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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Child Externalizing Behavior Problems Linked to Genetic and Non-Genetic Variation in Dental Caries
Lorber, M. F., Slep, A. M. S., Heyman, R. E., & Bretz, W. A. (2014) · Caries Research · doi:10.1159/000358100 · Cited by 5
Olave-Müller, P., Fajreldin, V., Coronado-Vigueras, L., López-Contreras, N., & Valenzuela, M. T. (2021) · International journal of odontostomatology · doi:10.4067/s0718-381x2021000400888 · Cited by 4
Jones, K. E., Simancas‐Pallares, M., Ginnis, J., Shrestha, P., & Divaris, K. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010632 · Cited by 4
Hoang, H. T., Huynh, N. C., Tran, T. T.-N., Nguyen, M. D., & Beltrán‐Aguilar, E. D. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e25035 · Cited by 5
“Dental caries has strong sociodemographic and commercial determinants [28 – 31], which may have contributed to changes in dental caries in the same 30 years.”
BackgroundQuality Measure Adherence and Oral Health Outcomes in Children
Choi, S. E., Pandya, A., White, J. M., Mertz, E., & Normand, S. T. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.53861 · Cited by 5
Evaluating the type of pediatric dental care use in the context of neighborhood opportunity
Kopczynski, K., Casamassimo, P. S., Amini, H., Peng, J., Gorham, T. J., & Meyer, B. D. (2024) · The Journal of the American Dental Association · doi:10.1016/j.adaj.2023.11.015 · Cited by 4
Model to explain dental visit for children aged 0 to 5: Scoping review of birth cohorts
Bérat, P., ANDRADE, V. D., Regnault, N., Tenenbaum, A., & Azogui‐Lévy, S. (2025) · PLoS ONE · doi:10.1371/journal.pone.0313922 · Cited by 4
The effect of social geographic factors on the untreated tooth decay among head start children
Heima, M., Ferretti, M., Qureshi, M., & Ferretti, G. A. (2017) · Journal of Clinical and Experimental Dentistry · doi:10.4317/jced.54228 · Cited by 4
Nguyen, T. M., Christian, B., Koshy, S., & Morgan, M. V. (2020) · Children · doi:10.3390/children7120257 · Cited by 7
“Given that family-level characteristics have an influential role in children’s oral health [12], interventions that include the primary carer in the oral health management of the child within school settings should be further investigated.”
BackgroundSmall-area contextual effects on children’s dental caries in Alberta: a multilevel analysis
Shi, C., Aparicio-Ting, F. E., Faris, P., Patterson, S. K., & McLaren, L. (2021) · Canadian Journal of Public Health · doi:10.17269/s41997-021-00485-9 · Cited by 4
Being Left Alone at Home and Dental Caries of Children Aged 6–7 Years
Matsuyama, Y., Isumi, A., Doi, S. K., & Fujiwara, T. (2021) · Journal of Epidemiology · doi:10.2188/jea.je20210321 · Cited by 4
Wanichsaithong, P., & Prasertsom, P. (2022) · International Journal of Dentistry · doi:10.1155/2022/9161619 · Cited by 4
“Furthermore, it is considered that children’s oral health is the responsibility of their parents, as kids may not be capable of caring for their oral health [27].”
Omara, H., & Elamin, A. (2022) · Clinical Epidemiology and Global Health · doi:10.1016/j.cegh.2022.101080 · Cited by 4
Association of temperament with oral health behaviour and caries status in Thai preschool children
Gultangvattana, P., Chutabhakdikul, N., Leelataweewud, P., Smutkeeree, A., & Jirarattanasopha, V. (2023) · International Journal of Paediatric Dentistry · doi:10.1111/ipd.13106 · Cited by 4
Gunasinghe, K. A. M. M., Wijesinghe, M. S. D., & Ratnayake, N. C. (2023) · Community Dental Health · doi:10.1922/cdh_00017gunasinghe06 · Cited by 4
Girard, I. M., Ward, P., Durey, A., McLean, C., Lund, S., Calache, H., Baker, S. R., & Slack-Smith, L. M. (2024) · Community Dentistry And Oral Epidemiology · doi:10.1111/cdoe.12973 · Cited by 4
It’s about More Than Just Baby Teeth: An Examination of Early Oral Care in Canada
Smith, L. L., Katz, L., Emery, H., Sieppert, J. D., Polsky, Z., & Nagan, K. (2014) · Universal Journal of Public Health · doi:10.13189/ujph.2014.020403 · Cited by 4
da Rocha, N. B., Garbin, C. A. S., Garbín, A. J. Í., Saliba, O., & Moimaz, S. A. S. (2017) · RGO - Revista Gaúcha de Odontologia · doi:10.1590/1981-863720170001000083221 · Cited by 4
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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