Oral health Oral Health and Health CareConception to IntroductionBirth Despite great strides in improving oral health, disparities still exist across all populationEarly Childhood groups. According to Healthy People 2010’s Oral Health Chapter and the US Surgeon General’sCaries Report, “Oral Health In America”, those suffering the worst oral health are:Treatment • The poor, particularly young children and older AmericansAction Steps • Racial and ethnic minorities • Medically and developmentally compromised individuals. The two most prevalent oral diseases are Tooth Decay (Dental Caries) and Periodontal Disease. • Both are infectious, chronic, progressive, and highly prevalent. • Both - if left untreated – result in pain, infection, dysfunction, and missed work or school. • Both are overwhelmingly preventable through self-care. • Both can be approached through disease management strategies in early stages yet require surgical interventions if allowed to progress. Caries is primarily a disease of childhood – typically established during infant and toddler years and continuing throughout life. Periodontal disease is primarily a disease of adulthood – typically established during the adolescent years and also continuing throughout life. Tooth decay Although preventable – dental caries remains the single most common, chronic disease of childhood; 5 times more prevalent than asthma (1). Prevalence : According to Healthy People 2010, oOne quarter (23%) of all US children have cavities by age 4. By second grade, one-half (502%) of all US children have experienced caries. This tremendous but unrecognized prevalence explains why the U.S. Surgeon General David Satcher called pediatric caries “the nation’s silent epidemic.” Distribution : This disease is highly concentrated in low-income and minority children as 80%
of the disease is localized in only 25% of children. NHANES III, US Centers for Disease Control and PreventionUnmet need : Among children reported by their parents to have one or more unmethealthcare needs, three times more children have unmet needs for dental care than medical.Fully one-quarter of parents whose children have special healthcare needs report unmet needsfor dental care. Newacheck et al Pediatrics 2000 from NHISConsequence : Untreated dental disease results in pain, infection, dysfunction, distractionfrom learning, and may inhibit general growth and development because of associated
nutritional liabilities.Periodontal diseasePeriodontitis is a chronic infectious and inflammatory disease of the gums and tooth-supporting bone. It is the single most common cause of adult oral dysfunction and tooth loss.It is typically painless until well advanced and produces few signs other than bleeding gums.Prevalence : Periodontal disease affects half (48%) of US adults and is particularly destructivein one-fifth (22%) of US adults.Distribution : Like childhood caries, periodontal disease disproportionately impacts people withlow income, minority status, and low educational attainment.Consequence : Periodontal disease is a recognized risk factors for heart disease, inadequateglycemic control in diabetics and putatively for poor pregnancy and birth outcomes. The USSurgeon General alerted the public to the link between periodontal disease and poor birthoutcome in 2001. “ The evidence associating moderate to severe periodontal disease in pregnant women with low-weight preterm births warrants attention to the importance of maintaining optimal oral health in pregnancy. The oral care clinician can contribute to birth defect prevention not only by treating oral disease, but also by providing educational messages to patients to promote the birth of healthy, full-term babies. ”. The publicpolicy issue: Although the science is as yet uncertain and clinical intervention trials are nowunderway at NIH, a number of leading public and private agencies have begun to alert womenof childbearing age about the mouth-pregnancy relationship.
Learning Objectives of Opening the MouthThe following learning objectives can be met by reviewing the entire Opening the Mouth program. • Describe the connection between oral health and overall health • Characterize dental caries as an infectious, transmissible, communicable disease • State the prevalence, acuity and consequence of dental disease • Differentiate the dental care finance, delivery and workforce issues from analogous medical care issues • List general action steps that can be taken to decrease oral health disparities • Describe action steps specific to Title V Maternal and Child Health Federal Block Grant programs that can be taken to decrease oral health disparitiesTo learn about these maternal-child oral health issues—from conception through toddler years—you canfollow the experience of Mrs. Perez and her daughter Maria by clicking on the navigation links below or atleft or on the pictures below. You can follow Mrs. Santos and her baby from pregnancy through the childs second year by clicking on the photos below