What Heart Health and Children’s Oral Health Reveal About the System We’re Building

February is observed as both American Heart Month and National Children’s Dental Health Month. In Texas, placing these two side by side offers more than a calendar coincidence.

It offers perspective.

At first glance, heart disease and childhood tooth decay seem worlds apart. One is associated with aging and cardiology, the other with early childhood and pediatric dentistry. But together, they illuminate something deeper about how our health system functions, specifically when and where do we invest in prevention?

A Clear Signal from Texas Data

Recent data presented by the Texas Health and Human Service Commission show that heart disease hospitalization charges in Texas exceeded $33.5 billion in 2023.

That figure reflects advanced disease acute events, complications, and inpatient care. It is not a prevention statistic; rather, a downstream statistic.

Children’s oral health does not carry a similar price tag headline. Yet untreated tooth decay remains the most common chronic condition of childhood, and preventable dental issues are a frequent reason for emergency department visits, one of the most expensive settings for care that could have been delivered earlier and more simply. In Texas, there were 122,096 emergency room visits for non-traumatic dental conditions in 2016, the average cost of which was $1,853 and an estimated 80% of which were preventable.

The scale differs.

The system pattern does not.

There is also a well-documented clinical association between periodontal disease and cardiovascular conditions. Chronic oral inflammation has been linked to increased risk of atherosclerosis and adverse cardiac events. While these causal pathways continue to be studied, the evidence underscores that oral health and cardiovascular health are biologically connected not isolated domains.

Yet even setting aside the clinical linkage, both conditions independently reveal a broader structural insight: when prevention is uneven, risk accumulates and costs concentrate downstream.

Prevention as Infrastructure, or an Afterthought?

What connects these two conditions is structural. Both reveal what happens when prevention is inconsistently embedded into the system, when:

• Routine care is fragmented,
• Workforce access varies by geography,
• Financing separates oral health from medical care, and
• Early risk is identified but not systematically managed.

Heart disease is the visible and costly endpoint of accumulated risk. Children’s oral health is often the earliest indicator of how well prevention is functioning.

As prevention becomes more consistently embedded, accessible, financed, measured, and expected, we anticipate seeing:

• Fewer emergency visits for dental pain,
• Earlier management of hypertension and metabolic risk, and
• Lower concentration of cost in hospital settings.

Texas has made significant investments in health care. The ongoing opportunity is ensuring those investments are activated early enough to change trajectory.

What This Means for Health System Transformation

Texas continues to face meaningful challenges in healthcare access and affordability. That reality shapes both childhood prevention and adult chronic disease outcomes.

If transformation efforts are serious about sustainability, they must grapple with a simple reality:

A system designed primarily to respond to advanced disease will always be more expensive than one designed to manage risk early.

Heart disease hospitalization charges exceeding $33 billion are not simply a cardiology concern. They are a reflection of long-term system design choices.

Children’s oral health offers an early indicator of how system design choices shape long-term outcomes.

Together, they challenge us to ask:

• Is prevention embedded as infrastructure — or layered on as programming?
• Are payment models aligned with early intervention?
• Is oral health integrated into primary care conversations?
• Are workforce investments reaching high-need communities?

A February Perspective

American Heart Month and Children’s Dental Health Month are often framed as awareness campaigns. In Texas, they can serve as something more: a diagnostic lens.

They reveal that:

• Risk accumulates long before hospitalization,
• Early signals appear in childhood, and
• Costs concentrate downstream when prevention is uneven.

The ongoing opportunity is to continue strengthening prevention as core infrastructure, foundational to health system design.

If we build differently at the front end, the back-end numbers will follow.

THI’s monthly Texas Health Lens blog offers independent, Texas-focused insights on complex health issues. If this perspective is valuable to you, consider supporting our work as a monthly donor.