Subject(s)
Government Programs , Health Policy , Oral Health , Policy Making , Societies, Dental , State Government , Dental Health Services , Health Care Coalitions , Health Care Reform , Health Services Accessibility , Humans , Maryland , Medicaid , Public-Private Sector Partnerships , United StatesSubject(s)
Health Priorities , Health Promotion , Oral Health , Community Networks , Cooperative Behavior , Dental Care/legislation & jurisprudence , Health Education, Dental , Health Literacy , Health Policy , Health Priorities/legislation & jurisprudence , Health Promotion/legislation & jurisprudence , Health Services Accessibility/legislation & jurisprudence , Humans , Maryland , Oral Health/legislation & jurisprudence , Public-Private Sector PartnershipsABSTRACT
PURPOSE: The purpose of this study was to describe dental caries experience in the primary and permanent dentitions of Maryland schoolchildren in kindergarten and third grade, with an emphasis on untreated disease. METHODS: Data came from the Survey of the Oral Health Status of Maryland Schoolchildren, 2000--2001. Outcome variables were measures of dental caries experience for primary and permanent teeth. Dental caries was scored only for lesions that were >0.5 mm, measured with a periodontal probe. Radiographs were not used. Descriptor variables included grade level, gender, race/ethnicity, eligibility for free or reduced meals at school, parent/ guardian education, dental insurance status, and region. The statistical software program SUDAAN was used to produce weighted estimates and account for the complex sampling design. RESULTS: More than 2 in 10 schoolchildren had a history of dental caries. In children with a history of disease, approximately half of the experience was due to untreated decay. Controlling for confounders, disparities in untreated dental caries were significantly associated with region, race/ethnicity, and parent/guardian education. CONCLUSIONS: Success in meeting the dental caries treatment needs in children will require attention to multiple family-level, community-level, and system-level barriers, especially among low socioeconomic status populations. Unless barriers are overcome, dental caries disparities will continue in Maryland.
