Honors Program


Document Type


Date of this Version

Spring 3-7-2022


Verbrugge, E. 2022. An Overlooked Epidemic: Pediatric Oral Health Concerns on the Rise in Rural Communities. Undergraduate Honors Thesis. University of Nebraska-Lincoln.


Copyright Emma Verbrugge 2022.


Pediatric oral health is a concern for many dentists and parents as they lay the foundation for long-term proper hygiene in children. Early childhood caries (ECC) is a disease of chronic tooth decay marked as the most common chronic disease of childhood in the world. Children living in rural areas are even more susceptible to this disease and thus significant attention is needed to curve these numbers. The consequences of ECC are much more than just cosmetic, but include heightened risk of gingivitis, periodontal disease, diabetes, cardiovascular disease, and much more. A foundational cause of poor dental hygiene lies with the innate anxiety towards dental care which can be enhanced from surrounding influences. This anxiety is part of a cycle, termed the cycle of dental anxiety, which lays out the continuous nature and gradual worsening of oral health. Intervention is needed at some point in the cycle if oral health is to improve, and I speculate intervention to be most important in the developing years of children under 14 years old.

I propose actions to be taken in three main areas of a child’s microsystem according to Bronfenbrenner’s Ecological Systems Theory. These areas include implementations in the school system, the dental office, and at home with parental behaviors. Having a three-fold approach to a child’s development of a dental care routine will, I conclude, drastically decrease the prevalence of ECC and subsequently slow the severity of the dental anxiety cycle.

Dental Brochure Theme 2 (1).pdf (124 kB)
Your Child's Oral Health and Your Role Brochure

Verbrugge Honors Thesis Presentation.mp4 (77385 kB)