Special Issue of Academic Pediatrics Reports on State of Pediatric Oral Health in US

Experts Pinpoint Areas for Further Improvement

New York, 8 December 2009 – Oral disease, primarily dental caries, is the most common pediatric disease and can lead to physical and psychological disabilities as well as significant morbidity in adulthood. In May 2000, Dr David Satcher’s landmark report, Oral Health in America: A Report of the Surgeon General, highlighted the state of oral health for children and adults in the United States and offered strategies to improve oral health outcomes. The November/December issue of Academic Pediatrics, devoted entirely to children’s oral health, represents a ‘‘midterm examination’’ of how far the US has come since the 2000 Surgeon General’s report in meeting Healthy People 2010 oral health objectives and other key recommendations.

Bringing together 19 contributions from experts in dentistry, medicine, nursing, and public policy, guest editors Wendy E. Mouradian and Rebecca L. Slayton have assembled an impressive summary of the state of children’s oral health in the US and urge healthcare professionals to make oral health a pediatric priority. A number of papers were presented at the landmark American Academy of Pediatrics’ (AAP) National Summit on Children’s Oral Health: A New Era of Collaboration, held November 7-8, 2008 in Chicago.

In his commentary, Editor-in-Chief Peter G. Szilagyi, University of Rochester Medical Center, asks the question, “Why shouldAcademic Pediatrics devote an entire issue to children’s oral health now?” His answers: “First, oral health is health, and children’s oral health is part of pediatrics...Second, we are far from achieving our Healthy People 2010 oral health objectives in reducing the prevalence of caries in children...Third, substantial disparities exist in children’s oral health and access to care...Fourth, oral health represents an excellent paradigm in which the traditional pediatric community needs to work more closely with other health professionals—in this case dental professionals—to advance the health of children.”

Szilagyi continues, “I look forward to the day when a future issue of Academic Pediatrics or a future Surgeon General’s report proclaims victory on the plight of dental caries and declares that children’s mouths are largely absent of dental or oral disease.”

Wendy E. Mouradian and her co-authors then present an overview of the papers and comment on progress made in meeting Surgeon General David Satcher’s goals set in 2000, calling for “dentists, physicians, and other health professionals who work with children to embrace a shared responsibility for children's oral health and work to overcome the historic separation between dentistry and medicine....” Dr. Satcher himself follows with a renewed call to arms to improve children’s oral health.

Rebecca L. Slayton and Harold C. Slavkin address how scientific and technological advances in sequencing of the human genome, tissue engineering and saliva diagnostics may have significant potential to impact oral health.

Paul S. Casamassimo relates the medical history of a young man with special-needs, to illustrate how oral health may be mishandled by both community dentists and physicians in a health care system with too many gaps, in “A Life Without Teeth.”

The Science and Surveillance section includes articles that discuss tooth decay, especially in younger children, and the lack of improvement in reducing this disease. Children’s diets, a subject of recent concern for obesity, can also increase dental caries.

Three articles dealing with Access and Barriers to Care are included. These review current measures of access to dental care for children, including those with special health care needs, and the ethical and policy issues in the care of children with craniofacial conditions including quality of life, costs of care, and prenatal diagnosis of craniofacial defects,

The Oral Health Workforce, including dental and medical education issues, is covered in six articles. Authors review the state of the oral health workforce, including new models of mid-level dental practitioners, and stress the need to better educate both dentists (especially general and pediatric dentists) and primary care medical providers (pediatricians, family physicians, nurse practitioners, physicians’ assistants) to promote children’s oral health and ensure they have adequate access to dental care.

Finally, two articles on Policy Achievements and Challenges discuss how government actions and policy decisions have affected children’s oral health. Burton Edelstein writes about congressional action to reauthorize CHIP (Child’s Health Insurance Program) and to include funding for oral care. James J. Crall discusses how the Surgeon General’s Report on Oral Health drove Congress and State Legislatures, Federal and State Agencies, the Federal Courts, and various professional societies and associations to adopt policies and procedures to enhance children’s oral health, and reflects on the work remaining to fully address children’s oral health needs.

