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Oral Health for Infants, Children, Adolescents, and Pregnant Women

Knowledge Path

February 2010

Introduction

This knowledge path about oral health for infants, children, adolescents, and pregnant women has been compiled by the National Maternal and Child Oral Health Resource Center (OHRC) and the Maternal and Child Health Library at Georgetown University. It offers a selection of current, high-quality resources that analyze data, describe effective programs, and report on policy and research aimed at improving access to oral health care and quality of oral health for infants, children, adolescents, and pregnant women. A separate section lists resources for consumers. The final part of the knowledge path presents resources on specific aspects of oral health: child care and Head Start, dental caries, dental sealants, fluoride varnish, K–12 education, pregnancy, school-based and school-linked care, and special health care needs. This knowledge path is designed for health professionals, program administrators, educators, policymakers, and consumers, and it will be updated annually.

Related knowledge path: See Health Insurance and Access to Care for Children and Adolescents.

Overview

For many Americans, oral health status has improved during the last two decades, and oral disease has declined significantly among school-age children in particular. However, dental caries remains the most prevalent chronic disease of childhood, and among children ages 2–5, the incidence of dental caries in the primary teeth has increased. Children and adolescents with special health care needs, as well as those from certain racial and ethnic groups, experience disproportionately high incidences of oral disease.

To help ensure optimal oral health status, it is imperative that oral health promotion, oral disease prevention, and oral health care be a part of local, state, and national health policy agendas. Policies are needed that better integrate oral health and systemic health; increase access to health-promotion activities, preventive care, and treatment; and reduce financial and other barriers to care. In particular, policies must address oral health concerns and unmet treatment needs, especially among vulnerable populations.

Resources for Professionals

Web Sites of National Organizations

Additional Resources from National Organizations

Web Sites of State Organizations

Additional Resources from State Organizations

Distance Learning Resources

Databases

The databases listed below are excellent tools for identifying data, additional literature and research, and programs about oral health and infants, children, adolescents, and pregnant women. Many of the entries below contain tips on how to use the databases efficiently. Please note that databases vary in how terms should be entered; for example, some require quotation marks and others don't. Enter search phrases as shown in bold below.

Data
  • Childstats.gov. Statistics and reports about children and families, including family and social environment, economic circumstances, health care, physical environment and safety, behavior, education, and health. Includes statistics about oral health. ChildStats.gov is a service of the Federal Interagency Forum on Child and Family Statistics. The forum's annual report, America’s Children: Key National Indicators of Well-Being, details the status of children and families in the United States.

  • Community Health Status Indicators (CHSI). County-specific data on health status indicators obtained from a variety of federal agencies including the Department of Health and Human Services, the Environmental Protection Agency, the Census Bureau, and the Department of Labor. Use the indicators to compare a county with counties similar in population composition and selected demographics and to characterize the overall health of a county and its citizens to support health planning. Select a state and county and click on Access to Care to view the number of dentists per 100,000 people. CHSI is a service of the Department of Health and Human Services (DHHS).

  • Data2010: The Healthy People 2010 Database. Data for tracking Healthy People 2010. To obtain oral health data, click on the field, Data by Focus Area. Under the field, Select a Focus Area, choose 21-Oral Health from the pop-up menu. Next, click on the button, Include Related Objectives from Other Focus Areas in the Table. Click on the Submit button, or use the other fields to narrow your search. This data set is provided by the National Center for Health Statistics (NCHS) via CDC Wonder.

  • Data Resource Center for Child and Adolescent Health (DRC). Data from the National Survey of Children’s Health, 2003 & 2007, and the National Survey of Children with Special Health Care Needs, 2001 & 2005/2006. Users can search and compare results on over 100 indicators of child health and well-being; view national and state profiles on key measures; explore survey content relevant to Healthy People 2010 objectives; and compare findings at all levels for children by age, race and ethnicity, income, or health status. Several indicators address oral health. DRC is a project of the Child and Adolescent Health Measurement Initiative (CAHMI).

