Waldman, H. B., & Perlman, S. P. (2006). Dental Clinics of North America, 50, 1-16.
Adolescence is a period when both medical and dental needs may be neglected. In the United States, almost 1.7 million adolescents have unmet dental needs-nearly 5 times the number who need eyeglasses and twice the number of those who have medical needs. Two-thirds of adolescents experience dental decay, approximately half need orthodontics, and many delay care because of cost. In 2002, 11% of children aged 12 to 17 years (2.7 million) were uninsured for healthcare. Children who lived in families other than those consisting of their biological parents who were married to each other had the worst health outcomes. Although dental caries decreased in the overall population during the last quarter of the 20th century, black adolescents continued to have greater numbers of untreated permanent teeth with caries than their white counterparts. Persistent higher rates of untreated dental caries exist among minority children, particularly those of Mexican American heritage, and among children living in families with incomes below the poverty level.
Government spending for dental services has been limited. Although Medicaid spending for dental care is only 1% of Medicaid expenditures, the State Children's Health Insurance Program (SCHIP), created in 1997, offers some promise. There are 29 million children with Medicaid and SCHIP, and those children are 1.5 times more likely to access dental services than are uninsured children; children covered by Medicaid are 3.5 times less likely to have unmet dental needs than are children without insurance. All states except Texas include dental benefits in SCHIP plans. Continued and expanded access to insurance programs covering dental care is an important policy initiative to monitor and support. This article provides us with good information about adolescent dental needs and should be used by nurses to advocate for better services for this population.
Judith A. Lewis