Dentistry is one of the prosperous spheres in the health care, as teeth are the essential elements of the human body. Furthermore, nowadays, dental caries is one of the most prevalent issues, and this fact makes it one of the most important diseases, which requires intervention (Centers for Disease Control and Prevention, 2015).
Rationale for the Topic – Dental Caries in Adults
The rationale is based is evidence-based:
- Common in the US – 91% of adults (20-64 years old) have caries (CDC)
- Untreated tooth decay – 27%
- dental carries is more dangerous for the older adults (40-64 years old)
- Only 34% of this social segment has all of the permanent teeth (Centers for Disease Control and Prevention, 2015)
Cases of inappropriate treatment and untreated decay are present.
Based on the factors provided above, the importance of the oral care cannot be underestimated among the adults, as a significant share of the population experiences problems with teeth. The primary causes for the selection of the problem for the research are the widespread nature of the issue and recognition of the oral disease.
About 91% of American adults aged between 20 years old and 64 years old had dental caries in permanent teeth in 2011–2012 (Centers for Disease Control and Prevention, 2015). The condition is higher among adults aged 35–64 at 94%–97% relative to adults aged 20–34 (82%). Cases of caries among adults aged 20–64 years old was lower for Hispanic (85%), non-Hispanic black (86%), and non-Hispanic Asian (85%) adults compared with non-Hispanic white adults (94%) (Centers for Disease Control and Prevention, 2015).
The CDC noted that in 2011–2012, practically all U.S. adults aged 65 and over (96%) with any permanent teeth suffered dental caries. The occurrence of tooth decay was the same among adults aged 65–74 and those aged 75 and over (Centers for Disease Control and Prevention, 2015). Tooth decay prevalence was lower for non-Hispanic black (91%) and Hispanic (86%) adults compared with non-Hispanic white adults (98%) (Centers for Disease Control and Prevention, 2015).
Dental Caries Relevance
Notwithstanding that dental caries seems to have reduced based on a report by the National Institute of Dental and Craniofacial Research (2014), there is a substantial disparity in its prevalence among population groups. The Whites and the elites have higher incidences of tooth decay, but the lower income groups alongside the Blacks and the Hispanics have a higher prevalence of untreated dental caries in permanent teeth. This high prevalence is largely attributed to the lack of access to dental health care services. Unfortunately, there has been more attention to the use of prevention strategies among children than adults in the use of fluoride products and sealants.
Prevention and Eradication of Dental Caries Program
This program aims at informing, educating, and empowering the community to take action in preventing and eradicating dental caries. In addition, it will stimulate involved stakeholders to mobilize community resources needed for the identification and treatment of these dental caries.
Creating awareness and educating the public on evidence-based strategies will be carried out through the social media. The social media is cost-effective in terms of cost and coverage; therefore, this avenue will be useful in disseminating information on healthy dental care practices to the public.
Community mobile clinics would allow low-income groups to get access to free check-ups and affordable treatment options.
Epidemiologic reconnaissance is the deliberate accumulation, recording, examination, understanding, and mirroring the present status of a group or the populace. It is an appropriate framework for oral health surveillance.
Dental Caries among Adults with Low Socioeconomic Status
The initial goal of the study is to find a connection between the caries severity and low income, frequency of visits to the dentist, and using the community benefits among the Brazilian adults (Costa, Vasconcelos, & Abreu, 2013). Thus, speaking of correlation of the socioeconomic status and caries intensity, adults with the low income had 2.2 higher chance of caries than individuals with a greater income (Costa et al., 2016). It was revealed with the help of using two focus groups with high caries and lower severity. In this case, the primary finding of this article is the fact that high caries severity vehemently pertains to the low-income level and decreased social cohesion.
A high level of caries and socioeconomic factors such as level of income, educational background, and socioeconomic status are interdependent (Costa et al., 2012).
The authors of the publication refer to the teeth retention as one of the factors, which require intervention (Dye, Li, Thornton-Evans, 2012).
Edentulism among Adults
Edentulism is an oral health condition associated with partial or complete loss of teeth. According to medical experts, the problem is most prevalent among older adults from poor populations. As of 2010, over 158 million people suffered from edentulism in the world. In addition, the condition is more common among females than in males. Some of the factors associated with the loss of teeth include changes in food preferences and taste, as well as nutritional deficiency.
Almost 19% of adults aged 65 years old and over were edentulous in 2011–2012. Edentulism was twice as common among adults aged 75 years and over (26%) relative to adults aged 65–74 (13%). Variations were also noted across race and sex. More non-Hispanic black adults aged 65 and over were edentulous (29%) compared with non-Hispanic white (17%) and Hispanic (15%) adults. A marginal state of complete tooth loss was higher among older non-Hispanic Asian adults (24%) relative to older Hispanic and non-Hispanic white adults. The prevalence of edentulism was almost the same between men (18%) and women (19%) (Centers for Disease Control and Prevention, 2015).
A Case Prevalence in Louisville, Kentucky
Louisville is one of the poorest cities in America. It has some of the highest rates of edentulism in the country. The prevalence of the condition among the older adult population is associated with various socio-economic and chronic conditions, such as asthma. Other factors linked to the problem are risky behaviors, such as smoking and infrequent dental visits.
