National Center for Education in Maternal and Child Health

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December 7, 2001

1. Resource Guide on Women's Oral Health Published

2. NCEMCH Releases Interchange on Oral Health

3. CDC Task Force Reports on Effectiveness of Oral Health Interventions

4. Study Cites Impact of Income on Children's and Adolescents' Preventive Dental Visits

5. Study Examines Preventive Medical and Dental Care Utilization Among Adolescents

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1. RESOURCE GUIDE ON WOMEN'S ORAL HEALTH PUBLISHED

The National Maternal and Child Oral Health Resource Center (NMCOHRC) recently published the Women's Oral Health Resource Guide. The guide lists resources on women's oral health, including journal articles, books, and reports. The guide also describes and provides contact information for professional organizations and federal agencies that are involved in women's oral health. Materials can be requested directly from the source or may be available for loan from NMCOHRC. The guide and NMCOHRC contact information are available at <http://www.mchoralhealth.org/PDFs/WomensResourceGuide.pdf>.

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2. NCEMCH RELEASES INTERCHANGE ON ORAL HEALTH

The National Center for Education in Maternal and Child Health (NCEMCH) recently released the MCH Program Interchange: Focus on Oral Health. The interchange, sixth in the MCH Program Interchange oral health series, lists materials of interest to the MCH community. The materials, which have been incorporated into the NCEMCH library, have been developed or are available from federal, state, and local agencies and volunteer and professional organizations. Topics include trends and statistics, education and care, early childhood caries, children with special health care needs, Medicaid and the State Children's Health Insurance Program (SCHIP), and policy and programs. Some materials are available for loan from the NCEMCH library or can be requested from the contributing agency or organization. The interchange is available at <http://www.mchoralhealth.org/resources.html>.

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3. CDC TASK FORCE REPORTS ON EFFECTIVENESS OF ORAL HEALTH INTERVENTIONS

The Centers for Disease Control and Prevention (CDC) Task Force on Community Preventive Services reports on evidence of the effectiveness of five population-based oral health interventions in Promoting Oral Health: Interventions for Preventing Dental Caries, Oral and Pharyngeal Cancers, and Sports-Related Craniofacial Injuries. The task force assessed the effectiveness of the interventions based on the systematic review and evaluation of 36 qualifying studies. The report, published in the November 30 issue of Morbidity and Mortality Weekly Report, presents information on the two interventions the task force recommends, describes how the reviews were conducted, and provides information designed to help apply the recommended interventions locally.

For prevention and control of dental caries, the task force strongly recommends these interventions:

• Community water fluoridation
• School-based or school-linked pit and fissure sealant delivery programs that involve a private dental practice or public dental clinic

The task force found insufficient evidence of the effectiveness of the remaining interventions and therefore makes no recommendation for or against them:

• Use of statewide or communitywide sealant promotion programs
• Population-based interventions for early detection of precancers and cancers
• Population-based interventions to encourage use of helmets, facemasks, and mouth guards to reduce oral-facial trauma in contact sports

The task force's finding of insufficient evidence of the effectiveness of these three interventions indicates the need for more research. Until the results of such research become available, the task force encourages health professionals to judge the usefulness of these interventions by other criteria.

Centers for Disease Control and Prevention. November 30, 2001. Promoting Oral Health: Interventions for Preventing Dental Caries, Oral and Pharyngeal Cancers, and Sports-Related Craniofacial Injuries--A Report on Recommendations of the Task Force on Community Preventive Services. Morbidity and Mortality Weekly Report 50(RR-21):1-13. Also available at <http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5021a1.htm>.

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4. STUDY CITES IMPACT OF INCOME ON CHILDREN'S AND ADOLESCENTS' PREVENTIVE DENTAL VISITS

"The percentage distribution of preventive [dental] visits for children and adolescents with higher income was significantly different from that for those in lower income groups," according to the authors of a study published in the November issue of JADA, the Journal of the American Dental Association. Noting the limited information available on access to and use of preventive dental care among children and adolescents whose families fall into the categories of "poor" (a family income at or below 100% of the federal poverty level [FPL]) or "near-poor" (a family income of 101-200% percent of the FPL), the authors used data from the 1996 Medical Expenditure Panel Survey (MEPS) to examine the impact of income on preventive dental visits made by children and adolescents under age 19.

