Sidebar: Eliminating Oral Health Disparities

Despite remarkable improvement in the nation's oral health over the years, not everyone in the U.S. has benefited equally. Oral, dental and craniofacial conditions remain among the most common health problems for low-income, disadvantaged, disabled and institutionalized individuals. Given the diversity of the U.S. population, it is unrealistic to anticipate easy, one-size-fits-all solutions. Approaches that are tailored and targeted to individual, community and societal/environmental-level factors are needed to achieve health equality.

The NIDCR-funded Centers for Research to Reduce Disparities in Oral Health have demonstrated the need to partner with communities throughout the research process in order to fully understand what factors contribute to dental disease in each community and to develop appropriate intervention strategies. For example, one Center discovered that only 14 percent of the tooth decay found among children in the poorest sections of Detroit can be attributed to "classical" risk factors. A community's cultural beliefs about preventive care, understanding of the importance of "baby" teeth, mistrust of drinking tap water, maternal health fatalism, fear of dental care and even the proximity to places of worship and grocery stores contributed to oral health risk. Creative interventions are needed to address these factors.

A primary goal of the NIDCR Oral Health Disparities Centers is to seek creative but practical approaches that are inexpensive, can be easily applied and are exportable to other underserved communities.

• The Boston University Center for Research to Evaluate and Eliminate Dental Disparities is developing interventions to prevent early childhood caries (ECC), that are appropriate for public housing and lay health workers. The center is also developing physician-delivered ECC-prevention interventions targeted at the caregivers of very young children.
• The University of California, San Francisco Center to Address Disparities in Children's Oral Health is exploring the effectiveness of different public health settings to prevent ECC with fluoride varnish. Additional projects will investigate the preventive effects of other treatments to prevent caries among older children.
• The University of Colorado Center for Native Oral Health Research is developing a research and community practice infrastructure to prevent oral diseases in American Indians and Alaska Natives. Community health workers are a key aspect of the intervention strategies.
• The University of Florida Southeast Center for Research to Reduce Disparities in Oral Health aims to reduce disparities in cancer survival by promoting early detection of oral and pharyngeal cancer through a rural community-based intervention project focused on African Americans.
• The University of Washington Northwest/Alaska/Hawaii Center to Reduce Oral Health Disparities is conducting community-based behavioral research with low-income pregnant women to enhance use of public dental care services for themselves and their infants.