It's More Common Than You Think

Dental caries is the most prevalent disease of childhood, occurring four times more frequently than asthma. National surveys have reported that 41 percent of two- to 11-year-olds had dental caries in their primary teeth, and 42 percent of six- to 19-year-olds had caries in their permanent teeth. Reports from the National Center for Health Statistics indicated higher prevalence, with 23 percent of two- to five-year-olds and 56 percent of six- to eight-year-olds having caries in their primary teeth and 58 percent experiencing caries in their permanent teeth during adolescence. The racial and ethnic disparities in children's access to dental care in the United States persist, with a higher prevalence of dental caries observed in vulnerable populations with limited social and economic support and resources. Children's utilization of dental care services covered by public insurance has increased over the last few decades. However, children's oral health is still a growing concern. A 2017 study by Dye et al. found that, although untreated dental caries have decreased for all two to eight-year-olds, nearly half of the six to eight-year-olds, roughly half, experienced dental caries in their primary teeth with no change between 1999 and 2004 and between 2011 and 2014. During the same periods, however, caries prevalence significantly increased from 60 percent to 69 percent in Hispanic six- to eight-year-olds. Also, Hispanic children are most likely never to have seen a dentist. Among children who are publicly insured, Hispanic and African American children have long periods between dental visits as well as higher rates of caries. The increase in treated dental caries suggests that more children are accessing services, but it also drives home an important point: we are getting to children too late. With every year past age one that we delay dental visits, it is increasingly likely that dental disease can no longer be prevented or arrested, but will require surgical intervention. The link between child abuse and neglect and dental caries is also getting attention, and research suggests an association between them. Viewing children in the context of their social situation, including their family's social capital, provides a vital lens to help identify those children who may require the most considerable early support and intervention to prevent poor health outcomes later in childhood.