Cited by 864Dental Health and Care UtilizationOral microbiology and periodontitis researchChild and Adolescent Health

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Influences on children’s oral health: A conceptual model

Fisher-Owens, Susan A., Gansky, Stuart A., Platt, Larry J., Weintraub, Jane A., Soobader, Mah-J, Bramlett, Matthew D., Newacheck, Paul W.·2007·Pediatrics

DOI 10.1542/peds.2006-3084

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Abstract

OBJECTIVES. Despite marked improvements over the past century, oral health in America is a significant problem: caries is the most common chronic disease of childhood. Much oral health research examines influences primarily in the oral cavity or focuses on a limited number of individual-level factors. The purpose of this article was to present a more encompassing conceptual model of the influences on children's oral health. METHODS. The conceptual model presented here was derived from the population health and social epidemiology fields, which have moved toward multilevel, holistic approaches to analyze the complex and interactive causes of children's health problems. It is based on a comprehensive review of major population and oral health literatures. RESULTS. A multilevel conceptual model is described, with the individual, family, and community levels of influence on oral health outcomes. This model incorporates the 5 key domains of determinants of health as identified in the population health literature: genetic and biological factors, the social environment, the physical environment, health behaviors, and dental and medical care. The model recognizes the presence of a complex interplay of causal factors. Last, the model incorporates the aspect of time, recognizing the evolution of oral health diseases (eg, caries) and influences on the child-host over time. CONCLUSIONS. This conceptual model represents a starting point for thinking about children's oral health. The model incorporates many of the important breakthroughs by social epidemiologists over the past 25 years by including a broad range of genetic, social, and environmental risk factors; multiple pathways by which they operate; a time dimension; the notion of differential susceptibility and resilience; and a multilevel approach. The study of children's oral health from a global perspective remains largely in its infancy and is poised for additional development. This work can help inform how best to approach and improve children's oral health.

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“While Fisher-Owens et al. developed a model regarding oral health in children (with influences from Bronfenbrenner’s work) some of the principles could be applied here [28,43].”
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Health Disparities and the Multicultural Imperative
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Association between Knowledge about Comprehensive Food Education and Increase in Dental Caries in Japanese University Students: A Prospective Cohort Study
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Application of the Theory of Planned Behavior to Predict Dental Attendance and Caries Experience among Children of Newcomers
Amin, M. S., Elyasi, M., Bohlouli, B., & ElSalhy, M. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16193661 · Cited by 19
“The complexity of caries etiology may be the main explanation for this result [21].”
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Sociodemographic Changes and Oral Health Inequities: Dental Workforce Considerations
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“Socioeconomic status and dental insurance are determinants of oral health and oral health–related quality of life (Fisher-Owens et al. 2007; Knorst et al. 2021).”
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Patient-Reported oral health outcome measurement for children and adolescents
Liu, H., Hays, R. D., Marcus, M., Coulter, I. D., Maida, C. A., Ramos‐Gomez, F., Shen, J., Wang, Y., Spolsky, V. W., Lee, S., et al. (2016) · BMC Oral Health · doi:10.1186/s12903-016-0293-x · Cited by 18
“This model builds upon our previous work on the multi-level influences of oral health [18].”
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Foláyan, M. O., Schroth, R. J., Ayouni, I., Nguweneza, A., Arheiam, A., Al-Batayneh, O. B., Virtanen, J. I., Gaffar, B. O., Duangthip, D., Sun, I. G., et al. (2023) · BMC Oral Health · doi:10.1186/s12903-023-03459-0 · Cited by 21
“Introduction The oral health of children is influenced by various family and community related factors [1], which are encompassed by the sustainable development goals.”
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Oral Health Disparities and the Future Face of America
Ebersole, J. L., D’Souza, R. N., Gordon, S., & Fox, C. H. (2012) · Journal of Dental Research · doi:10.1177/0022034512462034 · Cited by 17
“She also referenced a paper by Fisher-Owens and colleagues (Fisher-Owens et al., 2007), delineating a conceptual model to influence children’s oral health (Fig 2.). This model emphasizes multilevel, holistic approaches to analyses of the complex and interactive causes of children’s health problems, by including a broa…”
BackgroundInfluential
Social inequalities in children’s oral health-related quality of life: the Generation R Study
Kragt, L., Wolvius, E. B., Raat, H., Jaddoe, V. W. V., & Ongkosuwito, E. M. (2017) · Quality of Life Research · doi:10.1007/s11136-017-1679-1 · Cited by 17
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Validity of Measures Assessing Oral Health Beliefs of American Indian Parents
Wilson, A. R., Brega, A. G., Thomas, J. F., Henderson, W. G., Lind, K. E., Braun, P. A., Batliner, T. S., & Albino, J. E. N. (2018) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-018-0472-3 · Cited by 17
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Racial/ethnic inequality in the association of allostatic load and dental caries in children
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Impact of parental migration on oral health outcomes of left-behind school-aged children in Luchuan, southern China
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In Defense of Flossing: Can We Agree It's Premature to Claim Flossing is Ineffective to Prevent Dental Caries?
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Julihn, A., Soares, F. C., Hjern, A., & Dahllöf, G. (2021) · Acta Paediatrica · doi:10.1111/apa.15882 · Cited by 16
Fewer Children in Families Associated with Lower Odds of Early Childhood Caries: A Sample from Three Countries
Park, A. H., Kulchar, R. J., Susarla, S. M., Turton, B. J., & Sokal‐Gutierrez, K. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20032195 · Cited by 16
Oral Health of Women and Children: Progress, Challenges, and Priorities
Kumar, J. V., Crall, J. J., & Holt, K. (2023) · Maternal and Child Health Journal · doi:10.1007/s10995-023-03757-7 · Cited by 16
“developed a conceptual model that identified genetic and biological factors, social and physical environments, health behaviors, and dental and medical care (Fisher-Owens et al., 2007).”
Background
Influence of First-Time Mothers' Early Employment on Severe Early Childhood Caries in Their Child
Plutzer, K., & Keirse, M. J. N. C. (2012) · International Journal of Pediatrics · doi:10.1155/2012/820680 · Cited by 16
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Dental Caries: Racial and Ethnic Disparities Among North Carolina Kindergarten Students
MATSUO, G., Rozier, R. G., & Kranz, A. M. (2015) · American Journal of Public Health · doi:10.2105/ajph.2015.302884 · Cited by 16
A Qualitative Study of Child Nutrition and Oral Health in El Salvador
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Inequalities in Caries Experience Among Mongolian Children
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Enamel and Dentin Caries Risk Factors of Adolescents in the Context of the International Caries Detection and Assessment System (ICDAS): A Longitudinal Study
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Method
From describing disparities to understanding why disparities exist: Anti‐racist methods to support dental public health research
Fleming, E., Raskin, S. E., & Brody, E. R. (2022) · Journal of Public Health Dentistry · doi:10.1111/jphd.12503 · Cited by 16
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Background
Social Gradients in Dental Health among Low-Income Mothers and their Young Children
Grembowski, D. E., Spiekerman, C. F., & Milgrom, P. (2012) · Journal of Health Care for the Poor and Underserved · doi:10.1353/hpu.2012.0054 · Cited by 16
Paradigm shift: Infant oral health care – Primary prevention
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Emmanuelli, B., Knorst, J. K., Menegazzo, G. R., Mendes, F. M., & Ardenghi, T. M. (2021) · Caries Research · doi:10.1159/000515083 · Cited by 15

