Children in the United States miss more than 51 million school hours each year due to dental-related problems such as dental caries, according to the U.S. Department of Health & Human Services.

In a report by the Center for Disease Control regarding U.S. Health, dental caries is one of the most common childhood diseases. Utilization of dental care and the prevalence of untreated dental caries vary by income and by race and ethnicity, with those in higher income groups and non-Hispanic whites having higher utilization and lower untreated dental caries prevalence.

Chronic Tooth Disease In Children

Dental caries, also known as tooth decay, is one of the most common chronic diseases of childhood in the United States. The CDC report also highlights that utilization of dental care and the prevalence of untreated dental caries vary by income and by race and ethnicity, with those in higher income groups and non-Hispanic whites having higher utilization and lower untreated dental caries prevalence.

Dental caries is a chronic disease that affects the teeth of children and adults alike. However, it is most common among children. According to the CDC, more than half of children aged 6 to 8 have had a cavity in at least one of their baby teeth, and more than half of adolescents aged 12 to 19 have had a cavity in at least one of their permanent teeth. The prevalence of dental caries in children aged 2 to 5 years was 23%, reflecting a decrease of 5 percentage points since 1999–2004. However, significant disparities persist in the receipt of childhood preventive dental care, with young children, uninsured children, children living in poverty, non-Hispanic Black children, children from non–English-speaking households including immigrants and refugees, and children with special health care needs less likely to receive needed preventive oral health care.

Socioeconomic Disparities

The utilization of dental care and the prevalence of untreated dental caries vary by income and by race and ethnicity. Children aged 5 to 19 years from low-income families are twice as likely (25%) to have cavities, compared with children from higher-income households (11%). The prevalence of untreated dental caries in America’s youth is 13.0%. The prevalence decreased as family income increased, with youth with family incomes less than 100% of the federal poverty level having the highest prevalence. Disparities in untreated dental caries exist along race and Hispanic origin. Significant disparities persist in the receipt of childhood preventive dental care, with young children, uninsured children, children living in poverty, non-Hispanic Black children, children from non–English-speaking households including immigrants and refugees, and children with special health care needs less likely to receive needed preventive oral health care.

The reasons for these disparities are multifaceted. Factors such as lack of access to dental care, lack of dental insurance, and low socioeconomic status contribute to the disparities in dental care utilization and untreated dental caries prevalence. In addition, cultural beliefs and practices, language barriers, and lack of knowledge about oral health care also contribute to the disparities. The American Academy of Pediatrics (AAP) policy statement “Early Childhood Caries in Indigenous Communities” focuses on the specific challenges within this population. American Indian/Alaska Native children have the highest rates of dental caries in the United States. There are numerous reasons for these disparities, which are further explained in the Indian Health Service Data Brief “Oral Health of American Indian and Alaska Native Children Aged 1–4 Years: Results of the 2018–19 IHS Oral Health Survey.“

CDC Recommendations

The CDC recommends that children visit a dentist by their first birthday to spot signs of problems early. Fluoride varnish can prevent about one-third (33%) of cavities in the primary (baby) teeth. Children living in communities with fluoridated tap water have fewer cavities than children whose water is not fluoridated. Similarly, children who brush daily with fluoride toothpaste will have fewer cavities. Dental sealants can also prevent cavities for many years. Applying dental sealants to the chewing surfaces of the back teeth prevent 80% of cavities. Parents and caregivers can wipe gums twice a day with a soft, clean cloth in the morning after the first feeding and right before bed to wipe away bacteria and sugars that can cause cavities. When teeth come in, start brushing twice a day with a soft, small‑bristled toothbrush and plain water.