Dental Caries: Racial and Ethnic Disparities Among North Carolina Kindergarten Students.

OBJECTIVES: We examined racial/ethnic disparities in dental caries among kindergarten students in North Carolina and the cross-level effects between students' race/ethnicity and school poverty status. METHODS: We adjusted the analysis of oral health surveillance information (2009-2010) for individual-, school-, and county-level variables. We included a cross-level interaction of student's race/ethnicity (White, Black, Hispanic) and school National School Lunch Program (NSLP) participation (< 75% vs ≥ 75% of students), which we used as a compositional school-level variable measuring poverty among families of enrolled students. RESULTS: Among 70,089 students in 1067 schools in 95 counties, the prevalence of dental caries was 30.4% for White, 39.0% for Black, and 51.7% for Hispanic students. The adjusted difference in caries experience between Black and White students was significantly greater in schools with NSLP participation of less than 75%. CONCLUSIONS: Racial/ethnic oral health disparities exist among kindergarten students in North Carolina as a whole and regardless of school's poverty status. Furthermore, disparities between White and Black students are larger in nonpoor schools than in poor schools. Further studies are needed to explore causal pathways that might lead to these disparities.

Effects of Community Water Fluoridation on Dental Caries Disparities in Adolescents.

Despite improvements in the prevalence of dental caries, disparities are still observed globally and in the U.S. This study examined whether community water fluoridation (CWF) reduced dental caries disparities in permanent teeth of 10- to 19-year-old schoolchildren in North Carolina. We used cross-sectional data representing K-12 schoolchildren in North Carolina (NC) public schools. A poisson regression model was used to determine whether the association between children's parental educational attainment and the prevalence of dental caries of children differed by children's lifetime CWF exposure. We analyzed data on 2075 students. Among the children without any CWF exposure in their life, statistically significant caries disparities by parental educational attainment were observed. Compared to the children of parents with more than high school education, the relative risk for those with a parent with a high school education was 1.16 (95% CI = 1.01, 1.33) and those with less than a high school education was 1.27 (95% CI = 1.02, 1.60). In contrast, these disparities were not observed among children exposed to CWF throughout their lives. Socioeconomic disparities in dental caries were not observed among 10-19-year-old schoolchildren with lifetime CWF exposure. CWF seemed to reduce dental caries disparities.