The DOI matches its Crossref record; 134 of the 134 references it cites were found in a registry or an index.
Influences on children’s oral health: A conceptual model
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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“At the structural level, access barriers, poverty, rurality, and historic inequities influence both risk and the ability to complete timely treatment.”
From Equity or Two-Tier Care? Guardrails for Silver Diamine Fluoride and Delegated Early Childhood Caries Pathways (2026) · cites this paper as [1]
In the citing paper
“Early childhood caries (ECC) is widely understood as a multifactorial disease that arises from interactions among biological, behavioral, and structural determinants.”
From Equity or Two-Tier Care? Guardrails for Silver Diamine Fluoride and Delegated Early Childhood Caries Pathways (2026) · cites this paper as [1]
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Sadjadpour, F., Hosseinichimeh, N., Pahel, B. T., & Metcalf, S. S. (2024) · Frontiers in Oral Health · doi:10.3389/froh.2023.1285347 · Cited by 14
Impact of Parental Health Beliefs on Early Childhood Caries: A Two-Year Longitudinal Study
Chou, Y.-C., Cheng, F.-S., Weng, S.-H., Tseng, C. H., Hu, H., & Liu, C. (2025) · International Dental Journal · doi:10.1016/j.identj.2025.100902 · Cited by 9
“6,7 Key caregiver-level factors, such as oral health knowledge, health beliefs, self-efficacy, stress, and social support, are recognized as important contributors to children’s oral health behaviours and outcomes.”
Poirier, B., Hedges, J., Smithers, L. G., Moskos, M., & Jamieson, L. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19031150 · Cited by 9
A scoping review of early childhood caries, poverty and the first sustainable development goal
Tantawi, M. E., Attia, D., Virtanen, J. I., Feldens, C. A., Schroth, R. J., Al-Batayneh, O. B., Arheiam, A., & Foláyan, M. O. (2024) · BMC Oral Health · doi:10.1186/s12903-024-04790-w · Cited by 11
“We also assessed if poverty was measured at the individual, family, area, community, school, city and country levels by adapting the Fisher Owens conceptualization of the influences on child’s oral health [29].”
MethodNguyen, U., Rowe, D. J., & Barker, J. C. (2017) · PubMed · Cited by 9
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Barnes, E., Bullock, A. D., & Chestnutt, I. G. (2021) · Community Dentistry And Oral Epidemiology · doi:10.1111/cdoe.12698 · Cited by 9
“The macro context factors on oral health have been widely reported (38-41).”
BackgroundKaur, R., Lieberman, M., Mason, M. K., Dapkins, I. P., Gallager, R. P., Hopkins, K., Wu, Y., Troxel, A. B., Rashwan, A., Hope, C., et al. (2023) · Pilot and Feasibility Studies · doi:10.1186/s40814-023-01269-3 · Cited by 11
Social determinants of oral health and disease in U.S. men
Tomar, S. L. (2012) · Journal of Men s Health · doi:10.1016/j.jomh.2012.03.001 · Cited by 9
Impact of delayed gratification on oral health and caries status in the primary dentition.
Caleza-Jiménez, C., Yañez-Vico, R., Mendoza-Mendoza, A., Palma, J., & Iglesias-Linares, A. (2017) · E -journal of dentistry · doi:10.1016/j.jdent.2017.06.001 · Cited by 6
García-Pola, M., González-Díaz, A., & García-Martín, J. M. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18084096 · Cited by 9
“It is accepted that oral health is affected by personal, family, and socio-community factors [6], but the possible transmission of factors to a child determined by the mother’s health must also be considered [7].”
BackgroundPhilip, P., Prasanna, P., Remi, R. V., Samuel, R., George, W. T., Joseph, M. S. A., Lim, M. A. W. T., Armstrong, G., & Grills, N. (2024) · Journal of Applied Research in Intellectual Disabilities · doi:10.1111/jar.13278 · Cited by 8
Perić, T., Marković, E., Marković, J., Petrović, B., Kilibarda, B., Vuković, A., & Markovic, D. L. J. (2025) · Children · doi:10.3390/children12060692 · Cited by 8
“Early childhood caries is an etiologically complex disease that develops as a result of multiple risk factors, as well as and favorable dietary, socio-economic, behavioral and environmental influences [23–25].”
Bekes, K., Steuber, A. C. J., Challakh, N., Schmidt, J., Haak, R., Hraský, V., & Ziebolz, D. (2020) · BMC Oral Health · doi:10.1186/s12903-020-01302-4 · Cited by 8
“Parental education and employment status are also known to influence caries development [35].”
BackgroundAcculturation and dental sealant use among US children
Wiener, R. C., Findley, P. A., Shen, C., Dwibedi, N., & Sambamoorthi, U. (2021) · Community Dentistry And Oral Epidemiology · doi:10.1111/cdoe.12678 · Cited by 9
Applying World Dental Federation Theoretical Framework for Oral Health in a General Population
Ahonen, H., Pakpour, A. H., Norderyd, O. M., Broström, A., Fransson, E. I., & Lindmark, U. (2021) · International Dental Journal · doi:10.1016/j.identj.2021.09.001 · Cited by 8
pplications of Artificial Intelligence in Dentistry: A Narrative Review
Sikri, A., Sikri, J., Piplani, V., & Thakur, Y. (2024) · South Asian Research Journal of Oral and Dental Sciences · doi:10.36346/sarjods.2024.v06i01.001 · Cited by 8
Some young adults can maintain good oral health despite socioeconomic challenges
Nordström, M., Carlsson, P., Ericson, D., Hedenbjörk‐Lager, A., Jansson, H., Wolf, E., & Petersson, G. H. (2024) · European Journal Of Oral Sciences · doi:10.1111/eos.12985 · Cited by 8
Salehyar, M. H., Keenan, L., Patterson, S. K., & Amin, M. S. (2015) · International Journal of Circumpolar Health · doi:10.3402/ijch.v74.25417 · Cited by 8
Metadata
- 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)
- 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
- 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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