In honor of National Children’s Dental Health Month, The Children’s Partnership reaffirms our commitment to advancing race equity in all forms of health care, including oral health. As we’ve written before, systemic racism is a root cause of child health inequities and must be centered in our health policy conversations, especially in the wake of the COVID-19 pandemic.
Early childhood caries–or tooth decay–remains the most common chronic disease among children in the United States, despite being preventable. While California has made progress over the past five years under the Dental Transformation Initiative in improving the oral health status of children, data continues to show profound racial inequities when it comes to tooth decay and ability to access care.
Statewide, nearly 1 in 5 Black children in California needed dental care in the past year but did not get it, compared to 1 in 14 across all children. For families of color and low-income families, the social determinants of health, including poverty, food insecurity, language barriers, transportation access, immigration status, and many more, impact oral health status. And for the five million children enrolled in Medi-Cal, over 75% of whom are children of color, the negative impacts of the social determinants of health are compounded by the challenge of finding dental providers that accept Medi-Cal coverage. While rates of dental care utilization have dropped dramatically across the board during the COVID-19 pandemic, Black children enrolled in Medi-Cal received dental care at the lowest numbers among all children in 2020. It is clear that California must do better in ensuring Black children enrolled in Medi-Cal have adequate access to oral health care.
Local-level data on the status of tooth decay among children shows similar inequities. This month, Los Angeles County is releasing findings from its 2020 “Smile Survey:” a comprehensive overview of the oral health status of kids in the county. While full data will become available in the coming days, the preliminary findings demonstrate a sharp divide based on race: in Los Angeles, 53% of Latinx kindergarteners and 43% of Black kindergarteners have tooth decay– compared with only 26% of white kindergarteners. In coming months, data from the statewide “Smile Survey” will also be released, for the first time since 2005. This data is expected to show that California has made progress in reducing the overall experiences of tooth decay among kids, yet disparities based on race and income level persist.
One strategy for addressing these inequities is to prioritize bringing oral health care to where children are: at schools and at early learning sites. Under the Dental Transformation Initiative, multiple Local Dental Pilot Projects did just that by connecting thousands of kids in California with needed preventive and early intervention dental care in their communities. While the Pilot Projects unfortunately concluded in December 2020, the effective strategies they employed should be continued by our Medi-Cal program to increase access to needed oral health care for children of color. To read our recently released issue briefs authored in partnership with California Northstate University highlighting the Virtual Dental Home and Early Child Oral Health Assessment models in the Inland Empire project, click here.
In order to build upon the progress California has made in lessening the burden of childhood tooth decay, we must continue to examine and address oral health inequities through a racial justice lens. As we work to rebuild from the pandemic and to serve millions of children who have gone without preventive care this past year, it is clear that investments in oral health care must prioritize children and families of color.