It is noted that Kentucky has one of the most economically depressed urban neighborhoods in America. The average annual income for most individuals in the metropolitan is below $25,000. As a result, most people in the city are considered poor. The poverty level is one of the reasons why the prevalence of edentulism is high in the city.
Strategies for the State Health Department
Oral and pharyngeal cancers should be detected as early as possible. In this respect, appropriate medical training, practitioners’ knowledge enhancement, and patient education will be the most effective strategies designed by the State Health Department.
Implementation of Intervention Strategies
The first intervention implies raising the public awareness of the dental caries problem and promoting the relevant prevention measures among the population.
As long as poor healthcare awareness is often associated with low income, it is considered rational to adopt a low-cost strategy and ensure that the target population groups have the access to the offered options. As a result, it is proposed to choose the social media as the most cost-effective channel to disseminate the educational information.
It is suggested that the proposed educational material should not be excessively theoretical but should target to draw the public attention to the most important points of dental care: fluoride products, hygiene maintenance, and sugar intake among others.
The target populations are supposed to have a chance to receive the relevant consultations and discuss the most critical problems within the organized platform. To provide this option, it is essential to open a special Facebook page that will constantly be updated with new educational materials and will serve to be the common discussion forum for those interested in the dental care.
It is proposed that the program would involve volunteering dentists that will agree to collaborate and share their knowledge through the forum on a regular basis.
It is essential to organize special mobilized clinics that will be able to serve the needs of the population in different locations. Mobile specialized clinics should have relevant equipment to provide the standardized options such as check-ups and simple treatment procedures.
As long as the target population is represented by the low-income groups, it is essential to make the service affordable. As a result, the clinics should provide free check-ups, special discounts, and the cost of the offered procedures should be reduced. Hence, it will be necessary to address the sponsoring shareholders to cover the expenses.
It is essential to involve volunteering doctors that will agree to provide their services at reduced costs. Other general practitioners might likewise be welcomed to share the initiative.
Resources and Commitment Required
A number of resources were found to be important for a dental caries program, including funds, professional expertise, medical equipment and supplies, and informative brochures and posters.
It is essential to determine and acquire resources to ensure that a program succeeds. Without the necessary supplies, a project may suffer from different setbacks and ultimately, fail. The proposed dental caries management program requires various resources as described above. The resources will make it possible to meet the goals and objectives of the project.
The first strategy would involve reaching out to the community leaders to ensure that community acceptance and participation is assured. Once the trust of community leaders is established, it will be become easy to reach out to the community and win them to support the project. The second strategy would involve appealing to the interest of the partners to ensure that they give unwavering support to the project. The third strategy would involve drafting a memorandum of understanding with the donors, local municipality, and government agencies to guarantee long-term partnership that is beneficial to them and the project.
An incident of withdrawal by a partner or partners would compromise the viability of the project, especially when the project committee cannot find a replacement in time. For instance, if a donor withdraws support, the gap left should be filled immediately or the project might collapse. Due to competing interests among the community partners, lack of skills to manage the internal politics would compromise team work.
The first partner is Dr. Sarabjit Thind, who will fund and house the project. The funding can be from their personal contributions or from financial agencies. The provision of funds is critical to the success of the practice. The second partner will be Dr. Navnoor Gill, who is a dentist. Given that the project targets children and the elderly, the professional is a specialist in the field of geriatric and pediatric dentistry. The choice of the specific skill-sets is based on the prevalence of dental problems among the elderly and the children. The third partner is the County Health Department in Dayton. The agency will provide guidance on dental and oral health practice and policies. Partnering with the Department will provide linkages with other stakeholders in the dental care practice, such as suppliers and dental associations.
The dental practice will be located at 8340 Yankee Street, Centerville, Ohio. Dr. Sarabjit Thind’s clinic at Dayton Dental and Orthodontics Hospital is where the proposed practice will be situated. The location makes logistic sense given that it is an already existing practice. As such, the proposed dental clinic will not require new equipment, tools, and space. The location is accessible to patients. The clinic is located on the ground floor of the hospital, which is also accessible to people with disability. The identified premise has adequate space to hold several consultation rooms, a reception, and an operating theatre. The practice has adequate equipment to meet any dental emergencies.
Centers for Disease Control and Prevention. (2015). Dental Caries and Tooth Loss in Adults in the United States, 2011– 2012. Web.
Costa, S. M., Martins, C. C., Bonfim, M. d., Zina, L. G., Paiva, S. M., Pordeus, I. A., & Abreu, M. H. (2012). A Systematic Review of Socioeconomic Indicators and Dental Caries in Adults. International Journal of Environmental Research and Public Health, 9(10), 3540–3574. Web.
Costa, S. M., Vasconcelos, M., & Abreu, M. H. (2013). High Dental Caries among Adults Aged 35 to 44 Years: Case-Control Study of Distal and Proximal Factors. International Journal of Environmental Research and Public Health, 10(6), 2401– 2411. Web.
Dye, B. A., Li, X., & Thornton-Evans, G. (2012). Oral Health Disparities as Determined by Selected Healthy People 2020 Oral Health Objectives for the United States, 2009-2010. NCHS Data Brief, (104), 1-8.
National Institute of Dental and Craniofacial Research. (2014). Community and Other Approaches to Promote Oral Health and Prevent Oral Disease. Web.