  • Dental, Oral and Craniofacial Data Resource Center (DRC). A catalog of oral health surveys and archive of procedures related to oral health and a data-query system for oral health data from national health survey databases. DRC is a collaborative effort between the National Institute of Dental and Craniofacial Research (NIDCR) and CDC’s Division of Oral Health.

  • Healthcare Cost and Utilization Project (HCUP): HCUPnet. Health statistics and information on hospital in-patient and emergency department utilization at the national, regional, and state levels. To identify data about hospital use related to oral health and infants, children, and adolescents, select National Statistics on Children. Select Researcher, medical professional. Under type of query, select Statistics on specific diagnoses or procedures. Select a year (e.g., 2006). Select Diagnoses grouped by Clinical Classifications Software (CCS). Select Principal diagnosis. Under the field, Browse all CCS categories, scroll to 136 Disorders of teeth and jaw and 137 Disease of mouth. Hold the control key or Apple command key down, and click to select both categories. Click on Next. Select the outcomes and measures of interest (e.g., Number of discharges) and click on Next. Select patient and hospital characteristics (e.g., All patients in all hospitals) and click on Next. View your results. HCUP is an initiative of the Agency for Healthcare Research and Quality (AHRQ).

  • Medical Expenditure Panel Survey (MEPS). Information from this set of large-scale surveys of families and individuals, their health professionals, and employers across the United States. Includes information about dental visits, type of oral health professional, treatments and services performed, and prescribed medicines. MEPS is a service of the Agency for Healthcare Research and Quality (AHRQ). Recent statistical briefs include

    Dental Expenditures in the 10 Largest States, 2006. (2009).

  • National Quality Measures Clearinghouse (NQMC). Evidence-based health care quality measures and measure sets for health professionals, hospitals, and health plans to evaluate and improve the quality of health care for patients. To identify quality measures about oral health, enter the term "oral health" OR dental in the search box. Click on Search to get your results. The database is sponsored by the Agency for Healthcare Research and Quality (AHRQ).

  • Oral Health Data Systems. A collection of oral health data systems to monitor the prevalence of oral diseases and the factors influencing oral health in the United States. These systems are a collaborative effort between CDC’s Division of Oral Health and the Association of State and Territorial Dental Directors (ASTDD). The data systems are

    My Water's Fluoride. Information about the status of local water fluoridation systems. This database is currently available only for states that voluntarily participate in the Water Fluoridation Reporting System (WFRS).

    National Oral Health Surveillance System (NOHSS). Oral-health-surveillance indicators by state for dental visits, teeth cleaning, tooth loss (complete and partial), fluoridation status, dental sealants, dental caries experience, untreated dental caries, and cancer of the oral cavity and pharynx.

    Oral Health Maps. Indicators of oral health and preventive interventions for oral health by state or county using an interactive mapping application. Oral health indicators for children include dental caries experience, untreated dental caries, and dental sealants.

    Water Fluoridation Reporting System (WFRS). A water-fluoridation-monitoring tool for state and tribal water fluoridation program managers and oral health program directors or managers. This system requires special authorization for access. WFRS is the data source for the annual fluoridation information in the National Oral Health Surveillance System (NOHSS).

    Also see the Synopses of State and Territorial Dental Public Health Programs and the Dental, Oral and Craniofacial Data Resource Center (DRC).

  • statehealthfacts.org. State-level data on more than 500 health topics. Click on a state for individual state profiles, or click on specific topics to compare data for all states. For either option, select Health Status. Scroll down on the left sidebar and select Child Access to Medical and Dental Care. Scroll further to the Oral Health section (Note: this data focuses on adults only) and make a selection. Return to the home page for another search. Select Providers and Service Use. Scroll down on the left sidebar and select Dental Health Professional Shortage Areas. Scroll further to the Dentists section to find the number of dentists overall, per capita, by gender, and by specialty field, including dental public health, orthodontics, and pedodontics. Information can be displayed as tables, graphs, or color-coded maps. This database is a service of the Kaiser Family Foundation (KFF).

