Insight: Oral Health in Utah


Author: Julia Martin

“Good oral health is vital for children as it affects their overall health, social adjustment, appearance, school performance and ability to thrive”[1]

Oral health is an often overlooked and neglected health condition in Utah. The state's latest oral health campaign targets Utah teens,[2] While this is a step in the right direction, more emphasis needs to be placed on children's oral health. Unfortunately, the most recent data on children's oral health comes from the 2015-2016 State of Utah Children's Oral Health. According to the report, “levels of oral disease among Utah elementary school students are alarming”[3] (See Table 1 for a general summary of children’s oral health). These findings regarding children's oral health are further related to racial/ethnic minority status, federally funded public health insurance, and geographic location.

dental sealant

“A person’s ability to obtain oral health care is related to factors such as education level, income, race and ethnicity”[4]

Dental sealants are a low-cost and complete intervention in preventive dental care. Dental sealants help contain and reduce the effects of tooth decay. There are serious and significant differences in children's oral health when dental sealant use is taken into account. Children on Medicaid had higher rates of tooth decay (75.6% vs. 63.9% privately insured). One possible determinant of high rates of tooth decay is the declining use of dental sealants—32.9% of children on Medicaid use dental sealants, compared with nearly 50% (49.3%) of children on private insurance Sealants. In addition, dental sealant use was lower among minority children (33% vs 45%).[5] Specifically, Hispanic children are more likely to have untreated tooth decay (25% vs. 18% for non-Hispanic children) and have more unmet dental needs (15% vs. 4%) . These high prevalence rates can be attributed to the higher likelihood that Hispanic children do not have dental insurance (26% of Hispanic children do not have dental insurance).[6] Likewise, children who qualify for free and reduced lunch programs have higher rates of tooth decay and untreated cavities.[7] This again demonstrates the need to increase the use and accessibility of dental sealants to underserved racial/ethnic minority children.

geographical differences

“Where an individual lives and works can improve or limit access to oral health services”[8]

Oral health disparities are not limited by racial/ethnic minority identity. There are serious disparities in access to care and services between urban and rural areas. Rural areas face shortages of health care professionals and shortages of health care and transportation infrastructure.[9] A recent study of oral health status in Utah's Health Professional Shortage Areas (HPSAs) claimed that 66% of Utah's counties were in dental HPSAs. This study further concluded that nearly half of the people living in HPPSA require oral health care and more than half (60%) of the population have difficulty accessing adequate oral health care.[10] A disproportionate number of dentists work in urban counties compared to Utah's rural counties. 11.1% of Utah's dental workforce practices in rural counties, although 15.4% of Utah's population resides in these counties.[11]As of 2017, Salt Lake County had a far larger dental distribution surplus (43.7% of the workforce) than any other county in Utah (the closest was Utah County at 18.6% of the workforce).[12]

dental disease costs

Data from Utah clearly demonstrate the urgent need to improve oral health. Dental disease must be considered a major public health problem. The cost of neglecting oral hygiene is high. Patients who are unable to receive routine dental care are more likely to visit the emergency room. Based on the above-mentioned urban-rural differences, the rate of oral health-related emergency department visits in rural hospitals is significantly higher. These non-traumatic emergency dental visits cost the state an average of $52 million annually.[13] Because emergency rooms do not have the capacity to manage dental services, most patients receive only pain management rather than the true cause of dental disease, leading to continued cavities and emergency department use. If patients can afford routine dental care, these costs can be significantly mitigated.

Poor oral health is a downward spiral. Good oral health is essential for daily functions such as speaking, smiling, and eating.[14] Poor dental hygiene has serious consequences for individuals, communities and the future. Maintaining good oral hygiene is vital to overall health and well-being. Financial prosperity is also linked to oral health. Nationally, children with poor oral health “miss approximately 51 million hours of school each year.”[15] This severely hampers their education and likelihood of future success. In addition, poor oral health can also affect children's nutritional health.[16] The pain caused by tooth decay can inhibit a child's ability to eat and receive proper nutrition.

There is a need to expand oral health research and recognize the connection between the oral cavity and overall health. Disparities in access and affordability of oral health care are costly to the state and residents. The connection between children's oral health and access to educational health and success must be recognized to curb the lasting costs of care.

