The 2000 Surgeon General report states that oral health in America is a significant health factor for adults and children alike. Dental caries (tooth decay) is the single most common chronic childhood disease, 5 times more common than asthma and 7 times more common than hay fever. Once dental caries begin, they will progress until treated (Gehshan 2008). Unfortunately, this fact became a devastating reality for the family of Deamonte Driver, who at the age of 12 died from a bacterial infection that had spread to his brain. The infection originated from a decaying tooth. (Read the Washington Post article here.)
Oral disease has been associated with increased risk of cardiovascular disease, stroke, poor diabetes control, and premature childbirth (Rautemaa 2007). Studies have shown that 90% of the isolates associated with dental carries come from Streptococcus mutans, which use the sucrose in our diet to facilitate the formation of plaque. Research to reduce plaque formation through diet continues to gain support and offers insight into the significance between the association of nutrition, oral hygiene, and overall health.
Furthermore, the social impact of oral diseases in children is substantial. More than 51 million school hours are lost each year to dental-related illness. Poor children suffer nearly 12 times more restricted-activity days than children from higher-income families. Pain and suffering due to untreated diseases can lead to problems in eating, speaking, and attending to learning. “Diet, nutrition, sleep, psychological status, social interaction, school, and work are affected by impaired oral and craniofacial health” (Oral Health in America: A Report of the Surgeon General 2000).
In February 2009, Congress signed into law the Children’s Health Insurance Program Reauthorization Act (CHIPRA). As part of CHIPRA all states must provide comprehensive dental coverage to CHIP recipients and expand coverage to provide dental coverage to CHIP eligible children who otherwise have health coverage. For a complete explanation of CHIPRA and areas of provision visit Centers for Medicare and Medicaid Service: Children’s Health Insurance Program Reauthorization Act.
- Gehshan S. Foundations’ role in improving oral health: nothing to smile about. Health Affairs, 27(1):281-287, 2008.
- Rautemaa RR, Lauhio AA, Cullinan MP & Seymour GJ. Oral infections and systemic disease—an emerging problem in medicine. Clinical Microbiology & Infection, 13(11):1041-1047, 2007.
- U.S. Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health, 2000.
Publications from the HCH Clinicians’ Network
- Vision & Oral Health among Individuals Experiencing Homelessness (2015) | In Focus: A Quarterly Research Review
- Dental and Vision Care for Homeless Patients (2015) | HCH Clinicians’ Network | Healing Hands
- Oral Health Recommendations & Checklist (2009)
- Pediatric Oral Health: What Every HCH Provider Should Know (2007) | Healing Hands
- Your Mouth on Meth (2006) | Patient Education Pamphlet
- “Got Milk?” Responding to Pediatric Dental Injuries of Homeless Children (2005) | Case Report
- Filling the Gaps in Dental Care (2003) | Healing Hands
Clinical Guidelines & Practices
- Promising Practices for Health Center Oral Health Programs | National Network for Oral Health Access | NNOHA recognizes that oral health programs have different environments, infrastructure, cultures, availability of resources, local burden of disease and political considerations. Therefore, end-users need to critically assess the promising practice information and adapt ideas and strategies to better meet the needs of their unique Health Center service populations. The goal of NNOHA’s Promising Practices webpage is to share promising practices between Health Centers and cultivate innovative strategies and promising practices among Health Center oral health programs to improve oral health and reduce disparities.
- Safety Net Dental Clinic Manual | National Maternal and Child Oral Health Resource Center | Lack of access to dental care is a real problem for uninsured and underinsured individuals and families. This user-friendly, highly practical manual results from a collaboration among the Ohio Department of Health, the Indian Health Service, and the Association of State and Territorial Dental Directors. It presents a step-by-step approach for establishing a safety net dental clinic including chapters on:
- building community partnerships;
- strategic planning and needs assessment;
- facility needs for fixed dental clinic sites as well as mobile and portable dental care delivery systems;
- staffing size and mix;
- operations including details and examples of policies, procedures, guidelines and regulations; and
- quality assurance and accreditation.
- Sample Dental Forms | Health Care for the Homeless Information Resource Center | Forms specific to oral health from homeless health sites around the country. The collection includes dental records, client surveys, referral forms, medical/dental histories and a sample plan of treatment. You may print any of the samples to use as a starting point as you develop your own customized forms.
HCH Program Highlight
This video clip is from the Boston Health Care for the Homeless Program. Hear clients share their experiences of receiving good dental care from one of the programs’ esteemed dentists, Dr. Alan Filzer.
Research of Interest
- DiMarco M, Ludington S & Menke E. Access to and utilization of oral health care by homeless children/families. Journal of Health Care for Poor and Underserved, 21(2): 67-81, 2010.
- Fisher-Owens S, Barker J, Adams S, Chung L, Gansky S, Hyde S & Weintraub J. Giving policy some teeth: routes to reducing disparities in oral health. Health Affairs (Project Hope), 27(2):404-412, 2008.
- Milgrom P, Zero D & Tanzer J. An examination of the advances in science and technology of prevention of tooth decay in young children since the Surgeon General’s Report on Oral Health. Academic Pediatrics, 9(6):404-409, 2009.
Additional Online Resources
- Academy of General Dentistry
- American Academy of Pediatric Dentistry
- American Academy of Periodontology
- American Dental Association
- American Dental Industries Mobile Health
- Association of Clinicians for the Underserved: Oral Health. This page provides information on ACU’s Early Childhood Caries Project and links to professional education on oral health, tools for oral health, advocacy and state resources, and more.
- Centers for Disease Control and Prevention
- Colgate. Colgate-Palmolive Company offers dental professionals free Colgate toothpaste patient samples.
- Crest. Procter & Gamble offers dental professionals free Crest toothpaste patient samples. This site also includes many patient education materials in multiple languages.
- Delta Dental. This site on Oral Health & Wellness features a wealth of information for clients. Especially useful are the sections on diabetes and oral health, mouth problems and HIV, and the oral-systemic health connection.
- Hispanic Dental Association
- Homeless Veterans Dental Program. The Department of Veterans Affairs Office of Dentistry produces the Homeless Veterans Dental Program Newsletter.
- Methamphetamine Use and Oral Health. This section of the American Dental Association’s website includes an overview, what providers should look for, what to do when you suspect methamphetamine use, and links to additional resources.
- National Network for Oral Health Access
- Oral Health America