Caries and Treatment Patterns in Children Related to School Lunch Program Eligibility

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Abstract
This article presents the caries prevalence and treatment patterns of children relative to a classification of family economic status, based on the child's eligibility for the free or reduced-cost school lunch program. Dental caries prevalence is reported for children aged 8–11 years at the beginning of a longitudinal clinical trial in the nonfluoridated city of Tampa, Florida. These children were placed into one of three school lunch subsidy categories—poverty, near-poverty, and non-poverty—using federal government income eligibility guidelines for the school lunch program. The results support an inverse relation of caries prevalence to economic status, as well as the expected direct relation of family income to treatment needs met. The nonpoverty group exhibited the lowest number of decayed surfaces and had nearly 70 percent of their treatment needs met. The poverty group had significantly higher scores both for total caries experience (DMFS) and decayed surfaces (DS) than either of the other groups. Filled surfaces (FS) scores were not significantly different for any of the groups. This method of classifying children by school lunch program eligibility is considered valid because of the rigorous requirements used in determining family income, as well as the thorough verification procedure that is applied. The method is easy to use once officials have been convinced that confidentiality will be maintained.