Oral Health Care For Children Research Articles

EVALUATION OF AWARENESS, KNOWLEDGE AND ATTITUDE OF CLINICAL NURSES TOWARDS PRIMARY ORAL HEALTH CARE OF CHILDREN.

Background & objectives: Most of the toddlers and early childhood children in developing and under developing countries do not visit dental clinics for oral examinations earlier than three years of age though they often visit primary health care providers for regular medical checkups. Health care providers like nurses are easily available and are in frequent contact with expecting mothers and children for routine check ups. This provides an opportunity to join in oral health promotion and care into health care. Nurses play a major as well as prominent role in providing health services, along with the general physicians. Yet, the nurses can be efficiently employed to promote oral health awareness among the community level. The oral health should have greater importance in the nurse for identification and diagnosis of dental and oral diseases. The aim of this study was to study the awareness, knowledge and attitude towards primary oral health care of children among clinical nurses. Methods: A total of 200 clinical nurses received a questionnaire that included demographic data, questions to assess the oral knowledge, oral awareness and attitude towards primary oral health care of the children. Data was collected, tabulated and statistically analysed. Results: The result showed that most nursing students (80%) are unaware about primary oral health care disease and the importance of primary teeth are also not known by both the private and government college nursing students. Interpretation & conclusion: Primary health care nurses lack knowledge and awareness in oral and dental health care. Nurses have positive attitude and willingness to obtain more information for appropriate oral health care. Training and encouragement for the nurses helps to promote oral health and prevent dental diseases in children.

Oral Health Care of Children and Adolescents with Different Impairments of Cerebral Palsy: Barriers and Challenges

Objective: To evaluate the barriers to access and oral health care faced by children and adolescents with Cerebral Palsy (CP) according to their motor impairment through the perception of caregivers. Material and Methods: A case series study was carried out at three health institutions in Pernambuco, Brazil. The study sample consisted of 94 caregivers of 5-to-18-year-old patients with CP, according to GMFCS (The Gross Motor Function Classification System). Data were collected using a semi-structured form to evaluate the barriers to access and analyzed statistically by the chi-square and Fisher exact tests, adopting a 5% level of significance. In addition, binary logistic regression was performed to determine the weight of the variables in explaining the outcome variable. Results: There were major difficulties involving transportation (p=0.04) and structural accessibility to dental services (p<0.01) among children and adolescents with severe CP. In addition, the more severe the CP, the greater the difficulty of accessibility (OR=4.09,) and the lower the income (OR=8.80), the greater the motor impairment. Conclusion: Despite the availability of access to dental services, low-income families have more severe CP patients, contributing to the daily difficulties already faced by them in oral health care.

Analysis of the pattern, type and the extent of dental services provided to children and youth on the territory of Republic of Serbia

Background/Aim: The requirements for dental specialties and the number of specialists in each country are unique and strong indicator of the availability and affordability of primary health care for children and adolescents. The aim of this study was to determine the pattern, type and the extent of dental services, as well as the influence of regional factors and data on whether services are provided by a pediatric dentist or general dentist have effect on these parameters, based on information obtained from dentists providing dental care to children and youth. Material and Methods: Within the project "Program for the improvement of oral health of children and youth in the Republic of Serbia", supported by the Ministry of Health of Serbia, a research was conducted among dentists involved in dental care for children and youth in Serbia. Data collection from primary health care facilities was performed through a specially designed questionnaire. A total of 445 questionnaires were collected from dentists from 102 health centers in Serbia in the period June - October 2019. Results: There are significant differences between regions in the pattern, type and the extent of dental services. In the quantitative analysis, there are no significant differences in the type of dental services between pediatric and preventive dentistry specialists and general dentists. Conclusions: The data from the conducted research speak in favor of a large daily workload of dentists who deliver oral health care for children and youth in Serbia. Additional multifactorial analysis, which includes epidemiological data from the region, but also environmental, demographic and cultural parameters of oral health could be the basis for improving the provision of preventive dental and preventive oral care

Impact of the Coronavirus pandemic on children's oral health and caregiver's attitude towards Teledentistry: A Kuwait-based survey.

