Emerging Issues

Emerging issues are likely to affect further progress in this focus area. For example, the role of health literacy on oral health outcomes is a relatively new concept to dentistry. Health literacy has been shown to have a major impact on chronic diseases such as diabetes and heart disease. To date, such studies involving oral health have not occurred, but research is beginning in this area and may prove very helpful in achieving these objectives. For example, if a parent does not understand the potential benefits of fluoride toothpaste use and does not encourage his or her child to use it, the child is at high risk for dental decay.

Another emerging issue is the use of fluoride varnish as a preventive measure. A recent study demonstrated that caries rates can be reduced among young children with the application of fluoride varnish by a health care provider.¹⁷ One approach that could be effective is the application of fluoride varnish by nondental providers. Often a physician is the first health care provider to see young children at risk for dental decay. Because many poor and select racial and ethnic populations often face barriers in receiving early dental care, the time period between a child's first medical and first dental appointments can be great. Some programs, including State Medicaid programs, are encouraging physicians and members of their staff in both private practice and in community health programs to apply fluoride varnish to the teeth of their preschool patients at risk for dental decay. Use of fluoride varnish should include an educational component about the need for future applications of fluoride both in the home and at the dental clinic and the need for a dental home for themselves and their children.¹⁸

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