Oral Health

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Oral Health of Children

Child oral health is an important but overlooked aspect of child health. The Surgeon General reports that dental caries (tooth decay) occur five times more frequently than childhood asthma, and named it the most chronic disease among children⁵¹. In 2002, 77 percent of children in Bexar County had seen a dentist in the past year. Sample size prevents showing data for all sectors. In the southern part^β of Bexar County, 79 percent of children had visited the dentist in the past year. A slightly lower rate of 76 percent (but within the ± 4 percent sampling error) of children in the northern part of Bexar County had an annual dental visit. Increased community efforts, in conjunction with dental providers to emphasize the importance of dental care, could help improve the number of children receiving routine dental care.

In 2005, 16 percent of children 3-5 years of age enrolled in the largest Head Start program in Bexar County had untreated tooth decay. This rate had decreased each year since 2001 when 31 percent shown signs of untreated tooth decay. The screenings in 2005 found 38 percent of these children had experienced dental caries. Overall 13 percent of the young children had untreated tooth decay and had found that 33 percent of the young children had early childhood caries. The Healthy People 2010 objective for untreated tooth decay in children aged 2–4 years is 9 percent.⁵²

Information obtained from screening of children enrolled in the Parent Child Inc. Head Start program is presented to help demonstrate the magnitude of tooth decay among children. Though not representative of all children in Bexar County this information does indicate that oral health is a serious concern in this population.

Caries experience provides a measure of past and current disease as an indicator of the overall oral health. Over the past 5 years (2001-2005), the overall trend is toward an improvement in oral health with 49 percent of children having a caries experience in 2001 compared to 38 percent in 2005.⁵⁴ The Healthy People 2010 objective for a caries experience in primary teeth in 2–4 year old children is 11 percent⁵⁵. This statistic suggests that additional and dramatic improvement in the oral health status of children in Head Start is necessary to approach these national goals for health.

Early childhood caries or baby bottle tooth decay is a pattern of disease that is localized to the anterior or front teeth of infants and young children. This pattern is often associated with infant feeding practices. This condition can be debilitating and can result in the premature loss of the front teeth. Table 2 shows that 11.4 percent of young children ages 2-4 years over the past five years had experienced this condition. While we are observing a trend towards a declining prevalence, early intervention is imperative to prevent this profound disease.

Approximately 20 percent of the children in Head Start that were screened require additional dental care⁵. A significant trend towards improvement in treatment need is observed over five years (30 percent in 2001). While this represents a large percentage of young children with active disease, the consistent trend over the past five years is encouraging.

Oral health status among children in Head Start may not reflect the experience of the general community but given the large disparity between these children and the Healthy People 2010 objective, it is reasonable to say that there is substantial reason for concern about oral health of children in Bexar County.

Smoking

Smoking is the single most preventable cause of death and disease. In addition, tobacco cessation is the best way for a smoker to lower their level of risk for oral cancer and periodontal disease.⁵⁶ The Healthy People 2010 goal is to reduce the number of people who smoke cigarettes to no more than 12 percent of the adult population.

Use of tobacco is gradually declining across the United States and Texas. In 2002, 23 percent of Texans smoked, in the period 2004-2005 the rate has declined to 20 percent.

In the period 2004-2005, 19 percent of Bexar County residents reported being smokers. The West sector reports the highest use of tobacco at 26 percent. The Northeast and Northwest follow with 20 percent of residents reporting current smoking. Residents of North Central and East sectors report smoking at rates of 15 and 16 percent respectively. The South sector has the lowest rate of smokers at 13 percent.

The proportion of the surveyed population who smoke cigars, pipes and use smokeless tobacco has increased from the rate of almost 3 percent in 2002 to almost 8 in the period 2004-2005. Smokeless tobacco use is strongly correlated to an increased risk for oral cancer.

In the period 2004-2005, an estimated 65 percent of Bexar County smokers tried to quit smoking for one day or longer in the past year. This rate is up from the 43 percent responding to the same question in 2002.