To evaluate the impact of the coronavirus pandemic on children's oral health and caregiver's attitude towards teledentistry. A questionnaire was distributed to 583 caregivers of children aged between 3 and 10 years through electronic messages, which consisted of nine multiple choice questions divided into three parts. The first part included demographic data (age, gender, and educational level); the second part addressed the assessment of oral health of children by their caregivers during the lockdown, the reason and influence of the pandemic on the oral health of children; and the third part was related to caregiver's attitude towards healthcare system and teledentistry. Pearson's Chi-square test and Fisher's Exact test were used for analysis using SPSS (version 21.0). Around 93.5% of caregivers were not satisfied with their child's oral health. Approximately 91.5% of caregivers agree that the coronavirus pandemic has negatively affected their child's oral health. Most of them think that alteration in sleep patterns is the main reason. Ninety-three percent of caregivers have been reported to utilize teledentistry during the pandemic period, but 53.2% did not know whether teledentistry could solve their child's oral healthcare problems. About 7% disagree that teledentistry can be helpful for the oral healthcare needs of children. Coronavirus disease has a negative impact on children's oral health. There is a need to increase awareness about teledentistry among caregivers in Kuwait.

Representations of child oral health care in northeastern Brazil

Resumo O cuidado em saúde bucal com enfoque na integralidade em saúde de crianças em vulnerabilidade social auxilia a desenvolver indivíduos com uma maior consciência de si. Uma das suas dependências está no potencial modelador das ações, atitudes e intenções dos sujeitos em relação à saúde ou doenças bucais e seus modos de cuidar circulantes na sociedade. O objetivo central foi analisar as representações sociais do cuidado em saúde bucal de crianças em vulnerabilidade. Realizou-se uma pesquisa qualitativa e exploratória, cuja amostra foram 26 crianças entre cinco e 12 anos, numa unidade de atenção primária em saúde de Fortaleza, CE, entre maio e julho de 2021. Foi aplicada a técnica do desenho-estória com tema e realizada análise interpretativa das informações, utilizando elementos da teoria salutogênica e revisão narrativa, evocados através de representações sociais, por meio de análise temática do conteúdo. As crianças retratam a prática da escovação dentária enquanto hábito rotinizado ou coercitivo, como cuidado oral. Práticas de autocuidado oral, expressando ludicidade, associando a assistência odontológica e elencando variedade de elementos para a atividade foram pontuais. Nas representações da boca, o significado é atrelado aos dentes e aos lábios, desejos e idealizações para com eles, experiência de cárie e da perda do dente decíduo.

Knowledge on Childhood Dental Caries Among Parents of Under Five Children in A Community at Biratnagar, Nepal

Dental caries is a major public health problem globally and is one of the most chronic diseases in children. Children are susceptible to caries as soon as the first teeth appear. Parents are the primary decision-makers in matters of children's healthcare. If the parents are knowledgeable about the child's oral health care then childhood dental caries can be prevented. The objective of this study was to identify the knowledge on childhood dental caries among parents of under five children. A descriptive, cross-sectional study was carried out among parents of under five children in a community of Biratnagar 12. Sample was selected using non probability purposive sampling method and data was collected by face-to-face interview using a self-developed, semi-structured interview guideline. Descriptive statistics i.e. frequency, percentage, mean and standard deviation was used to assess the level of knowledge and inferential statistics i.e chi square was used to find the association between dependent and independent variables. About three fourths (71%) of the parents were of age group 20-30 years and 88% of them were mothers. Most of the parents (90%) were aware that dental caries can occur in under five children and excessive sugar intake was the most common cause as reported by all of them. Only 40% knew that dental caries is transmissible and among them 97.6% responded by sharing of toothbrush. Regarding good brushing habit, most of the parents were aware. Almost all (95%) knew that proper tooth brushing helps to prevent dental caries whereas only 19% were aware about use of fluoridated tooth paste as preventive measures. Meanwhile, only 12% of the parents were aware that first dental visit should be done when first tooth erupts or within 1 year of age More than half (79%) had good knowledge on childhood dental caries but there was no association of knowledge with socio-demographic variables. The study concluded that more than half of the respondents had good knowledge on childhood dental caries and none of the socio-demographic variables were associated with the level of knowledge of parents on dental caries. Despite good knowledge, prevalence of childhood dental caries is high in our society thus reflecting the need to assess the practice of dental care.

Mather’s behavior and motivations for children oral health care in the Ammatoa Tribe of Kajang-Bulukumba, South Sulawesi-Indonesia

Mather’s behavior and motivations for children oral health care in the Ammatoa Tribe of Kajang-Bulukumba, South Sulawesi-Indonesia

Ten-year changes in children's oral health disparities: Findings from the 3rd and 4th oral health surveys in Beijing, China.