  • State Health Workforce Profiles. Data on supply, demand, distribution, education, and use of health personnel, including dentists, dental hygienists, and dental assistants. Estimated numbers of workers indicate the size of the state's health work force. Per capita ratios facilitate comparisons with other states and the nation. The profiles were developed by the Center for Health Workforce Studies at the State University of New York at Albany.

  • Title V Information System (Title V IS). Data from annual Title V Block Grant applications and reports submitted by all 59 U.S. states and jurisdictions. To learn about states' efforts to address oral health, conduct several searches. Select Measurement and Indicator Data. Under National Data, select National Performance Measures. Choose a report option (e.g., Most Recent Year Available). Select a state or region and Performance Measure #09 to find the percentage of third-grade students who have received protective sealants on at least one permanent molar tooth. Click on Start Search to get your results. Return to Measurement and Indicator Data and scroll to the section, State Data. Select State Priority Needs Keyword Search; Keyword: Oral Health; Population: Children (1 through 21); and the desired state or region to learn about programmatic efforts to improve oral health. Click on Start Search to get your results. Repeat the search and substitute Population: Pregnant Women. Return to Measurement and Indicator Data and scroll to the section, State Data. Select State Performance Measures and click on Search by Keyword/Population. Select Keyword: Oral Health and Population: Children (1 through 21). Click on Start Search to get your results. Repeat the search and substitute Population: Pregnant Women. Title V IS is a service of the Maternal and Child Health Bureau (MCHB).

  • Also see the National Center for Health Statistics (NCHS).
Literature and Research Databases
  • American Dental Association (ADA) Online Library Catalog. Information about books, reports, guidelines, proceedings, dissertations, historical materials, and journal titles on a wide range of dentistry and oral health topics.

  • ClinicalTrials.gov. Information about clinical research studies in human health, including oral health. Included are a summary of the purpose of the study, recruiting status, criteria for participation, location of the trial, and contact information. To identify oral-health-related studies involving infants, children, and adolescents, click on Search for Clinical Trials and select Advanced Search. Type mouth diseases OR tooth diseases in the Conditions field. Scroll to Age Group and select Child (birth–17). Click on Search to get your results. To identify oral-health-related studies involving pregnant women, click on Search for Clinical Trials and select Advanced Search. Type pregnancy in the Search Terms field and mouth diseases OR tooth diseases in the Conditions field. Click on Search to get your results. To narrow either search, click on the tab, Results by Topic. Click on By Category under the heading, Conditions. Click on Mouth and Tooth Diseases to see the breakdown of your search results by topic. ClinicalTrials.gov is a service of the National Institutes of Health (NIH) and is developed by the National Library of Medicine (NLM).

  • Cochrane Database of Systematic Reviews. Systematic reviews of health care interventions internationally. Provides access to abstracts that can be browsed by title or by topic such as Oral Health. Access to the full-text article requires a per-view payment or a subscription that is available in many hospital and university health sciences libraries. The database is published by the Cochrane Collaboration, an international nonprofit organization based in the United Kingdom.

  • Database of Abstracts of Reviews of Effects (DARE). Summaries of systematic reviews that have met strict quality criteria. Included reviews must be about the effects of interventions. Each summary also provides a critical commentary on the quality of the review. Type ("oral health" OR dental) AND (infants OR children OR adolescents OR pregnancy) in the search field and click on search to identify abstracts. Select a publication date range to further limit your search. DARE is produced and maintained by the Centre for Reviews and Dissemination at the University of York.

  • Health Workforce Information Center (HWIC): Dental Occupations. Information about resources, organizations, funding, events, and news that focus on the national dental work force (i.e., dental assistants, dental hygienists, dental laboratory technicians, and dentists). HWIC is operated by the University of North Dakota School of Medicine and Health Sciences.