Authors: Fisher-Owens, S. A., Gansky, S. A., Platt, L. J., Weintraub, J. A., Soobader, M.-J., Bramlett, M. D., & Newacheck, P. W.
Affiliations: Department of Pediatrics
University of California, San Francisco (US)
Statworks, Boston, Massachusetts
Centers for Disease Control and Prevention (US)
ORCID: Gansky, Stuart A.
Weintraub, Jane A.
Venue: Pediatrics
Publisher: American Academy of Pediatrics (AAP)
Published: 2007-09-01
Volume: 120
Issue: 3
Pages: e510-e520
ISSN: 0031-4005 (ISSN-L)
1098-4275
DOI: 10.1542/peds.2006-3084
OpenAlex: W2039971937
Semantic Scholar: 26d7508015c25539bc2679c72746d3458dd6f669
Cited by: 864
References: 134
Citations by year: 2026: 50 · 2025: 58 · 2024: 79 · 2023: 57 · 2022: 83 · 2021: 77 · 2020: 63 · 2019: 57 · 2018: 39 · 2017: 53 · 2016: 35 · 2015: 58 · 2014: 35 · 2013: 37 · 2012: 36
FWCI: 9.76
Type: journal article
Language: en
Open access: closed
Locations: PEDIATRICS (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health
National Institute of Dental and Craniofacial Research (R03 DE165701, R03DE016571, U54DE014251)
Topics: Health Sciences › Dentistry › General Dentistry › Dental Health and Care Utilization
Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Child and Adolescent Health
Keywords: children's oral health, dental caries, conceptual model, multilevel analysis, social determinants of health, family and community influence, social environment, physical environment, health behavior, access to dental care, health care, differential susceptibility, resilience, temporal dimension
MeSH terms: Anthropometry, Child, Child Development, Disease Susceptibility, Family, Humans, Insurance, Dental, Health Knowledge, Attitudes, Practice, Models, Biological, Oral Health, Oral Hygiene, Patient Acceptance of Health Care, Risk Factors, Sex Factors, Social Environment, Socioeconomic Factors, Health Behavior, Dental Care for Children, Racial Groups

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Influences on children’s oral health: A conceptual model

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