School-Based Caries Prevention, Tooth Decay, and the Community Environment

Area of Science:

• Public Health
• Pediatric Dentistry
• Social Epidemiology

Background:

• Child oral health inequities are influenced by school and community environments.
• The impact of these environments on school-based caries prevention effectiveness is not well understood.

Purpose of the Study:

• To assess the association between school/community environments and dental caries.
• To examine the moderating effects of these environments on school-based caries prevention.

Main Methods:

• Multilevel mixed-effects regression analysis.
• Analysis of a 6-year prospective cohort study of children in a school-based caries prevention program.

Main Results:

• Living in dental shortage areas and higher proportions of children on free/reduced lunch were linked to increased caries risk.
• Caries prevention reduced untreated caries risk per visit, but total caries experience increased over time.
• Prevention was more effective for children with prior dental care and in schools with higher proportions of low socioeconomic status students.

Conclusions:

• School and community environments directly affect oral health and modify the impact of school-based caries prevention.
• School-based caries prevention can reduce oral health inequities, particularly when integrated into schools.
• The socioeconomic context of schools and communities influences the effectiveness of preventive dental care programs.