Disparities in children's oral health and access to dental care

Dental caries can be prevented by a combination of community, professional, and individual measures including water fluoridation, professional ly appl ied topical fluorides and dental sealants, and use of fluoride toothpastes. Yet, tooth decay is the most common chronic disease of childhood. Dental c ave is the most prevalent un met health need in US children with wide dispa rities existing in oral health and access to care. Only 1 in 5 children cov ered by Medicaid received preventive oral care for which they ave eligible. Children from low income and minority families have poorer oral health out comes, fewer dental visits, and fewer protective sealants. Water fluoridati on is the most effective measure in preventing caries, but only 62% of wate r supplies are fluoridated, and lack of fluoridation may disproportionately affect poor and minority children. Childhood oral disease has significant medical and financial consequences t hat may not be appreciated because of the separation of medicine and dentis try. The infectious nature of dental caries, its early onset, and the poten tial of early interventions require an emphasis on preventive oral care in primary pediatric care to complement existing dental services. However, man y pediatricians lack critical knowledge to promote oral health. We recommen d financial incentives for prioritizing Medicaid Early and Periodic Screeni ng, Diagnostic, and Treatment dental services; managed care accountability; integration of medical and dental professional training, clinical cave, an d research; and national leadership.