ObjectivesLittle is known about children's oral health disparities and their changes in developing countries. This study aimed to measure rural‐urban and maternal education‐related disparities in dental visits and untreated caries among Chinese children, and to describe their changes between 2005 and 2015.MethodsThe 12‐year‐old children's oral health data were from the 3rd (2005) and 4th (2015) oral health surveys in Beijing, China. Rural‐urban disparities and maternal education‐related disparities in dental visits and untreated caries were measured. The slope index of inequality (SII) and a relative index of inequality (RII) were applied to reflect the absolute and relative disparities respectively. These were estimated using a generalized linear regression model.ResultsData were analysed from 388 children in 2005 and 1926 children in 2015. The proportion of 12‐year‐old schoolchildren who visited the dentist was 24.0% in 2005 and 36.0% in 2015. Untreated caries prevalence in 2005 and 2015 was 20.9% and 16.2% respectively. Rural‐urban disparities in dental visits narrowed between 2005 and 2015 (SII: −10.75 to −3.30, RII: 0.55 to 0.87), and maternal education‐related disparities in dental visits also decreased during this decade (SII: −18.52 to −8.49, RII: 0.38 to 0.65). These changes were statistically significant. For disparities in untreated caries, only maternal education‐related disparities in untreated caries in 2015 were found. The SII and RII were 6.39% (95% CI: 1.65, 11.13) and 1.57 (95% CI: 1.13, 2.20) respectively. The change in disparities in untreated caries was not statistically significant for rural‐urban disparities (P = .319) or maternal education‐related disparities (P = .501).ConclusionsThese findings indicate that in Beijing, China, disparities in children's dental visits narrowed between 2005 and 2015. However, maternal education‐related disparities in dental visits and in untreated caries were still apparent, suggesting that policies to improve children's oral healthcare utilization equality should target the children with less‐educated mothers.

Non-restorative cavity treatment: from guidelines to the practice

The new KIMO guidelines ‘Oral Health Care for Children’ approach caries as a behavioural related disease and unequivocally assign priority to causal caries treatment, emphasising lifestyle and behavioural changes. The 5-step concept of non-restorative caries treatment (NRCT) is recommended as treatment of choice for cavitated dentine lesions in primary dentition. Communicative aspects of NRCT are supported by limited technical interventions, for the purpose of effective oral care. A balance between aetiological and symptomatic treatment is sought for each child individually, in close cooperation with the parents. Technical aspects per tooth range from limited interventions like making cavities accessible for brushing, applying fluoride varnish or SDF, covering the cavity with a layer of glass ionomer cement to treatment like ART restoration or the Hall technique, in cases of necessity. Lifestyle changes lead to sustainable treatment results and enhance the quality of life of the child or young person.

COVID-19 Implications on Oral Health and Emerging Preventive and InnovativeTreatment Approaches in Children: Literature Review

Emergence of Severe Acute Respiratory Syndrome COV-2 (SARS COV-2) causing COVID-19 has led to a global pandemic. The virus is highly infectious causing severe infection of airways. However,COVID-19 seems to affect children less severely as compared to adults,yet they remain vulnerable to infection and pose a substantial transmission risk. Currently, there is no active treatment and diagnosis is still a challenge. This puts the dental offices at a risk of cross infection between the children and the dentists. The impact of the coronavirus on the oral health care of children and their families is significant and will have long term ramifications for health outcomes. Current restrictions on aerosol generating procedures provide an opportunity to re-orientate dental care towards less invasive and more preventive approach. In the current pandemic scenarios apart from various infection control measures and preventive approaches, innovative concepts like tele-dentistry and dental home, too,are acting as a great tool providing additional solutions for prevention of infection transmission. Aim:- The aim of this article is to analyze the implications of COVID-19 on the oral health of children and to provide specific modifications for preventive treatment approach along with use of innovative interventions in management of paediatric patientsin the pandemic. KeyWords: -COVID-19, preventive oral health, tele-dentistry,paediatric dentistry.

Attitude and practices of parents toward their children's oral health care during COVID-19 pandemic.

