Oral Health

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.


  1. Gehshan S. Foundations’ role in improving oral health: nothing to smile about. Health Affairs, 27(1):281-287, 2008.
  2. 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.
  3. 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

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;
  • financing;
  • 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

Additional Online Resources