Abstract
Despite remarkable reduction in the prevalence of dental caries in the United States, dental caries is still a highly prevalent disease among children who are socially disadvantaged (racial/ethnic minority, poor, rural, immigrants). Consequently, caries sequelae such as dental pain, need for dental treatment under general anesthesia, and future orthodontic treatment, are also concentrated among the most socially disadvantaged children. To make the situation more appalling, those children who need treatment the most are the ones least likely to visit the dentist. Low income children are less likely to visit the dentist in part because of family's competing needs for limited resources, shortage of pediatric dentists, and dentists not taking uninsured or publicly insured patients. In the same vein, if these children do not have access to dental care, they are deprived from effective caries preventive measures that are dentist-dependent such as sealants and professionally applied fluoride. Dentistry has done well at devising caries preventive and treatment strategies; but these strategies have missed the most needed segment of society: disadvantaged children. The challenge now is to develop innovative strategies to reach these children.
Highlights
Disparity in young children's oral health tells a story of the most vulnerable of the vulnerable
Disparity amongst children can be found in nearly every marker of health, disparity in oral health is disturbing because dental caries is the most common chronic disease of childhood [2]
BMC Oral Health 2006, 6:S3 section we describe the prevalence of Early Childhood Caries (ECC) and treatment issues relevant to oral health disparity
Summary
Disparity in young children's oral health tells a story of the most vulnerable of the vulnerable. They named such exclusionary practices as: being treated disrespectfully by the clinic staff, discrimination, long wait times, limitation in provider choice, and difficulties with transportation to the appointments Another problem is the low perceived need among caregivers of 2–5 year olds; data from NHANES III show that while 19% of these children had normative needs (needs that are defined by a dentist), only 9% or the parents indicated a perceived need [24]. Dentists in these programs are required to see a percentage of children covered by Medicaid as part of their patient load or are required to serve full time for a number of years in specified sites located in underserved areas (see: http:// nhsc.bhpr.hrsa.gov/join_us/lrp.asp) Another successful program providing timely dental services to preschool children is North Carolina's "Into the Mouths of Babes." This program is unique in that it was the first to train medical providers to offer dental services such as risk assessment, screening, referral, fluoride varnish application, and caregivers' counselling. Expansion of functions of auxiliary dental personnel is important to increase services for preschool children
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