No abstract

No abstract

Understanding caries etiology and distribution is central to understanding potential opportunities for and likely impact of new biotechnologies and biomaterials to reduce the caries burden worldwide. This review asserts the appropriateness of characterizing caries as a "pandemic" and considers static and temporal trend reports of worldwide caries distribution. Oral health disparities within and between countries are related to sugar consumption, fluoride usage, dental care, and social determinants of health. Findings of international and U.S. studies are considered in promoting World Health Organization's and others' recommendations for science-based preventive and disease management interventions at the individual, clinical, public health, and public policy levels.

CONTEXT Dental sealants and composite filling materials containing bisphenol A (BPA) derivatives are increasingly used in childhood dentistry. Evidence is accumulating that BPA and some BPA derivatives can pose health risks attributable to their endocrine-disrupting, estrogenic properties. OBJECTIVES To systematically compile and critically evaluate the literature characterizing BPA content of dental materials; to assess BPA exposures from dental materials and potential health risks; and to develop evidence-based guidance for reducing BPA exposures while promoting oral health. METHODS The extant toxicological literature and material safety data sheets were used as data sources. RESULTS BPA is released from dental resins through salivary enzymatic hydrolysis of BPA derivatives, and BPA is detectable in saliva for up to 3 hours after resin placement. The quantity and duration of systemic BPA absorption is not clear from the available data. Dental products containing the bisphenol A derivative glycidyl dimethacrylate (bis-GMA) are less likely to be hydrolyzed to BPA and have less estrogenicity than those containing bisphenol A dimethacrylate (bis-DMA). Most other BPA derivatives used in dental materials have not been evaluated for estrogenicity. BPA exposure can be reduced by cleaning and rinsing surfaces of sealants and composites immediately after placement. CONCLUSIONS On the basis of the proven benefits of resin-based dental materials and the brevity of BPA exposure, we recommend continued use with strict adherence to precautionary application techniques. Use of these materials should be minimized during pregnancy whenever possible. Manufacturers should be required to report complete information on the chemical composition of dental products and encouraged to develop materials with less estrogenic potential.

The mouth is an obvious portal of entry to the body, and oral health reflects and influences general health and well being. Maternal oral health has significant implications for birth outcomes and infant oral health. Maternal periodontal disease, that is, a chronic infection of the gingiva and supporting tooth structures, has been associated with preterm birth, development of preeclampsia, and delivery of a smallfor-gestational age infant. Maternal oral flora is transmitted to the newborn infant, and increased cariogenic flora in the mother predisposes the infant to the development of caries. It is intriguing to consider preconception, pregnancy, or intrapartum treatment of oral health conditions as a mechanism to improve women's oral and general health, pregnancy outcomes, and their children's dental health. However, given the relationship between oral health and general health, oral health care should be a goal in its own right for all individuals. Regardless of the potential for improved oral health to improve pregnancy outcomes, public policies that support comprehensive dental services for vulnerable women of childbearing age should be expanded so that their own oral and general health is safeguarded and their children's risk of caries is reduced. Oral health promotion should include education of women and their health care providers ways to

No abstract

Multifactorial policy alternatives to increase the availability of dental professionals who care of the underserved include proposed changes in dental education, licensure, scope of practice for allied dental personnel, and federal and state financing of public insurance. Also needed are local efforts to establish social norms and activities among private dentists that engage more private practitioners in care of the underserved.

Most US children today have public or private dental health insurance, yet oral health among publicly insured children remains a policy concern. We analyzed data for 2011-12 from the National Survey of Children's Health to compare oral health status and the use of dental care among publicly and privately insured children. After we adjusted for demographic and parent characteristics, we found no differences between the two groups in parent-reported use of dental care or unmet need for dental care. However, compared to parents of privately insured children, parents of publicly insured children were less likely to report that the condition of their child's teeth was excellent or very good and more likely to report that the child had had a dental problem in the past twelve months. Family income differences between the groups accounted for much of this disparity. Our findings suggest that Medicaid is meeting its mandate to ensure that dental care is as available for children in the program as it is for privately insured children, but refinements in Medicaid policy are needed to improve poor children's oral health.