  • HP2010 Information Access Project: Oral Health. Automatic search mechanism for published literature indexed in PubMed and related to the Healthy People 2010 oral health objectives. Also links to the narratives for each of these objectives and the complete chapter about oral health in the text, Healthy People 2010: Understanding and Improving Health (2nd ed.). (2000). This service is provided by the Partners in Information Access for the Public Health Workforce, a collaboration of federal agencies, public health organizations, and health sciences libraries.

  • Maternal and Child Health Library at the National Center for Education in Maternal and Child Health (NCEMCH), Georgetown University. Databases to collect, manage, and disseminate knowledge about MCH, with special emphasis on knowledge gained from initiatives and programs supported by the Maternal and Child Health Bureau (MCHB). The library collaborates with the National Maternal and Child Oral Health Resource Center (OHRC) on the oral health content of its databases. The library's bibliographic database is

    MCHLine®. Online catalog of materials in the Maternal and Child Health Library. The OHRC collection of oral health print and electronic materials is also accessible via MCHLine®.

    Also see the MCH Organizations Database.

  • National Guideline Clearinghouse (NGC). Evidence-based clinical practice guidelines and related materials for health professionals. Identify guidelines by entering the following search phrase in the Search box: ("oral health" OR "dental health services") AND (infant OR child OR adolescent OR pregnancy). Click on Search to get your results. NGC is an initiative of the Agency for Healthcare Research and Quality (AHRQ).

  • National Institutes of Health (NIH) Research Portfolio Online Reporting Tool (RePORT): RePORTER. Reports, data, and analyses of NIH research activities, including information on NIH expenditures and the results of NIH-supported research. To identify information on the topic, conduct several searches. First, enter "oral health" infants in the search field and click on Submit query to get your results. Conduct additional searches using the following search phrases (must be searched separately): "oral health" children; "oral health" adolescents; "oral health" pregnancy; dental infants; dental children; dental adolescents; dental pregnancy. There will be some overlap in your search results. Narrow your searches by selecting a state or adding terms to other search fields.

  • PubMed. More than 19 million citations for biomedical articles from MEDLINE and life science journals. Citations may include links to full-text articles from PubMed Central or publisher Web sites. To identify articles about oral health and pregnancy, enter the search phrase, (oral health OR dental health services) AND pregnancy. Click on Limits and make the following selections on the page: select a date (e.g. Published in the last 2 years); click on Languages: English; Click on Species: Humans; and select Search Field Tags: MeSH Major Topic. Click on Search to get your results. To identify articles about oral health and infants, children, and adolescents, conduct a separate search. Enter the search phrase, oral health OR dental health services. Click on Limits and make the following selections on the page: select a date (e.g. Published in the last 2 years); click on Languages: English; Click on Species: Humans; Click on Ages: All Child: 0-18 years; and select Search Field Tags: MeSH Major Topic. Click on Search to get your results. Add search terms to further limit your searches (e.g., (oral health OR dental health services) AND dental caries). Use the MeSH (Medical Subject Headings) database to identify search terms. PubMed is a service of the National Library of Medicine (NLM). Also see the HP2010 Information Access Project for access to published literature related to the Healthy People 2010 oral health objectives.

  • Also see the Education Resources Information Center (ERIC) Database and the NIDCR Special Care Database.
Programs Databases
  • Community Pediatrics Grants Database. Archive of community pediatrics grant projects. Identify projects by selecting Oral/Dental Health in the topic field. Click on Basic Submit to get your results. To narrow your search, select a target population and/or a state, territory, or country. The database is a service of the American Academy of Pediatrics (AAP). AAP also supports oral health grants via its Community Access to Child Health Program and the Healthy Tomorrows Partnership for Children Program.