Findings include the following:

• The percentage of non-Hispanic black and Hispanic children and adolescents who had made a preventive dental visit was lower than that of non-Hispanic white children and adolescents.
• The proportions of children and adolescents who had made a preventive dental visit and whose families were poor or near-poor were similar but lower than those of children and adolescents whose families were in the middle and higher income levels for all racial and ethnic groups.
• Children and adolescents whose families were poor or near-poor were less likely to have had a preventive dental visit.
• Children and adolescents from minority groups and children younger than 5 also were less likely to have had a preventive dental visit than nonminority and older children and adolescents.
• There were no significant relationships between age, sex, and race and ethnicity, and poverty levels, with respect to children and adolescent's use of preventive dental care.

The authors assert, "It is important to evaluate estimates of dental care utilization by looking at FPL poor and near-poor categories separately and to monitor future trends in access to care by these two groups, particularly in states that do not provide similar access for them." In addition, they believe "it is important to monitor numbers of both dental visits for any reason and dental visits for preventive care." The authors conclude that their study provides baseline information for future follow-up of the impact of intervention programs and that future studies will help determine whether the dental profession has been successful in improving access to care and utilization among the poor and near-poor child and adolescent population.

Watson MR, Manski RJ, Macek MD. 2001. The impact of income on children's and adolescents' preventive dental visits. JADA, the Journal of the American Dental Association 132(11):1580-1587. Available at <http://www.ada.org/prof/pubs/jada/index.asp>.

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5. STUDY EXAMINES PREVENTIVE MEDICAL AND DENTAL CARE UTILIZATION AMONG ADOLESCENTS

Adolescents without health insurance, those with low family incomes, and those whose parents have low education levels are significantly less likely to get regular preventive medical care, according to a study published in the December issue of the Journal of Adolescent Health. The authors used data from the 1994-96 National Longitudinal Study of Adolescent Health (Add Health) to examine the relationships between the use of preventive medical and dental services and adolescents' demographic characteristics, as well as those of their parents. Unlike many previous studies, Add Health asked adolescents themselves about their use of health services, rather than relying on the reports of their parents.

Study findings indicate the following:

• Approximately 32% of adolescents who responded to the Add Health survey had not had a physical or dental examination in the year before the survey.
• Nearly 12% of the adolescents had no health insurance. These adolescents were nearly twice as likely as insured adolescents not to have had a medical examination and more than twice as likely not to have had a dental examination in the past year.
• Black and Hispanic adolescents were more than twice as likely to have never seen a dentist than white adolescents.
• Adolescents born outside the United States were more than twice as likely to go without dental care than those born in the United States.

The authors state that their findings are "particularly timely as states implement Medicaid expansions and separate state health insurance programs under the State Children's Health Insurance Program (SCHIP)" because more adolescents will become eligible for coverage. They say that their findings also "demonstrate the need to promote the importance of preventive medical and dental care to previously uninsured teens, many of whom may be unaccustomed to regular well-child visits," to help ensure that adolescents will use the services for which they are eligible.

Yu SM, Bellamy HA, Schwalberg RH, et al. 2001. Factors associated with use of preventive dental and health services among U.S. adolescents. Journal of Adolescent Health 29:395-405.

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MCH Alert © 2001 by National Center for Education in Maternal and Child Health and Georgetown University. MCH Alert is produced by the National Center for Education in Maternal and Child Health under its cooperative agreement (MCU-119301) with the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services. The Maternal and Child Health Bureau reserves a royalty-free, nonexclusive, and irrevocable right to use the work for federal purposes and to authorize others to use the work for federal purposes.

Permission is given to forward MCH Alert to individual colleagues. For all other uses, requests for permission to duplicate and use all or part of the information contained in this publication should be sent to MCH Alert Editor, National Center for Education in Maternal and Child Health, at mchalert@ncemch.org

The editors welcome your submissions, suggestions, and questions. Please contact us at the address below.

EDITORS: Jolene Bertness, Tracy Lopez

COPYEDITOR: Beth Rosenfeld

FOUNDING EDITOR: Laura Kavanagh

National Center for Education in Maternal and Child Health
Georgetown University

2000 15th Street North, Suite 701
Arlington, VA 22201
(703) 524-7802
(703) 524-9335 (fax)
E-mail: mchalert@ncemch.org
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