ORAL HEALTH:
Oral health has an important role in almost every part of life. Oral Cavity- Your mouth is the mirror of your body. The systemic diseases, which affect the human body might be evident before the appearance of signs. Oral health is important regardless of age, sex, race, and ethnicity. Oral health affects your ability to speak, eat, smile, and show emotions. It also alters self-esteem, school performance and attendance at work and school.
Oral diseases are chronic treatable conditions of the cavity. Oral diseases are cavities, gum diseases, and oral cancer. About 34% of the communities at the age of 40 are shown to have at least one caries and about 40% of the communities have a toothache at least once a year which costs about 1.2 million of tax-payers money.
Cavities (also called tooth decay) are one of the most common chronic diseases in the United States. By age 34, more than 80% of people have had at least one cavity. More than 40% of adults have felt pain in their mouth in the last year. The nation spends more than $124 billion a year on costs related to dental care. On average, over 34 million school hours are lost and over $45 billion is lost in productivity each year due to unplanned (emergency) dental care.
Oral health has been linked with other chronic diseases, like diabetes and heart disease. It is also linked with risk behaviors like using tobacco and eating and drinking foods and beverages high in sugar.
CHILDREN'S ORAL HEALTH:
OVERVIEW:
Cavities (also known as caries or tooth decay) are one of the most common chronic diseases of childhood in the United States. Untreated cavities can cause pain and infections that may lead to problems with eating, speaking, playing, and learning. Children who have poor oral health often miss more school and receive lower grades than children who don’t.
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About 1 of 5 (20%) children aged 5 to 11 years have at least one untreated decayed tooth.
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1 of 7 (13%) adolescents aged 12 to 19 years have at least one untreated decayed tooth.
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Children aged 5 to 19 years from low-income families are twice as likely (25%) to have cavities, compared with children from higher-income households (11%).
The good news is that cavities are preventable. Fluoride varnish can prevent about one-third (33%) of cavities in the primary (baby) teeth.2 Children living in communities with fluoridated tap water have fewer cavities than children whose water is not fluoridated.3 Similarly, children who brush daily with fluoride toothpaste will have fewer cavities. Dental sealants can also prevent cavities for many years. Applying dental sealants to the chewing surfaces of the back teeth prevent 80% of cavities.
ORAL HEALTH DISPARITIES:
In the 21st century, the perspective of health has changed dramatically. The community has begun to understand the inter-relationship between systemic health and oral health and its importance of maintaining better oral health. The community centers which are wide-spread in united states focuses on improving the oral health of Americans by improving the access to preventive community oral health programs. yet millions of Americans are unable to access the oral health services and hence profound oral health disparities exist.
Oral Health disparities are termed as oral health outcome of an ethnic group at the lowered level than the normal oral health status of the general population. Race or ethnicity, Sex, age, sexual identity, disability, socioeconomic status, and geographic location determine the oral health status of an individual. The Socio-economic factor is the major determining factor of oral health disparities.
According to the CDC, oral health disparities are common in vulnerable and low-income communities. Some of their findings are:
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The poor oral health is seen in Non-Hispanic Blacks, Hispanic, American-Indians, and Alaskan Natives of all the ethnic groups.
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The Children of Mexican- American, Black Non-Hispanic Communities in the age of 2- 8 years are shown to have a higher prevalence rate of dental caries.
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Adults of Non-Hispanic Black Americans, Mexican-Americans are found to have two times caries rates than Hispanic white Americans. The periodontal disease is higher in Mexican-Americans and Non-Hispanic Blacks with men having a higher rate than women.
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Adults in the age of 35-44 years with less than school education are shown to have three times higher caries rate, and periodontal problems than with college degree.
In 2017, we founded our organization, Center for Oral Health Equity and Research to envision its goal of reducing radicalized oral health services for low socioeconomic communities. The center of oral health equity applies our strategic framework to educate, create awareness, alter health belief of communities, and to improve the accessibility rate of the oral health services, and to reduce the barriers of the health care system. The four principles of the strategic framework are to improve accessibility, to integrate with primary health care, to increase workforce and inter-professional education, and focus on research and evidence-based dentistry.