The articles appear in Academic Pediatrics, Volume 9, Issue 6 (November/December 2009) published by Elsevier. The entire issue is publicly available online via open access at http://www.academicpedsjnl.net/.

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Full text of the entire issue is freely available online at http://www.academicpedsjnl.net/. To schedule an interview with an editor or author, please contact Wendy E. Mouradian, MD, MS, University of Washington School of Dentistry at 206-543-0903,mourad@u.washington.edu.

Academic Pediatrics: Special Issue on Children’s Oral Health
Volume 9/Issue 6 (November/December 2009)

Wendy E. Mouradian, MD, MS, Associate Dean and Professor, Department of Pediatric Dentistry, University of Washington Schools of Dentistry, Medicine and Public Health, Seattle

Rebecca L. Slayton, DDS, PhD, Professor and Head, Department of Pediatric Dentistry, University of Iowa College of Dentistry, Iowa City

Table of Contents:

Oral Health in Children: A Pediatric Health Priority
Peter G. Szilagyi

Progress in Children’s Oral Health Since the Surgeon General’s Report on Oral Health
Wendy E. Mouradian, Rebecca L. Slayton, William R. Maas, Dushanka V. Kleinman, Harold Slavkin, Dominick DePaola, Caswell Evans, and Joan Wilentz

Children’s Oral Health: The Time for Change is Now
David Satcher

Scientific Investments Continue to Fuel Improvements in Oral Health (May 2000–Present)
Rebecca L. Slayton and Harold C. Slavkin


A Life Without Teeth
Paul S. Casamassimo


Changes in the Oral Health of US Children and Adolescents and Dental Public Health Infrastructure Since the Release of the Healthy People 2010 Objectives
Scott L. Tomar and Anne F. Reeves

Update on Early Childhood Caries Since the Surgeon General’s Report
Norman Tinanoff and Susan Reisine

An Examination of the Advances in Science and Technology of Prevention of Tooth Decay in Young Children Since the Surgeon General’s Report on Oral Health
Peter Milgrom, Domenick T. Zero, and Jason M. Tanzer

The Contribution of Dietary Factors to Dental Caries and Disparities in Caries
Connie Mobley, Teresa A. Marshall, Peter Milgrom, and Susan E. Coldwell


Update on Disparities in Oral Health and Access to Dental Care for America’s Children
Burton L. Edelstein and Courtney H. Chinn

Dental Care and Children with Special Health Care Needs: A Population-Based Perspective
Charlotte W. Lewis

Critical Issues in Craniofacial Care: Quality of Life, Costs of Care, and Implications of Prenatal Diagnosis
Ronald P. Strauss and Cynthia H. Cassell


Addressing Children’s Oral Health in the New Millennium: Trends in the Dental Workforce
Elizabeth Mertz and Wendy E. Mouradian

Dental Education’s Role in Improving Children’s Oral Health and Access to Care
N. Sue Seale, Alton G. McWhorter, and Wendy E. Mouradian

Adding Dental Therapists to the Health Care Team to Improve Access to Oral Health Care for Children
David A. Nash

Educating Pediatricians and Family Physicians in Children’s Oral Health
Alan B. Douglass, Joanna M. Douglass, and David M. Krol

Oral Health and Pediatricians: Results of a National Survey
Charlotte W. Lewis, Suzanne Boulter, Martha Ann Keels, David M. Krol, Wendy E. Mouradian, Karen G. O’Connor, and Rocio B. Quinonez

Role of Pediatric Nurse Practitioners in Oral Health Care
Donna Hallas and Donna Shelley


Putting Teeth in CHIP: 1997–2009 Retrospective of Congressional Action on Children’s Oral Health
Burton L. Edelstein

Oral Health Policy Development Since the Surgeon General’s Report on Oral Health
James J. Crall

Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy and the organization of child health services. It includes systematic reviews of primary care interventions and important methodology papers to aid research in child health and education.

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