Oral Health of Women and Children: Progress, Challenges, and Priorities

SignificanceWhat is already known on this subject? Existing publications discuss the extent to which women, children, and adolescents experience oral health problems, effective policies and programs, and the need to integrate oral health care into the overall health care system.What does this study add? This manuscript provides a historical perspective on efforts and progress made to address the causes of high oral disease rates, unmet oral health treatment needs, and profound oral health disparities. It also discusses challenges that four major programs have encountered in working to achieve better oral health outcomes. In addition, it makes recommendations for improving oral health and calls for a national workshop to develop a framework for future actions. IntroductionTooth decay remains the most prevalent chronic disease in children and adults, even though it is largely preventable. Studies show that mothers' oral and overall health is linked to children's oral health and pregnancy outcomes. This paper examines achievements during the last 20 years, assesses current challenges, and discusses future priorities.Oral health statusData show a modest improvement in children's oral health during the last 20 years; however, tooth decay still affects more than half of adolescents. According to national survey data, about 26% of working-age adults had untreated tooth decay. Overall, significant oral health disparities by race/ethnicity and income persist.Dental service utilizationThe annual dental visit rate for children in the 2015 Medical Expenditure Panel Survey was 48%. Among children enrolled in Medicaid, dental visit rates increased from 18% in 1993 to nearly 50% in 2018. About 46% of women are estimated to receive teeth cleaning during pregnancy. Over the years, race or ethnicity and income-level differences in dental visits observed in the early 2000s have narrowed substantially in children but not among pregnant women.DiscussionMany effective interventions are available at the community and individual levels but are underutilized. Lack of integration of oral health into the overall health care system and programs, community conditions, poverty, and limited health literacy make it difficult for families to engage in healthy habits, use preventive interventions, and access treatment promptly.ConclusionTo further improve oral health, policy and system reforms are needed to address the factors mentioned above. Therefore, we urge the federal Maternal and Child Health Bureau to take steps to convene a workshop to develop a framework for future actions.