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Children
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Oral Heath Disparities in Children and Adolescents: Determinants and Challenges
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Oral Heath Disparities in Children and Adolescents: Determinants and Challenges

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Dentistry & Oral Medicine".

Deadline for manuscript submissions: 30 January 2025 | Viewed by 2165

Special Issue Editor

Dr. Caroline M. Sawicki

E-Mail Website
Guest Editor
Division of Pediatric and Public Health Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
Interests: pain; anxiety; stress; pediatric dentistry

Special Issue Information

Dear Colleagues,

Access to dental care for prevention and treatment is crucial to ensure optimal oral health. Dental care has recently been identified as the most prevalent unmet health need among children in the United States. The disparity in oral health among children and adolescents is a pressing concern, highlighting inequities in access to dental care and meeting specific oral health needs. Financial barriers constitute a significant deterrent to obtaining dental care, especially for children who reside in low-income households. Children from low-income and minority families have poorer oral health outcomes, fewer dental visits, and fewer protective sealants. Water fluoridation is the most effective measure in preventing dental caries, though a lack of fluoridation may disproportionately affect poor and minority children. Oral health is also the most prevalent unmet health need of children with special health care needs.

The goal of this Special Issue is to raise awareness and highlight the current issues surrounding oral health determinants and disparities in children and adolescents. We invite manuscripts that comprehensively describe the prevailing understanding of oral health determinants and disparities in youth and focus their attention on addressing the oral health statuses of children and their access to care.

We welcome original research reports, reviews, and meta-analyses for submission to this Special Issue, and we encourage the submission of proposals for interdisciplinary work and collaborative research. We look forward to receiving your contributions and creating a Special Issue with the aim of providing readers with updated research findings and novel data in understanding the oral health determinants and disparities in children and adolescents.

Dr. Caroline M. Sawicki
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • access to care
  • oral health determinants
  • oral health disparities
  • children’s oral health
  • childhood caries
  • special health care needs
  • untreated dental disease

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Published Papers (3 papers)

