Elsevier

Dental Abstracts

Volume 60, Issue 5, September–October 2015, Pages 241-242
Dental Abstracts

The Big Picture
Failing to address the problem

https://doi.org/10.1016/j.denabs.2015.05.002Get rights and content

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Background

Although caries is almost entirely preventable, it remains the most common chronic disease in children and affects the health of many children and adults. At least 20% of those living in the United States have one or more untreated carious lesions, with those at the lower end of the income scale nearly twice as likely to have untreated lesions compared to other adults. Almost half of children age 5 years have already experienced tooth decay, and dental problems keep more than half of all new

Three-Legged Stool of Access

To lower rates of tooth decay and establish good oral health requires three essentials legs:

  • 1.

    Dental care must be affordable through lower costs or through programs such as dental insurance or Medicaid.

  • 2.

    Patients must be able to find dentists who accept their insurance and who can be reached with reasonable ease.

  • 3.

    Patients must be willing to access the dental services, having understood the importance of oral health and being motivated to follow through with action.

All three factors must be present

Vulnerable Populations

Among school-aged children untreated caries is the most common chronic disease. Expanded coverage has been made available through changes in Medicaid and the Affordable Care Act, but few practitioners see Medicaid patients because reimbursement rates are so low, the paperwork burden is so high, and Medicaid patients have notoriously high “no-show” rates, which places an economic burden on the dental office. Early childhood preventive dental services are provided in 48 states to children

Future Directions

Risk level assessment is essential in providing good caries management. This assessment includes determining the likelihood of new cavitated or incipient caries lesions over a certain period of time and the likelihood that the size or activity of current lesions will change. Research efforts are directed toward identifying therapeutic agents to treat caries disease and not simply address the results of the process. It is also hoped that a drug will be created to attack the oral biofilm and

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Syrop J: The caries conundrum. Inside Dentistry vol 11, issue 3. 2015

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