Disparities in children's oral health and access to dental care
Disparities in children's oral health and access to dental care
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DOI：
10.1001/jama.284.20.2625
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发表时间：
2000-11-22
影响因子：
120.7
通讯作者：
Crall, JJ
中科院分区：
文献类型：
--
作者：
Mouradian, WE;Wehr, E;Crall, JJ
龋齿可以通过社区、专业和个人措施的组合来预防，包括水氟化、专业应用的局部氟化物和牙科密封剂以及使用含氟牙膏。然而，蛀牙是儿童最常见的慢性疾病。牙科洞穴是美国儿童中最普遍的未满足的健康需求，在口腔健康和获得护理方面存在很大差异。只有五分之一的医疗补助儿童接受了他们有资格获得的预防性口腔护理。来自低收入和少数民族家庭的儿童口腔健康状况较差，牙科就诊较少，保护性密封剂较少。饮水加氟是预防龋齿最有效的措施，但只有62%的供水加氟，缺乏加氟可能会对贫困和少数民族儿童造成不成比例的影响。儿童口腔疾病具有重大的医疗和经济后果，但由于医学和牙科的分离，可能不会受到重视。龋齿的传染性、早期发病和早期干预的潜力要求在初级儿科护理中强调预防性口腔护理，以补充现有的牙科服务。然而，许多儿科医生缺乏促进口腔健康的关键知识。我们建议优先考虑医疗补助早期和定期筛查，诊断和治疗牙科服务的财政激励措施;管理式医疗责任;医疗和牙科专业培训，临床洞穴和研究的整合;和国家领导。
Dental caries can be prevented by a combination of community, professional, and individual measures including water fluoridation, professional ly applied topical fluorides and dental sealants, and use of fluoride toothpastes. Yet, tooth decay is the most common chronic disease of childhood. Dental cave is the most prevalent un met health need in US children with wide disparities existing in oral health and access to care. Only 1 in 5 children covered by Medicaid received preventive oral care for which they ave eligible. 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 caries, but only 62% of water supplies are fluoridated, and lack of fluoridation may disproportionately affect poor and minority children.Childhood oral disease has significant medical and financial consequences that may not be appreciated because of the separation of medicine and dentistry. The infectious nature of dental caries, its early onset, and the potential of early interventions require an emphasis on preventive oral care in primary pediatric care to complement existing dental services. However, many pediatricians lack critical knowledge to promote oral health. We recommend financial incentives for prioritizing Medicaid Early and Periodic Screening, Diagnostic, and Treatment dental services; managed care accountability; integration of medical and dental professional training, clinical cave, and research; and national leadership.