The impact of COVID-19 has affected billions of people affecting nearly all domains of life, including patient's healthcare needs. Due to constrained dental services during lockdown, pediatric dental needs were severely compromised therefore, parental attitude and practices of maintaining child's oral hygiene impose significant impact on child's oral hygiene. This study aims to assess the attitude and practices of parents toward their children's oral health care during COVID-19 pandemic. The present cross-sectional study was conducted with a sample of 120 parents selected randomly from the outpatient department after obtaining informed consent. A structured questionnaire was used to assess attitude and practice of parents toward their child's oral hygiene during lockdown in COVID-19 pandemic. The overall attitude and practice score of parents in maintaining their child's oral hygiene was low, with mean value of 2.36 ± 1.36 and 2.51 ± 1.50, respectively. 60.8% of parents reported the need of dental treatment for their child during the lockdown period whereas 50.8% parents contacted the dentist during this period; majority (37.5%) of which reported due to toothache. 68.3% of parents would like to visit nearby dental hospital for emergencies during lockdown period. Only 33.3% of parents took extra efforts to maintain their child's oral hygiene while 45% made dietary changes in their child's diet to prevent tooth decay. The overall attitude and practices of the parents were poor toward the oral health of their children during the lockdown period in COVID-19 pandemic. There is urgent need of increasing awareness among parents regarding the importance of maintaining their child's oral health. The inability to see the doctor should at least encourage better home practice measures for future. The concept of tele-dentistry is very new and will be the need of the coming modern times.

Influence of Depression and Use of Alcohol and / or Tobacco by Parents in the Oral Health of Children with Disabilities

Objective: To investigate the influence of parental depression and substance use in the oral health care of children with disabilities. Material and Methods: A cross-sectional study was conducted involving 151 children with disabilities and their parents/caregivers. To detect the presence of depression and alcohol or tobacco use, the parents/caregivers answered three questionnaires: two versions of the Patient Health Questionnaire (PHQ), AUDIT (Alcohol Use Disorders Identification Test), and the Fagerstrom Test for Nicotine Dependence (FTND). Then, the children with disabilities underwent oral examination to evaluate biofilm control, gingival condition and the dental carie index (decayed, missing, and filled teeth - dmft ̸ DMFT). Results: There was a statistically significant association between tobacco use and dental caries in deciduous teeth (p=0.046). The children of smokers had six times greater need for dental treatment than that of non-smokers (OR= 6.36; CI= 1.3-30.5). There was no statistically significant association between the oral health of the children with disabilities and parental alcohol consumption and depression (p>0.05). Children with medical condition had a higher need for dental treatment than children with intellectual disability (p=0.003). Conclusion: Parental smoking habits increase dental caries in the deciduous teeth of children with disabilities, but parental depression and alcohol use do not influence the oral health of children with disabilities. Children with medical condition have more treatment needs than children with intellectual disability.

The Effectiveness of the Use of Sign Language Videos in Improving the Behavior of Dental and Oral Health Care in Children with Impairment in SLB Negeri 1 Jambi City, Indonesia

The Effectiveness of the Use of Sign Language Videos in Improving the Behavior of Dental and Oral Health Care in Children with Impairment in SLB Negeri 1 Jambi City, Indonesia

Cross-sectional analysis of dental treatment under general anaesthesia in hospitalised Western Australian children in 2018-19.

Objective To date, there has been little research that has comprehensively analysed dental treatment under general anaesthesia (DGA) at Perth Children's Hospital (PCH) for dental emergencies (dental pain and sepsis). This cross-sectional descriptive analysis of the PCH dental department analysed the demographic of children admitted and the type of treatment used, and assessed the cost. Methods This was a retrospective descriptive study analysing the dental records of patients ranging from 2 to 16 years of age at PCH in Western Australia. Of the 310 cases randomly selected from the 2018-19 study period, 202 were admitted for DGA. Two outcome measures were derived: cumulative count of treatment mix and cost analysis. Results The mean (±s.d.) age at the time of admission was 6.2±2.6 years and the mean (±s.d.) decayed (d/D), missing, (m/M) and filled (f/F) teeth (dmft/DMFT) was 2.1±0.8. Of the 429 teeth affected, 282 were molars. Treatments were grouped therapeutically; of the 856 treatments performed, 465 were extractions (54%). The total cost, consisting of direct and indirect costs, was A$313823, and equated to an approximate mean (±s.d.) of A$1554±109 per case. Conclusion Untreated dental caries was the most common cause for hospital admission. Most cases presenting at the emergency department were young children (<7 years old) who underwent extractions under DGA. What is known about the topic? The Child Dental Benefits Schedule (CDBS) was introduced to improve access and affordability to oral health care for children without private dental insurance. However, a significant number of children are still being admitted to hospital for emergency dental treatment. What does this paper add? Despite the availability of the CDBS, untreated dental caries remains one of the most common reasons for dental emergency in the PCH. What are the implications for practitioners? Not only are direct costs a burden on the health budget, but indirect and intangible costs also affect children and their families.

