Dental hygienists promote oral health and provide preventive services to patients throughout their lifespan. The Commission on Dental Accreditation, Dental Hygiene Standards emphasize that graduates must be competent in providing dental hygiene care for all patient populations, including children.1 In fact, promoting pediatric oral health begins prior to birth with the expectant mother and/or caregiver. Oral health care to include education is essential during pregnancy; specifically, around the prevention and treatment of dental caries for the mother and unborn child.2 In the U.S., from 2013-2016, roughly 30% of women aged 20-44 years had untreated dental caries.3 Expectant mothers and caregivers with untreated dental caries, increases their child’s risk for dental caries. Caries-causing bacteria that are transmitted via vertical (e.g., mother/caregiver to child) and horizontal (e.g., family or peers similar in age) also increases this risk.4 Dental caries experiences among children remain a global public health concern. Globally, in 2019, the estimated prevalence and cases of dental caries in primary teeth among children aged 1-9 years was 42.7% and 514 million, respectively.5 Early childhood caries (ECC) is of importance to young children, as it is the result of one or more decayed, filled, or missing primary tooth due to decay among those who are ≤ 71 months. Among children aged ≤ 3 years, any evidence of a smooth-surface decayed lesion is considered severe early childhood caries (S-ECC).6 While dental caries continues to impact children at an early age, it is largely preventable, and the risk factors are modifiable.7 Dental caries is considered a noncommunicable disease, and factors associated with the cause and prevention are influenced by social determinants of health (SDoH).7 Social determinants of health are conditions such as economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social community context that influence individual’s health, well-being and quality of life.8 When a caregiver and their family have one or more SDoH, it may be challenging to focus on oral health behaviors and practices for themselves or the child. Therefore, these risk factors must be considered when promoting pediatric oral health with caregivers, families, and other health professionals. Educating and providing expectant mothers or caregivers with resources to share with family members who will be engaging with or caring for the child is equally important.
Dental hygienists have always been leaders and partners in the community promoting pediatric oral health through Head Start programs, school-based dental sealant programs, and non-traditional spaces such as medical settings. Dental hygienists have a vital role with Head Start through the Dental Hygienist Liaison (DHL) program; a partnership between the National Center on Health, Behavioral Health and Safety (NCHBHS) and the American Dental Hygienists’ Association.9 This program provides an opportunity for each state to have a dental hygienist collaborate with Head Start programs, staff, families, state and local organizations to promote access to oral care and dental homes, share information on preventing oral diseases, and promote healthy behaviors (e.g., oral health practices, nutrition, regular dental visits) for pregnant women and children enrolled in Head Start.9 The school-based dental sealant program is another oral health promotion initiative in which dental hygienists have had an important role in providing care for children. In 2019, 64% of states reported having a school-based dental sealant program.10 This program allows oral health professionals “to meet the students where they are.” As a result, it increases the number of children receiving dental sealants, prevents dental caries, and reduces oral health disparities among children from low-income households.10 Dental hygienists working in non-traditional settings such as schools or mobile units, increase access to care and promote oral health across the lifespan. In 40 states, the statutes allow dental hygienists to practice in medical settings such as hospitals, long-term care units, primary care, or specialty clinics, federally qualified health centers, free clinics, tribal clinics, public health settings, just to name a few.11 Dental hygiene collaborations in non-traditional settings provide an opportunity to continue addressing preventable oral diseases experienced by children.
Children’s Oral Health Month is a time to reflect on opportunities for growth and initiatives to continue. There is a continued opportunity for growth in reducing dental caries among children. Based on the Healthy People 2030 report, there has been some improvement in the reduced proportion of children and adolescents with active and untreated tooth decay.12 Specifically, there has been a 1% change from baseline 13.4% (2013-2016) to 12.4% (2017-2020, latest reported data) among children and adolescents aged 3-19 years with active or untreated dental caries. However, the target goal of 10.2% is projected by 2030. Early interventions that focus on incorporating the SDoH and the family unit when discussing pediatric oral health behaviors and practices will be imperative in the continued efforts to reduce childhood dental caries. Dental hygiene collaborations with initiatives such as the Head Start program, school-based dental sealant programs, and medical settings have addressed disparities and increased access to care for children and families. Promoting pediatric oral health is a continued conversation that requires partnerships with health professionals, the community, caregivers, and families. As oral health prevention specialists, dental hygienists should be leading these conversations.
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