  • Discretionary Grant Information System (DGIS). Information about more than 900 grants issued by the Maternal and Child Health Bureau (MCHB). To view performance measure data for three MCHB programs about oral health, select Performance Measures. Click on Program. Data about the three programs must be searched and viewed separately, as follows: (1) under Child and Adolescent Health, select Children’s Oral Healthcare Access Program; click on Next; select the performance measure; and click on Next to view the data; (2) under Child and Adolescent Health, select Oral Health; click on Next; select the performance measure; and click on Next to view the data; and (3) under Training, select Pediatric Dentistry; click on Next; select a performance measure; and click on Next to view the data. For program information about grants related to oral health, select Abstracts. Type dental dentist =oral in the search box, select Any of the words, and click on Search to get your results. To find products and publications produced by MCHB training grantees, select Program Data; click on Training; and click on Search Products and Publications. Type dental dentist =oral in the search box; select Any of the words; and click on Search to get your results.

  • Health Care Innovations Exchange. Profiles of successful and attempted innovations and tools to improve health care delivery with a particular emphasis on reducing disparities in health care and health among racial, ethnic, and socioeconomic groups. View the profiles, Dental Health Care. The exchange is an initiative of the Agency for Healthcare Research and Quality (AHRQ).

  • Health Services Research Projects in Progress (HSRProj). Information about ongoing health services research and public health projects. To identify projects, enter ("oral health" OR dental) AND (infant OR child OR adolescent OR pregnancy) in the search box. Click on Search to get your results. HSRProj is funded by the National Library of Medicine (NLM).

  • MCH Organizations Database. Information on over 2,000 government, professional, and voluntary organizations involved in MCH activities, primarily at a national level. View OHRC's list of links to clearinghouses and resource centers, government agencies (federal and state), foundations, Head Start–related centers and offices, policy and research centers, professional associations, programs and initiatives, and voluntary organizations. For a broader list of oral health organizations, enter "oral health" in the keyword field of the database search form. Click on Search to get your results. The database is a service of the Maternal and Child Health Library.

  • Medicaid Benefits: Online Database. Information about benefits covered, populations served, and the limitations, co-payments, and reimbursement policies that apply to Medicaid benefits for all 50 states, the District of Columbia, and U.S. territories. Search by state or for benefits by service (Select Practitioner Services, Dental Services). This database is a service of the Kaiser Family Foundation (KFF).

  • State and Territorial Dental Public Health Activities. Descriptive summaries for oral health public health activities that states and territories have reported as successful within the context of their environment and resources. Contact information is given with the summaries. The database is searchable by topic and state. This database is a product of the Association of State and Territorial Dental Directors (ASTDD).

  • Synopses of State and Territorial Dental Public Health Programs (Synopses). Characteristics of and programs conducted by state and territorial oral health programs, including water-fluoridation programs, dental sealant programs, oral-health-education programs, and oral-health-screening programs. This information is useful in tracking progress toward the Healthy People 2010 oral health objectives. Synopses is a collaborative effort between CDC’s Division of Oral Health and the Association of State and Territorial Dental Directors (ASTDD).

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Newsletters and Online Discussion Lists

Resources on Specific Aspects of Oral Health

Child Care and Head Start

Dental Caries

Dental Sealants

Fluoride Varnish

K–12 Education

Pregnancy

School-Based and School-Linked Care

Special Health Care Needs

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Oral Health for Infants, Children, Adolescents, and Pregnant Women: Knowledge Path, 11th ed. (July 2010).
Authors: Susan Brune Lorenzo, M.L.S., Maternal and Child Health Library; Katrina Holt, M.P.H., M.S., R.D., OHRC.
Contributors: Jolene Bertness, M.Ed., OHRC; Elizabeth Lowe, M.P.H., R.D.H., OHRC; Ebony Stoutmiles, OHRC.
Reviewers: Sarah Kolo, OHRC; Pamella Vodicka, M.S., R.D., Maternal and Child Health Bureau.

 

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National Maternal and Child Oral Health Resource Center Georgetown University