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NEW YORK, Mar 26 (Reuters Health) - Free, universal access to full dental care does not brush away the dental difference between children from different socioeconomic backgrounds, according to a report.
Children's home dental practices and their parents' educational level were significantly related to dental health, Drs. Amid I. Ismail and Woosung Sohn of the University of Michigan's School of Dentistry found in a study of Canadian first graders. Their report is published in the March issue of the Journal of the American Dental Association.
The researchers evaluated the dental history and dental health of more than 1,200 first-graders in Nova Scotia. The province has provided free, universal dental care since 1975, so all the children in the study had access to care since birth.
The researchers interviewed parents about children's dental care history and examined the children themselves for cavities and other signs of poor dental health.
More than 90% of the children had their first visit to the dentist by at least age 2 and continued to have annual checkups, Ismail and Sohn report. But children whose parents had completed a university education had significantly better dental health than those whose parents had a lower educational level, with fewer cavities, fillings and other signs of tooth decay.
Fluoridation in school drinking water also made a difference in the children's dental health, the researchers found. Those who attended schools with an optimal fluoridation level had significantly fewer cavities, and their dental decay scores were almost half those of children whose schools had less optimal levels.
Ismail and Sohn note that providing access to dental care does not by itself accomplish the goal of eliminating disparities in dental health. Other factors "point to the importance of positive oral health behaviors and exposure to fluoride in reducing the burden of (cavities) in children," they write.
"Oral health cannot be promoted solely via the provision of professional dental care. Rather, it must be promoted at home and through community-based preventive services, general oral health promotion programs such as school-based education, and the mass media's promotion of dental appearance."
SOURCE: Journal of the American Dental Association 2001;132:295-303.
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