist within this population. This paper aims to identify oral health disparities within underserved populations, which can guide public health professionals to explore and implement strategies to eliminate inequalities and disseminate health equity to this group.
We conducted a Basic Screening Survey (BSS) to describe the prevalence of caries, fillings, and sealants, as well as treatment urgency. We used a simple random sample of 40 schools to provide a statewide estimate for students in third grader for oral health indicators. With the limited sample size, we could not describe findings on race and other factors. Therefore, we selected ten sentinel schools using race, proportion of free/reduced – price lunch, and urban/rural status; these had higher proportions of students from minority and/or lower socioeconomic communities representing the disparities in oral health.
Sentinel school third graders had rates of dental sealants comparable to third graders statewide (62% vs 64%), much higher than that of the US average (32%). The prevalence of caries experience was almost 50% higher than that of the state (77% vs 55%) and the US average (52%). The prevalence of untreated caries was almost double that of the statewide average (35% vs 18%) and higher than that of the US (29%).
We devised a sentinel approach to gather oral health data. The most common use of sentinel sites is by infectious disease specialists to identify trends/changes in a single indicator. Our approach allows estimates to be generated that are indicative of the health status of sub – populations at a lower cost than large, statewide surveys. In sentinel schools, a high prevalence of untreated caries and caries experience existed despite a high sealant rate. This may be due to the high proportion of immigrants and lack of prior fluoridation exposure. Further progress in eliminating disparities and improving better access to quality oral health care for those without such services will require efforts and collaboration from state and local governments and communities.