Many things affect our health. The environment, socioeconomic status (SES), biology, and many others have an influence on our over all health every day. All of these are included in reasons for poor oral hygiene, but one factor in particular rises to the surface, behavior. Behavior is what promotes of inhibits health. Lack of good dental hygiene practices among today’s youth is a growing problem. Poor dental hygiene leads to tooth decay, which manifests itself in the form of dental caries. The CDC sites dental caries as the leading chronic disease in youth. The reason this problem is so important is because of the long-term implications of those who experience tooth decay coupled with the extremely preventable nature of the issue. Those with poor dental hygiene often find themselves on a less promising path. Low-income youth are in the midst of those most effected by tooth decay for many reasons. They experience lower levels of access to treatment either through lack of insurance or payment, no transportation, or simply geographic positions of providers. Also, deficient hygiene practices, lack of fluoridated water, high sugar and low nutrient diet fall under these reasons. While these factors are more prevalent in today’s low-income community, dental health behavior as a whole has been poorly prioritized resulting in our current situation. Lower rates of dental decay will start with basic dental hygiene. Brushing teeth, flossing, mouthwash, and regular dental appointments all form the basic practices that will result in healthier teeth, most of which are cheap and effective. Until the population understands the importance of a healthy mouth and takes advantage of the reasonably priced resources at our disposal, we will only continue to perpetuate the issue.
     There are a number of diseases and issues that occur alongside poor dental hygiene. Within the mouth, you can encounter dental decay, dental caries, and gum disease or periodontal disease. Gum disease can either present itself in the mildest form of Gingivitis with mild pain, and bloody, inflamed gums to peridontitis where the body betrays the mouth and begins destroying its infrastructure. Tooth decay is a result of plaque from saliva working with sugars and starches to form an acid that erodes the enamel or your teeth. After wearing away the enamel, the tooth decay eventually manifests itself as dental caries, better known as cavities.  (Peterson, 2005) Dental health issues may not be fatal most of the time, but they often have other implications. Those with poor oral health often have a more difficult time finding a job, performing in social situations, and other areas that affect overall quality of life.
     Apart from diseases of the mouth, poor dental hygiene can lead to a variety of other health related problems. Those with periodontal disease are at higher risk for cardiovascular disease because the bacterium from the mouth compromises the carotid artery. (Watt, 2012)  Similar blood clots put those with poor oral hygiene at risk for stroke. This is an example of how one vulnerable part of the body can have fatal repercussions because of their location to vital organs or systems.
     The Center for Disease Control (CDC) cites tooth decay, or dental caries, as the leading chronic disease in youth. (Centers for Disease Control, 2012) While water fluoridation has drastically controlled the rate of decay that alone is not the answer. The National Institute of Dental and Craniofacial Research conducted research on dental caries and decay in primary teeth of children two to eleven. Over all, 42 percent of children experience dental caries in their primary teeth. The disparity between low and higher income gains prominence through these statistics. For those children living under 100% of the poverty status, over 54% experience dental caries while of those who live 200% above the poverty, only 32% experience dental caries. The same applies to tooth decay. Of those children living under 100% poverty level, 32.5% had untreated dental decay in their primary teeth. For those living above 200% poverty level, only 15% had untreated tooth decay showing big differences between higher and lower income groups. (National Institute of Health, 2011) There are two observations to gather from the data. The percentage of children in general encountering some form of dental decay is extremely high, and the rates of those with untreated decay are too high. Second, the disparities between lower and higher income children with regard to dental hygiene indicate some gap in resources, knowledge, or other factors. When looking at the statistics, oral health appears to be a wide spread issue. If health behaviors can be emphasized and developed among today’s youth, oral health will be greatly enhanced.  
     Healthy People 2020 recognizes the mouth and its health as fundamental for a person’s overall well being. The overarching goal with regard to dental health is stated as to “Prevent and control oral and craniofacial diseases, conditions, and injuries, and improve access to preventive services and dental care.” (Healthy People 2020, 2012) Dental Hygiene fits in with the Healthy People 2020 goals with regards to two main objectives.  The first being “ Reduce the proportion of children and adolescents who have dental caries experience in their primary or permanent teeth.” (Healthy People 2020, 2012)  This goal is extended into three age groups: 3 to 5, 6 to 9, and 13 to 15, for each of which the goal is to reach a 10 percent improvement in adolescents and dental caries. The second Health People 2020 objective pertaining to this subject is to “reduce the proportion of children and adolescents with untreated dental decay.”  (Healthy People 2020, 2012) This too is divided into the same three age groups. For each of these age groups they again seek a 10 percent improvement in the treatment of tooth decay. Healthy People 2020 has many other goals with respect to dental care because they, much like the rest of the world should, see the mouth as one of the most vulnerable areas of the body that, if not taken care of properly, can be the source of many life altering episodes. Another reason oral health has become a focal point for the Healthy People initiative is the reality that dental hygiene plays an important part in directing an individual down the path they will continue on.
     Oral health is a vital part of sustaining a healthy life style. The world’s population has lost perspective on oral health. To combat this issue several theories have been applied to examine the prevalence of basic dental hygiene practices in youth especially directed towards underprivileged children. Many predisposing, enabling, and reinforcing factors go into why this is such a growing problem.  Finally, there are a number of programs and interventions that are yet to be installed, but are still in the works.