Lancaster Physician Winter 2018 - 19

winter 2018

Children's Dental Health

I

n 2000, David Stacher, the US surgeon
general, released a milestone report,
Oral Health in America, in which
he stated, "oral health and general
health are inseparable." Since then there
has been ample research to link chronic
oral infections with cardiovascular disease,
stroke, respiratory issues, and diabetes.
Most of this research pertains to the adult
population. But how does poor oral health
impact the most vulnerable, our children?
To be sure, dental caries is the most
prevalent disease affecting children 2 to 11
years old. It is four times more common
than asthma among those 14 to 17 years
of age. By the time individuals turn 20,
9 out of 10 will have experienced tooth
decay. While there has been some improvement in the prevalence of dental caries,
especially in the permanent dentition in
6- to 19-year -olds, there has been a 17
percent increase in dental caries in children
between the ages of 2 and 4 since 1994.
Additionally, there are significant disparities in the experience with dental disease
by income. Disadvantaged children suffer
two times the rate and severity of dental
caries, and their disease is twice as likely to
go untreated as that of their more affluent
peers. In 2007, the story of the death of
12-year-old Deamonte Driver in Baltimore
secondary to an infection of odontogenic
origin resulted in journalistic, public, and
political indignation over how a "simple"
dental infection, which could have been
cured by an $80 extraction (had it been
available in a timely manner), resulted
in complex and unsuccessful medical
treatment costing $250,000.
Deamonte's death was tragic. For most
children, the consequences of poor oral
health, while much less drastic, can still
be significant. The craniofacial complex
and housed oral structures, as Dr. Stacher
said, "represent the very essence of our
humanity." Untreated dental disease
invariably results in pain that is difficult to
escape and affects basic functions such as
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LANCASTER

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PHYSICIAN



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