Knowledge, Attitude, and Practices of Parents on the Importance of Their Children's Oral Health in Greater Noida, India

Background: Parents and family members are considered the primary source for knowledge about child rearing and health habits for children. Young children's oral health maintenance and outcomes are influenced by their parent's knowledge and beliefs, which affect oral hygiene and healthy eating habits. Parental perception has a long-term influence in determining a child's oral health status. Aim: The aim of this study is to assess the oral health-related knowledge, attitude, and practices (KAP) of parents with children aged 3–5 years. Materials and Methods: A total of 500 parents of children aged 3 to 5 years were included in the study. A self-administered questionnaire, written both in English and local language (Hindi), validated through pre-tested survey, was given to the parents to assess the oral health related KAP. The results were calculated on the basis of frequency and percentages using the SPSS software. Results: Males comprised 49.8% and females comprised 50.2% of the respondents of questionnaire. Majority of fathers and mothers of the study population agreed for the importance of primary teeth. Almost all the participants in this study agreed that a child's teeth should be brushed/cleaned. A little less than half of study population considered 1 year as the suitable age for the child's first dental visit. A higher proportion of females as compared to males felt that night time bottle/breastfeeding leads to caries. Conclusion: Parental attitude, knowledge, and practices are responsible for their child's oral health. No statistical significance was seen between mothers and fathers on perception of their child's oral health care.

TO ASSESS THE KNOWLEDGE, ATTITUDE AND PRACTICES AMONG THE GYNECOLOGISTS REGARDING THE INFLUENCE OF PERINATAL MATERNAL ORAL HEALTH IN DETERMINING THE FUTURE DENTAL HEALTH OF THE CHILD

Background: Perinatal and infant oral health should be considered as the foundation of Pediatric preventive oral health care. A proper perinatal oral health care guidance provided by Gynecologists during the time of pregnancy can help an expectant mother to improve or maintain good oral health status and thereby reduce the complications that can be associated with poor oral health in the mother and can indirectly dictate the future oral health and general health of her child. Gynecologists who are aware about the infectious nature of the oral microbes and the effect of discrete periods or windows of inoculation should instruct the mother about the higher risk of developing dental caries in their children by the modification of maternal dental flora using proper perinatal preventive programs. Aim:To assess the Knowledge, Attitude and Practice of Gynecologists of Central Kerala about the importance of early oral health care for children. Materials and methods:A questionnaire based cross sectional survey was conducted among 200 Gynecologists from Ernakulam and Thrissur district, Central Kerala, India. After obtaining the consent and explaining the nature of the study, a single investigator distributed the questionnaire among the randomly selected participants and requested to answer within 15-30 minutes. The answered sheets were collected back on the same day itself. Result: A statistical evaluation using the Chi-square was done to evaluate the homogeneity of the respondents and one way ANOVA to evaluate the influence of study parameters on categorical scale. Mean percentage score of each category was evaluated. The result showed that the Gynecologists had a good attitude towards child oral health related topics but a less score was obtained for the knowledge and practice category. Conclusion:Majority of the participants from the study advocated the need of improving their knowledge regarding the child health related topics in future to fill their knowledge gap so that they can effectively devote time and effort to inspect oral health of the child. Gynecologists preferred CME(Continuing medical education) and their respective journals for the purpose. An improvement in the multidisciplinary approach of Pedodontists was advocated to implement a positive attitude among these contributors so that they can perform preventive measures in the most effective and efficient way to nurture a caries free smile in a childs future.

Clinical practice guidelines: Oral health care for children and adults living with epidermolysis bullosa.

