In today’s diverse and multicultural society, understanding how ethnicity and cultural backgrounds influence children’s oral health is essential for providing equitable dental care. Research shows that kids from certain ethnic and minority groups often face disparities in oral health outcomes due to a complex combination of socioeconomic factors, education, cultural beliefs, language barriers, and limited access to care.1,2Let’s take a look at some of these issues and how dental professionals can play a role in addressing such challenges and promoting inclusivity in pediatric oral health services and outcomes.
Oral Health and Ethnicity
Studies have consistently shown that children from minority populations experience higher rates of dental caries and periodontitis compared to their non-Hispanic White peers.3 Despite increased efforts to promote access to care among minority populations, large oral health disparities remain, with Black and Hispanic children having the poorest oral health of any racial or ethnic groups in the US.1,3 Such disparities suggest ongoing underlying structural and systemic barriers.
Immigration status also plays a role in levels of dental care and provision. First-generation immigrant children, particularly from racial or ethnic minority groups, are less likely to visit a dentist and more likely to experience untreated dental caries.4 Cultural norms, limited knowledge about preventive care, and challenges navigating healthcare systems can also contribute to delayed or insufficient treatment for such kids and their families.1,4
Cultural and Structural Influences
Cultural and family values around health may play a role in influencing oral hygiene practices for kids from diverse backgrounds. For example, some communities may not prioritize regular dental visits, relying instead on home-based or traditional remedies.1,5Other factors may play a role in influencing levels of dental hygiene, such as health literacy, diet, preventative oral care and effectiveness of communication with health care providers.
An historical mistrust of healthcare systems and differing health beliefs may also affect cooperation with dental professionals. Language access is another key issue. Without translation services and culturally appropriate educational materials, providers risk miscommunication and missed opportunities to build trust with kids and their carers from ethnic populations.5
Barriers to Preventive Care
In the US, children from racial and ethnic minority groups, particularly Black, Hispanic, and Native American populations, have lower rates of preventive dental visits compared to non-Hispanic White children.1,2 This disparity is influenced by factors such as socioeconomic status, insurance coverage, geographic location and transport issues.1 Preventive tools such as sealants, which are proven to reduce cavities, are underutilized in low-income and minority populations. A lack of parental awareness around prevention and limited oral health education in culturally diverse communities further widen the gap.1
Studies into ethnic and cultural influences on dental health show the disparities of preventative oral care and poorer outcomes for kids from minority groups. However, these influences are difficult to separate from other factors, including socioeconomic status, language barriers, levels of household education, maternal health, neighborhood and community safety and healthcare provision.1,5,6
How Can Dental Professionals Help?
Dental teams can play a crucial role in reducing disparities in pediatric oral health through inclusive and culturally aware provision. Strategies could include:
- Improve Language Accessibility: Provide educational materials and services in multiple languages to cater to diverse populations. Interpretation services, visual aids and culturally relevant illustrations can also improve oral hygiene instruction.7
- Community Engagement: Collaboration and outreach programs with community organizations such as schools and faith groups can help promote oral health awareness and access to dental services for underserved kids and their families.
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Make Preventative Care Easy: Making toothbrushing a simple and fun activity can help motivate kids to brush on their own without the need for parental supervision. Willo is the fully automated toothbrushing system that is clinically proven to remove more plaque than manual toothbrushes to support long-term oral health. Willo helps kids overcome challenges to effective brushing such as:
o A lack of dexterity
o A lack of patience and sustained focus
o Difficulty understanding proper brushing techniques - Inclusive Treatment Planning: Tailoring behavior guidance techniques to individual families, while actively listening and responding with empathy, improves patient experience and outcomes. Consider cultural aspects such as dietary habits, traditional health practices, and family dynamics when designing treatment plans to ensure relevance and acceptance.4
- Enhance Cultural Competency: Providing training for the dental team can increase understanding of cultural differences in health beliefs and practices, enabling more effective communication and care delivery.4
Moving Forward
Reducing oral health disparities among children from ethnically and culturally diverse backgrounds is no simple task and requires a multifaceted approach. By promoting culturally sensitive care, providing increased access to education and preventive services, and advocating for systemic change, dental professionals can be powerful agents in improving equity in pediatric oral health. By embracing inclusivity and cultural competence, dental professionals can help to ensure all children have the opportunity to achieve optimal oral health.
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References:
1. Robison V, et al. Racial/Ethnic Disparities Among US Children and Adolescents in Use of Dental Care. Prev Chronic Dis. 2020;17:190352.
2. Hannan CJ, et al. Addressing Oral Health Inequities, Access to Care, Knowledge, and Behaviors. Prev Chronic Dis. 2021;18:210060.
3. Choi S, et al. Analysis of Race and Ethnicity, Socioeconomic Factors, and Tooth Decay
Among US Children. JAMA Network Open. 2023;6(6):e2318425.
4. Luo H, et al. Dental Caries and Preventive Dental Visits Among Children in the U.S. The Impact of Race/Ethnicity and Immigration. AJPM Focus. 2024;3(4):100230.
5. Reich S, et al. Disparities in the Quality of Pediatric Dental Care: New Research and Needed Changes. Society for Research in Child Development, Social Policy Report. 2018;31(4):1–27.
6. Guarnizo-Herreño C, and Wehby G. Explaining Racial/Ethnic Disparities in Children’s Dental
Health: A Decomposition Analysis. Am J Public Health. 2012;102:859–866.
7. American Academy of Pediatric Dentistry. Behavior guidance for the pediatric dental patient. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2024:358-78.
