Dental cavities and gum disease remain the two most common oral health conditions—and they are often preventable. Cavities are also the most widespread chronic childhood disease and can continue into adulthood. Dental decay and other oral diseases at any age impact quality of life, school and work performance, and ability to access various opportunities.
In addition to increasing the availability of school-based preventative oral health services, policy changes, such as expanding the scope of practice laws for dental hygienists, have been shown to increase access to care and improve outcomes for children.
According to the North Carolina Department of Health and Human Services (NCDHHS) Division of Public Health Oral Health Section’s The Tragic Truth: Children’s Oral Health Declines in NC Post-COVID report, school-based services may be the only option to access dental care for children who are most at risk for developing oral disease in North Carolina.1
Find out how the ongoing impact of the COVID-19 pandemic and what the report revealed about the state of oral health for North Carolinian children.
Lack of Access to Oral Health Services During the COVID-19 Pandemic & Beyond
During the COVID-19 pandemic, the American Dental Association (ADA) recommended that dental practices postpone optional dental procedures like routine cleanings to decrease the likelihood of spreading the virus. According to an ADA Health Policy Institute survey, in March 2020, 76 percent of dental offices surveyed were closed for everything except emergency services, 19 percent were fully closed, and 5 percent were seeing fewer patients.2
While closures were necessary at the beginning of the pandemic to protect patients and providers, we continue to see the negative effects of this prolonged period of dental practice closures and limited school-based oral health services on children and communities.
Ongoing & Exacerbated Racial & Socioeconomic Disparities in Oral Health
Oral disease continues to disproportionately impact certain racial and ethnic groups. According to the Centers for Disease Control and Prevention (CDC), “non-Hispanic Blacks, Hispanics, and American Indians and Alaska Natives generally have the poorest oral health of any racial and ethnic groups in the United States.”2
Overall, only 39 percent of children from families with lower incomes and those at higher risk of cavities have received dental sealants compared with 46 percent for children from families with higher incomes.2
The Tragic Truth Report by the NCDHHS Oral Health Section
A key role of the North Carolina Oral Health Section (OHS) is to monitor community oral health across the state. In November 2023, Jessica Scott-Jeffries, DHSc, RDH School Oral Health Coordinator and Osaremhen Ikhile, BDS, DrPH Oral Epidemiologist from the NCDHHS Division of Public Health Oral Health Section published their research findings in The Tragic Truth: Children’s Oral Health Declines in NC Post-COVID.
Annually, the Public Health Oral Health Section collects oral health data on kindergartners using the Basic Screening Survey (BSS). Oral health indicators used in the survey include:
- Untreated decay,
- Treated decay, and
- No decay experience.
The first two indicators help determine “how well communities can access and use dental services,” while the third indicates “how well the overall oral health system and other determinants of health support optimal oral health of communities.”
NC Children’s Dental Health Statistics Post-COVID-19 Pandemic
The NCDHHS Division of Public Health Oral Health Section found:
- Untreated tooth decay in children is the highest it has been in five years.
- Treated decay in children is the lowest it has been in five years.
- No decay experience in children is the lowest it has been in five years.
Racial Disparities in Children’s Oral Health
In North Carolina, there has been a…
- 3-fold rise in untreated tooth decay among Native Hawaiian/Pacific Islander kindergartners compared to Asian kindergartners with no increase in untreated decay.
- 2.5x decrease in treated decay among Native Hawaiian/Pacific Islander kindergartners.
- American Indian/Alaskan Native and Asian kindergartners had less treated decay.
- 2.5x decrease in treated decay among Native Hawaiian/Pacific Islander kindergartners.
- American Indian/Alaskan Native and Asian kindergartners had less treated decay.
Poor oral health significantly impacts overall health and these systemic oral health disparities must stop. Not receiving the oral health care that they need and deserve can negatively impact children throughout their entire lives.
Two important steps to address the negative effects of the pandemic we continue to see today include 1) increasing access to preventative oral health services through school-based programs and 2) scope of practice policy changes essential.
To learn more, read The Tragic Truth: Children’s Oral Health Declines in NC Post-COVID.
1The Tragic Truth: Children’s Oral Health Declines in NC Post-COVID
2Oral Health and COVID-19: Increasing the Need for Prevention and Access
NCOHC, a Foundation for Health Leadership & Innovation program, works to advance systems-level changes, improving the overall health and well-being of all North Carolinians by increasing access and equity in care. Sign up for our monthly newsletter to join the network and get involved!