Table 1

Source: Utah Department of Health, Division of Family Health and Preparedness, Oral Health Program, and Information Resources Program. Oral health status of children in Utah, 2015-2016. November 2016.

Julia Martin is an intern at the Cam C. Gardner Policy Institute studying political science and psychology at the University of Utah

Note: The views expressed are those of the author and do not reflect the institutional position of the Gardner Institute. We hope the opinions we share contribute to the marketplace of ideas and help people make their own informed decisions™.

[1]Institute of Medicine (US) Commission on Health Care Services. The U.S. Oral Health Workforce in the Next Ten Years: Workshop Summary. Washington, DC: National Academies Press (USA); March 2009. Current oral health needs and access to care. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK219678/?report=reader

[2]Neufeld, L., Silver, M., & Cotton, M. (2020). (represent). 2019-2020 Youth Oral Health

Activity. Utah Department of Health. Retrieved from https://health.utah.gov/oralhealth/resources/reports/2019-2020%20-%20Adolescent%20Oral%20Health.pdf

[3]Utah Department of Health, Division of Family Health Preparedness, Oral Health Programs and

Data resource planning. Oral health status of children in Utah, 2015-2016. November 2016.

[4]U.S. Department of Health and Human Services. (2017). oral health. Excerpted from Healthy People 2020 Topics and Objectives: https://www.healthypeople.gov/2020/topics-objectives/topic/oral-health

[5] Utah Department of Health, Division of Family Health Preparedness, Oral Health Programs and

Data resource planning. Oral health status of children in Utah, 2015-2016. November 2016.

[6] Utah Department of Health, Division of Family Health Preparedness, Oral Health Programs and

Data resource planning. Oral health status of children in Utah, 2015-2016. November 2016.

[7] Utah Department of Health, Division of Family Health Preparedness, Oral Health Programs and

Data resource planning. Oral health status of children in Utah, 2015-2016. November 2016.

[8] Office of Health Disparities. Addressing oral health disparities in urban settings: Strategic approaches to promote access to oral health care. Salt Lake City (UT): Utah Department of Health, Office of Health Disparities; January 2018.

[9] Office of Health Disparities. Addressing oral health disparities in urban settings: Strategic approaches to promote access to oral health care. Salt Lake City (UT): Utah Department of Health, Office of Health Disparities; January 2018.

[10] Pinzon, LM, Petukhova, Y., Pham, S., Knighton, R.., He, J., Phan, HT, Garcia-Godoy, F., Rackham, L., & Power, JM (2021). Oral health status of the Utah Health Professional Shortage Area (HPSA) population. 10.21203/rs.3.rs-500508/v1

[11] Utah State Council on Medical Education (2017). Utah Dental Workforce 2017: Supply Study

Distribution of Utah Dentists. Salt Lake City, Utah. Retrieved from https://umec.utah.gov/wp-content/uploads/Utah-Dentist-Workforce-Report-2017-1.pdf

[12] Utah State Council on Medical Education (2017). Utah Dental Workforce 2017: Supply Study

Distribution of Utah Dentists. Salt Lake City, Utah. Retrieved from https://umec.utah.gov/wp-content/uploads/Utah-Dentist-Workforce-Report-2017-1.pdf

[13] Oral Health Initiative (2019). Analysis of emergency non-traumatic dental visits in Utah, 2007-2017. Retrieved from https://health.utah.gov/oralhealth/resources/reports/2019%20-%20UDOH%20Analysis%20of%20Emergency%20Dept%20Non-traumatic%20Dental%20Visits.pdf

[14]Baiju, RM, Peter, E., Varghese, NO, & Sivaram, R. (2017). Oral health and quality of life: Current concepts. Journal of Clinical and Diagnostic Research: JCDR, 11(6), 21-26. https://doi.org/10.7860/JCDR/2017/25866.10110

[15]Institute of Medicine (US) Commission on Health Care Services. The U.S. Oral Health Workforce in the Next Ten Years: Workshop Summary. Washington, DC: National Academies Press (USA); December 2009. Improving Cost of Access to Oral Health Services for Children. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK219660/?report=reader

[16] Institute of Medicine (US) Commission on Health Care Services. The U.S. Oral Health Workforce in the Next Ten Years: Workshop Summary. Washington, DC: National Academies Press (USA); December 2009. Improving Cost of Access to Oral Health Services for Children. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK219660/?report=reader



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