please edit this paper. Oral Health Inequity Among Latino/Hispanic Individuals in the United States
Issue Description
Oral health is an important factor in the general well-being of individuals(Patrick et al., 2006). All people should have achieved the same degree of oral health(Oral Health in America, 2000). However according to Surgeon General many individuals are suffering from endless pain leading to complications damaging quality of life(Oral Health in America, 2000). There are different factors concerning oral health disparities consisting of social, economic, and biological (Patrick et al., 2006). Among people in the US, children, the elderly, low social class individuals, and minority groups are affected more than others(Oral Health in America, 2000). Among different races and ethnicities, Asian and Latino individuals experienced more disparities compared to white individuals or non-Hispanic people(Graham et al., 2005; Vargas & Ronzio, 2006). Health disparity is a term that defines uneven proportion risk of being unhealthy, disabled or death in a particular population or group(Patrick et al., 2006). Latino individuals have the greatest percentage of untreated tooth decay and the lowest level of dental appointments among all races and ethnicities in the US(Wall & Brown, 2004). In this paper for both the purpose of not defining people by their group and maintaining the consistency Latinos/Hispanics is called “Latino/Hispanic individuals”.
Three Reasons for Addressing the Importance of the Issue
Oral health is an important factor of defining health quality between both adults and children. Consequently, low oral health impacts the quality of life adversely(Abanto et al., 2011; Batista et al., 2014). Also, experiencing childhood caries is a factor anticipating probability of future caries(O’Sullivan & Tinanoff, 1996). So, it could be understood that it would affect children’s future, as well. One of the issues determining oral health quality is accessing to dental care. Access barriers are lack of insurance, language barrier, immigration and financial status, lack of transportation(Arcury & Quandt, 2007; Castañeda et al., 2010; Heyman & Núñez, 2009). As a result, marginalized Latino individuals are bearing uneven burden of oral disease(Graham et al., 2005) .
Issue Patterns and Inequities
The Third National Health and Nutrition Examination (NHANES III) data from 1988–1991 show that Latino children receive little preventive interventions; for instance, only 10% of Mexican–American children aged 8 received sealants, compared to 29% of non–Hispanic White children(Selwitz et al., 1996). Tooth decay affects Mexican-American adults disproportionately(Winn et al., 1996). Adult Mexican-Americans had a 40% untreated oral illness rate in 1991 compared to only a 24% rate for non-Hispanic whites(Winn et al., 1996). Mexican Americans, Cuban Americans, and Puerto Ricans visited the dentist less frequently than non-Hispanic whites, according to the National Health Interview Survey (1999). Particularly, Hispanic children are twice as likely as non-Hispanic white children to have untreated dental caries in their permanent teeth (Vargas et al., 1998). 
Cultural Humility and Strategies
All of contributing factors of visiting dentists should be considered(Graham et al., 2005). As Castañeda et.al stated only increasing access to dental Medicaid would not result in more dental visits, because there are several other factors needed to be met(Castañeda et al., 2010). As a result if we fail to consider availability and accessibility to dental needs, the situation will not enhance(Castañeda et al., 2010; Patrick et al., 2006). Also, cognitive stereotypes of patients and discriminative providers’ practices are the reasons of under-using of dental care(Patrick et al., 2006). On the other hand private dentist tend to open their offices in urban metropolitan areas ensuring they would visit more middle and higher income patients compared to rural areas. For example, in Mississippi 40% of the dentists are working in just two metropolitan areas whereas in 38 counties rural areas proportion of people are 4000 to one dentist(Krause D et al., 2003).
Given the shortage of dentists and private offices which do not accept Medicaid(Castañeda et al., 2010; Patrick et al., 2006), one strategy to cope with this problem would be training more dentists and sending them to rural and areas in need of dental care. Besides we could invest on Latino-based dentists who are familiar with the culture and Latino/Hispanic individuals’ needs. Therefore, Latino/Hispanic dentists would be the voice of this minority group experiencing oral health inequity. So that they will be actively participate in addressing this issue with being oriented on the culture and stereotypes.
People in oral health care would like to help people with Medicaid, but paper works and high number of no-shows has deteriorate their willingness(Castañeda et al., 2010). So, as a dentist and a public health professional I must be able to familiarize myself with the culture and limitations of Latino/Hispanic individuals so I would be able to help them in an effective manner. For example, I did not know having Medicaid will not necessarily help Hispanic/Latino individuals. Therefore, I have to keep myself updated about these issues by talking to Hispanic/Latino individuals directly about their problems in oral health field using Kleinman’s exploratory models continually(Kleinman & Benson, 2006). In addition, as a health care practitioner I would be also able to check my perspectives toward not only Hispanic/Latino individuals, but also in contact with other groups of people to understand if there is any reflexivity and positionality in my thoughts (Hsiung, 2008; Social Identity Map, n.d.). Journaling and incidence critical evaluation would be two of many tools for self reflection that I used the most when I was working as a dentist. I used it as a tool for self evaluation of my day in the clinic.