Crall James J, Vujicic Marko
James J. Crall (
Marko Vujicic is the chief economist at and vice president of the Health Policy Institute, American Dental Association, in Chicago, Illinois.
Health Aff (Millwood). 2020 Oct;39(10):1762-1769. doi: 10.1377/hlthaff.2020.00799.
Considerable progress has occurred in the US over the past quarter-century in terms of improving children's oral health. Federal and state policies, programs, and partnerships have contributed to improvements in oral health status. Medicaid and Children's Health Insurance Program coverage expansions helped increase the use of dental services, and investments in safety-net facilities and training programs helped expand service delivery and the oral health workforce. Nevertheless, dental caries remains the most common chronic disease of childhood, notable oral health disparities persist, and the adoption of evidence-based innovations remains slow and uneven. This article highlights improvements during the past twenty-five years in US children's oral health and oral health care that stem from major federal and state initiatives, as well as persistent disparities. We offer promising strategies for reducing gaps and suggestions for overcoming challenges to future progress, including renewed emphasis on oral health during early childhood; greater integration in education and clinical service delivery programs; development of standardized quality measures; and data collection systems that support more robust surveillance, program monitoring, and system improvements.
在过去的四分之一个世纪里,美国在改善儿童口腔健康方面取得了显著进展。联邦和州的政策、项目以及合作关系都对口腔健康状况的改善做出了贡献。医疗补助计划(Medicaid)和儿童健康保险计划(Children's Health Insurance Program)覆盖范围的扩大有助于增加牙科服务的使用,对安全网设施和培训项目的投资有助于扩大服务提供范围和口腔健康专业人员队伍。然而,龋齿仍然是儿童最常见的慢性疾病,显著的口腔健康差异依然存在,基于证据的创新措施的采用仍然缓慢且不均衡。本文重点介绍了过去25年里美国儿童口腔健康和口腔医疗保健方面源于联邦和州主要举措所取得的进展,以及持续存在的差异。我们提供了缩小差距的可行策略以及克服未来进展挑战的建议,包括重新强调幼儿期的口腔健康;在教育和临床服务提供项目中加强整合;制定标准化的质量衡量标准;以及建立支持更有力监测、项目监督和系统改进的数据收集系统。