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Research

12 pages, 446 KiB  
Article
Caries Level in 3-Year-Olds in Germany: National Caries Trends and Gaps in Primary Dental Care
by Ruth M. Santamaría, Christian H. Splieth, Roger Basner, Elisabeth Schankath and Julian Schmoeckel
Children 2024, 11(12), 1426; https://doi.org/10.3390/children11121426 - 26 Nov 2024
Viewed by 437
Abstract
Background: Nationally representative long-term data on caries in the primary dentition are rare but essential for determining the need for prevention and treatment. This research assessed the prevalence and trends of dental caries in 3-year-old children across Germany, with national data analyzed and [...] Read more.
Background: Nationally representative long-term data on caries in the primary dentition are rare but essential for determining the need for prevention and treatment. This research assessed the prevalence and trends of dental caries in 3-year-old children across Germany, with national data analyzed and compared with the corresponding data for 6–7-year-olds. Methods: Data were extracted from the most recent German National Oral Health Survey in 2016. Children aged 3 years were examined by calibrated dentists in 10 German regions using the WHO criteria for d3–4mft, including assessment of initial carious lesions d1–2mft. In addition, the Significant Caries Index (SiC), the Care Index (CI) and the Specific Affected Caries Index (SaC) were considered to identify provision of care and risk groups. Results: In a total of 95,127 3-year-old preschool children, caries prevalence was 13.7% with a mean d3–4mft of 0.48. Including initial carious lesions, prevalence increased to 18.7% (mean 0.67 d1–4mft). Dependent on the German region, d3–4mft values varied noticeably from 0.38 (Schleswig-Holstein) to 0.58 (Saxony-Anhalt and Berlin). Comparing data from 3-year-olds to 6–7-year-olds, the d3–4mft value for 6–7-year-olds (1.73) was more than three times higher than that for 3-year-olds (0.48). The SiC value was 1.47 for 3-year-olds and 4.88 for 6–7-year-olds, while the SaC values were 3.57 and 3.97, respectively. The Care Index was low for both groups (26.1% and 57.5%, respectively). Conclusions: Germany exhibited a high level of dental caries in the primary dentition for 3 (13.7%) to 6–7-year-olds (44%) children. This large cross-sectional study revealed considerable room for improvement in the early caries prevention and treatment within the well-equipped German dental health infrastructure. Full article
(This article belongs to the Special Issue Oral Heath Disparities in Children and Adolescents: Determinants and Challenges)
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7 pages, 592 KiB  
Article
Caries Incidence in School-Based Prevention Programs in the Presence of Interval Censoring
by Ryan Richard Ruff
Children 2024, 11(11), 1350; https://doi.org/10.3390/children11111350 - 5 Nov 2024
Viewed by 557
Abstract
Background/Objectives: School-based caries prevention can increase access to critical dental services and reduce oral health inequities. However, little is known regarding the incidence of dental caries in children participating in school caries prevention, and caries diagnosis is often interval censored. Methods: In this [...] Read more.
Background/Objectives: School-based caries prevention can increase access to critical dental services and reduce oral health inequities. However, little is known regarding the incidence of dental caries in children participating in school caries prevention, and caries diagnosis is often interval censored. Methods: In this paper, we used data from a longitudinal, school-based, randomized clinical trial of minimally invasive treatments for dental caries to estimate the per-visit incidence rate and compare the hazard of dental caries in children receiving either silver diamine fluoride or glass ionomer dental sealants. To account for interval censoring, we used semiparametric transformation models for univariate failure time data and imputed caries incidence using G-imputation. Results: There were 3040 children that met inclusion criteria for analysis, 1516 (49.9%) of which were randomly assigned to receive silver diamine fluoride and 1524 (50.1%) were assigned to receive glass ionomer dental sealants and atraumatic restorations. There were no differences in the hazard of caries between treatments (HR = 0.99, 95% CI = 0.72, 1.24), while children with caries at baseline had a significant increase in the hazard of new caries (HR = 2.54, 95% CI = 2.26, 2.83) compared to those that were caries free. The per-visit caries incidence ranged from 4.8 to 11.1 at the individual level and increased with each successive study observation. Conclusions: School-based caries prevention can positively affect caries incidence, and the results can be used to inform future program design and implementation. Full article
(This article belongs to the Special Issue Oral Heath Disparities in Children and Adolescents: Determinants and Challenges)
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15 pages, 2422 KiB  
Article
Pediatric Dentists’ Practice Patterns in the Screening, Diagnosis, and Management of Temporomandibular Disorders
by Caroline M. Sawicki and Linda Sangalli
Children 2024, 11(10), 1168; https://doi.org/10.3390/children11101168 - 26 Sep 2024
Viewed by 721
Abstract
Background/Objectives: Pain associated with temporomandibular disorders (TMDs) is the main non-odontogenic cause of orofacial pain among youth. Pediatric dentists are often the first healthcare practitioners to perform a comprehensive oral examination in children, which should include evaluation of the temporomandibular joint, masticatory muscles, [...] Read more.
Background/Objectives: Pain associated with temporomandibular disorders (TMDs) is the main non-odontogenic cause of orofacial pain among youth. Pediatric dentists are often the first healthcare practitioners to perform a comprehensive oral examination in children, which should include evaluation of the temporomandibular joint, masticatory muscles, and surrounding structures for signs and/or symptoms of TMD. This study assessed pediatric dentists’ practice patterns in the screening, diagnosis, and management of TMD. Methods: A 19-item online survey was used to assess pediatric dentists’ clinical practice patterns and perceived knowledge and comfort levels in the screening, diagnosis, and management of TMD. The survey was distributed in July 2024, with a one-month window open for the study. Confidence levels and perceived knowledge were compared according to years from graduation and frequency of TMD screening assessment with ANOVA or independent t-test, as appropriate. Open-ended items were analyzed thematically. Results: A total of 206 pediatric dentists and pediatric dentistry residents participated in this study. A share of 72.8% of respondents reported that up to 25% of their patients per week present with signs and symptoms of TMD. About one-fifth of pediatric dental providers never complete a screening history for TMD (22.1%) or a clinical assessment of TMD-related structures (21.6%). There was overall low self-perceived knowledge and confidence among pediatric dentists regarding the diagnosis, screening, and management of TMD in children and adolescents, regardless of the number of years from graduation. Respondents who reported seeing up to 50% of TMD patients reported significantly more knowledge and confidence in diagnosing pediatric TMD than those who encountered fewer TMD patients. An overwhelming majority (81.6%) indicated a need for continuing education courses and training focused on the management of TMD in pediatric patients. Conclusions: Providers reported low confidence and self-perceived knowledge about TMD in pediatric populations, a high rate of referral of patients with TMD, and a particular interest for professional development opportunities focused on management of TMD. Full article
(This article belongs to the Special Issue Oral Heath Disparities in Children and Adolescents: Determinants and Challenges)
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