ABSTRACTBackgroundInherited epidermolysis bullosa (EB) is a genetic disorder characterized by skin fragility and unique oral features.AimsTo provide (a) a complete review of the oral manifestations in those living with each type of inherited EB, (b) the current best practices for managing oral health care of people living with EB, (c) the current best practices on dental implant‐based oral rehabilitation for patients with recessive dystrophic EB (RDEB), and (d) the current best practice for managing local anesthesia, principles of sedation, and general anesthesia for children and adults with EB undergoing dental treatment.MethodsSystematic literature search, panel discussion including clinical experts and patient representatives from different centers around the world, external review, and guideline piloting.ResultsThis article has been divided into five chapters: (i) general information on EB for the oral health care professional, (ii) systematic literature review on the oral manifestations of EB, (iii) oral health care and dental treatment for children and adults living with EB—clinical practice guidelines, (iv) dental implants in patients with RDEB—clinical practice guidelines, and (v) sedation and anesthesia for adults and children with EB undergoing dental treatment—clinical practice guidelines.Each chapter provides recommendations on the management of the different clinical procedures within dental practice, highlighting the importance of patient‐clinician partnership, impact on quality of life, and the importance of follow‐up appointments. Guidance on the use on nonadhesive wound care products and emollients to reduce friction during patient care is provided.ConclusionsOral soft and hard tissue manifestations of inherited EB have unique patterns of involvement associated with each subtype of the condition. Understanding each subtype individually will help the professionals plan long‐term treatment approaches.

Use of nitrous oxide in children with special health care needs

Providing optimal oral health care for children and individuals with special health care needs (SHCN) is an integral professional and ethical responsibility of dentists. Children with special health care needs may have behavioral factors, medical complexities, and/or intellectual disabilities which influence their ability to cooperate for dental treatment. They may have elevated dental fear and anxiety which may not be alleviated with basic behavior guidance strategies alone. The option to offer inhalational nitrous oxide provides an adjunctive method to help reduce a child's pain and anxiety during dental treatment. Inhalational nitrous oxide can be simply administered via a well-fitting nasal hood. Based on the underlying medical condition of the child, it may be necessary to monitor oxygen saturation with pulse oximetry. Administration of 100% oxygen preoperatively and upon completion of treatment is an essential step applicable to all the patients. Children recover quickly from the effects of nitrous oxide after post-treatment oxygenation and can be discharged to the parent without any residual effects. With appropriate case selection and administration technique, inhalational nitrous oxide is a safe and effective technique to provide dental treatment for children with special health care needs.

Effectiveness of “Heni’s Dental Flannel Book” On Improving Dental Health Care among Early Childhood

One of the factors causing dental caries is the lack of children's knowledge resulting in a lack of awareness of children maintaining dental hygiene. To increase children's knowledge can promote dental health through child oral health education and mouth. The use of media is still less effective in health education that has been running. Therefore the need for innovation and development is to use media innovation "Heni's Dental Flannel Book." The study aimed to develop "Heni's Dental Flannel Book" media as a health education book and the effectiveness "Heni's Dental Flannel Book" for increasing the dental health care of Early Childhood Education Programs. Research and Development (R &amp; D), there are ten stages of research, namely: information gathering, design models, validation expert, revision, product trial (Pre experiment with one group pre-test post-test, a sample of 15 children), modification, application trial (Quasi-experimental with pre-test and post-test nonequivalent control group design, a sample of 20 children in the intervention group and 20 children in the control group, final product revision, production of a product. Data were tested using ANOVA, Shapiro Wilk, Wilcoxon test, Mann-Whitney test. "Heni's Dental Flannel Book" is useful as an effort to increase dental and oral health care for Early Childhood Education Programs, as indicated by a p-value&lt;0.001. Children's knowledge is characterized by a p-value&lt;0.000, a child's attitude is shown by a p-value &lt;0.000. There is a difference in the effectiveness of smart dental books and flipchart in increased dental and oral health care for children with a p-value of &lt;0.000. “Heni’s Dental Flannel Book” effectively improve children's knowledge and attitudes

Children's Oral Health: Progress, Policy Development, And Priorities For Continued Improvement.

Considerable progress has occurred in the US over the past quarter-century in terms of improving children's oral health. Federal and state policies, programs, and partnerships have contributed to improvements in oral health status. Medicaid and Children's Health Insurance Program coverage expansions helped increase the use of dental services, and investments in safety-net facilities and training programs helped expand service delivery and the oral health workforce. Nevertheless, dental caries remains the most common chronic disease of childhood, notable oral health disparities persist, and the adoption of evidence-based innovations remains slow and uneven. This article highlights improvements during the past twenty-five years in US children's oral health and oral health care that stem from major federal and state initiatives, as well as persistent disparities. We offer promising strategies for reducing gaps and suggestions for overcoming challenges to future progress, including renewed emphasis on oral health during early childhood; greater integration in education and clinical service delivery programs; development of standardized quality measures; and data collection systems that support more robust surveillance, program monitoring, and system improvements.