The importance of preventative care in oral health promotion
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This thesis aims to examine the current state of oral health promotion with respect to fluoridation, the impact that the lack of dental care has financially on the patient and the overall health system and a discussion of alternative options that could help to improve the current state of oral health care. While acknowledging research and official reports that indicate dental caries as the most prevalent preventable health condition in the lives of children, this thesis is a literature review studying the positive and negative effects of systemic and topical fluoride on both adults and children. Exploring differing perspectives of fluoridation's benefits and efficacy as a preventative oral health care measure, including community water fluoridation and topical fluoride application, this thesis will examine its effects on dental caries nationally and internationally. Although the prevalence of caries has decreased, to date, no systematic reviews have addressed adequately the disparities between incidence, severity, and recurrence of dental caries especially between children and adults. Likewise, substantial research has not yet adequately addressed the differences found in children that may make them more susceptible than adults to over fluoridation through a combination of systemic, topical fluoridation and water consumption. The literature review also includes the breakdown of costs and cost-effectiveness of dental care, including factors that increase cost, as well as suggestions to shift towards an emphasis on preventative care in attempt to reduce overall costs. Improving access to care especially to the underinsured is discussed. Furthermore, a review of the dental therapist occupation utilized successfully in other countries is discussed as this could be a viable solution for the shortage of dental professionals in areas with minimal access of care here in the United States. This is turn may reduce the number of disparities in oral health care, by reducing the severity of oral health disorders that result from an increased delay or neglect in treating the onset of dental caries from a preventative perspective. The primary measure of impact reported in several studies reviewed was the reduction in advanced care restorations, including surgery, needed with increased preventative care measures. Evidence of the effectiveness of preventative oral health care including systemic and topical fluoridation implementation and city-specific school-wide initiatives to administer dental sealants for children covered by government-sponsored programs are growing. Moving forward towards a more prevention-based system with early detection and better access for all, these changes should help lead to increased oral health initiatives and improved oral and healthcare overall.