The partnership of Eastman Dental Center with the City of Rochester and Rochester City Schools to prevent or reduce disparities in oral health began in 1915 with a gift from George Eastman enabling the creation of the Rochester Dental Dispensary. Today, that partnership extends to the University of Rochester Medical Center, including the School of Medicine and Dentistry. However, despite this rich history of collaboration and an extensive network of community-based oral health facilities, fewer than 30% of children from the most impoverished neighborhoods in the city receive regular oral health care. Further, little is known about disparities in oral diseases or dentofacial disorders among Rochester-dwelling Hispanic families from Puerto Rico and Central America. On the basis of regularly scheduled oral health surveys of Rochester school children, a comprehensive database on the distribution of dental caries has been compiled. However, little data on caries prevalence or incidence by race or ethnic group are available. Similarly, while we know that fewer than 30% of Medicaid eligible Rochester children utilize oral health care services, there are no data on barriers to utilization of the abundant and conveniently located neighborhood and school-based oral health care facilities, nor have effective interventions been developed to improve utilization. Little attention has been given to cultural and behavioral characteristics of minorities that may profoundly influence utilization. Given the rich infrastructure and abundant resources available to us, we have formed a community partnership and a multidisciplinary research collaborative to undertake research on preventing or reducing oral health disparities. In this proposal, we describe three specific aims to: 1) organize research teams; 2) link research and community partners; and 3) refine research questions and design studies that will address the following four lines of research: 1) Assess the distribution of oral disease/disorders, with emphasis on dental caries; investigate factors associated with any excess morbidity observed in Rochester-dwelling Hispanic children and contrast findings with matched cohorts of African-American and Caucasian children; 2) Determine the impact of existing oral health care programs on disparities in oral disease morbidity; 3) Identify barriers to effective utilization of the oral health care system; and, 4) Develop intervention strategies that will prevent or reduce disparities in both the levels of oral diseases as well as in access to, and effective utilization of, the oral health care system.