Our Strategic Framework:
Accessibility Rate of Oral Health Services: The percentage of the community who are able to access dental services for the lifetime without having barriers for well being of oral health. Nationally, the percentage of children having an annual visit with Medicare insurance has increased from 29 in 2000 to 48% in 2013 whereas children with private insurance rate have dramatically risen to 60% in the similar period. Among the adult population, the utilization rate of oral health services are found are declining gradually due to the limited coverage of private insurance and the less dental safety net for adults in Medicare and Medicaid. The lack of comprehensive coverage and the higher oral health needs among vulnerable communities explicitly reveal the inadequate national dental health programs, oral health policies.
Integration with Primary Care: The implementation of the strategy "Health for All" though has not been effectively implemented. The resources have not been effectively devoted to meet the high oral health demands of the vulnerable communities and hence the integrated approach of the community care model should be introduced. In spite of the epidemic nature of oral diseases, appropriate attention has not been provided to integrate it with the medical care system. The separation of medical services from dental services plays a significant role in creating oral health disparities. The integrated intervention approach which focuses on collaboration with primary care system, referral, and navigation system will be useful for vulnerable communities with lowered oral health literacy rate to navigate the complex and fragmented system which then probably results in lowering the oral health disparities. The primary solution is to develop an integrated health care system which emphasizes the importance of oral health and encourages vulnerable communities to utilize the available oral health services. The integrated intervention approach will improve the utilization of dental services and will save billions in oral health care expenses.
Professional Education and Work Force:
The lack of accessibility rate among vulnerable and marginalized communities results in the less diverse, well-trained workforce to meet their oral health needs. The sparsely populated low-income communities though have lower oral health needs but it still sends a strong signal a need for oral health services. In 2018, about 11% of dental providers are devoting their time and efforts in rural areas which would be insufficient to create oral health equity. The oral health inequity is due to the unwillingness of a dental provider to practice in rural areas and higher demands in educational and community organizations. Interprofessional education focuses on training allied dental health professionals and medical professional to deliver dental services. It exposes them to the team- orientated practice, values of peer opinion which will change the attitude of the professionals about inter-professional delivery system and hence will reduce the oral health disparities.
Evidence-based Dentistry and Research:
A method of practicing dentistry which allows using judicious integration of systematic assessments of oral health and systemic health with expertise level of the practitioner and the social and cultural values, patient preferences. However, it is perhaps impossible to implement. Two major barriers are lack of modern dental technological advancements and dental treatments and subjective preference of a patient.
The unavailability of dental technological advancements that improve preventive service is not widely distributed across several segments of the population. For Instance, differences do exist in the dental radiologic techniques across several practices due to the difference in the eligibility of the individual's health plan which will result in oral health disparities.
The cultural factor plays an important role in creating a difference in valuing the treatment and will alter the preference of dentist and patient and hence the oral health disparities do exist. The varying literacy levels between the patient and dentist will have a will have a difference of opinion in the selection of treatment options where the dentist will eventually inclined to the subjective preference of the patients and hence there is no commitment to practice evidence-based dentistry could not be effectively implemented. The limited data of dentistry and inadequate attention of researching oral health programs further widens the gap in disparities of oral health.
The research is an integral part of dentistry to provide quality dental services to communities so our organization promotes a multidisciplinary approach in conduct cutting-edge basic and translational clinical and health science research to transform clinical practice and education.
Vision:
To initiate the model of evidence-based dentistry with our research and advocacy efforts to reduce the decentralization of oral health services.
MISSION:
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To reduce the rate of oral health diseases due to environmental, social, economic and behavioral causes.
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To disseminate oral health facts and promote healthy lifestyles in low socioeconomic and marginalized sections of communities.
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To develop an affordable and accessible oral health system that provides oral health for all.
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To advocate for oral health policies that emphasize oral health in the community programs and in health programs.
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To implement the change in the work-force in the dentistry with the dental therapists model and community worker model