Oral Health Is Public Health: Why Prevention Must Be Part of California's Health Equity Strategy

For decades, oral health has been treated as separate from the rest of the healthcare system. Dental benefits are often carved out from medical insurance. Public health discussions frequently focus on chronic diseases, infectious disease outbreaks, housing policy, or behavioral health. Oral health is mentioned — but rarely centered.

This separation is artificial. The U.S. Surgeon General's landmark report made this clear: oral health is essential to overall health and well-being. Research supported by the National Institutes of Health and the CDC has continued to demonstrate the connection between oral disease and systemic health outcomes.

Dental caries remain the most common chronic disease of childhood in the United States. CDC data shows more than half of children ages 6-8 have experienced decay. We know how to prevent cavities. Sealants prevent up to 80% of decay in molars. Fluoride varnish reduces risk. The gap is not evidence — it is implementation.

Research supported by NIH has demonstrated associations between oral inflammation and systemic conditions including diabetes and cardiovascular disease. Poor oral health can complicate diabetes management. Inflammation associated with periodontal disease may contribute to broader systemic stress.

Health equity conversations often focus on insurance expansion, transportation infrastructure, food access, and environmental exposures. But oral health disparities follow the same patterns. CDC data shows children from lower-income households are significantly less likely to receive dental sealants.

School-based dental sealant programs are one of the clearest examples of prevention integrated into public health design. The Community Preventive Services Task Force strongly recommends these programs. Children without sealants have nearly three times more cavities than children with sealants.

Separating oral health from general public health planning has consequences. Dental-related emergency department visits cost billions annually. When oral health is siloed, prevention funding becomes inconsistent, coordination with schools weakens, and disparities widen.

If California were to fully integrate prevention-based oral health into its health equity strategy, the outcomes could be transformative: fewer untreated cavities among children, lower Medicaid dental expenditures, reduced emergency department utilization, improved school attendance, and strengthened chronic disease management.