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Americans Doing Better with Oral Health

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Americans Doing Better with Oral Health

Americans Doing Better with Oral Health

September 12, 2005
By: Jean Johnson for Dental1

It’s nice to get some good news, even if it does come tempered with considerable caution – and references to economic class issues related to dental health.

Released in late August, the report, “Surveillance for Dental Caries, Dental Sealants, Tooth Retention, Edentulism, and Enamel Fluorosis – United States, 1988-1994 and 1999-2002,” pointed to both positive trends and to outstanding problems.
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Tips for keeping healthy teeth:

Use fluoride toothpaste

Confine consumption of sugary foods to mealtimes and then brush directly after

Avoid sugary drinks between meals

Keep a toothbrush at the office to brush after lunch

Brush four minutes morning and night and floss each tooth surface 8-10 swipes

Once a week, try an eight minute brush for that fresh from the hygienist feeling


“The oral health status of Americans has significantly improved during the past decade,” according to a late-August report released by the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health and Nutrition Examination Survey (NHANES). Listed among major findings are:

1) A decrease, since 1994, in the percentage of children and teens that have never had tooth decay in their permanent teeth. This ranged from a 4 percent decrease in decay for Mexican-American children and adolescents, to an 18 percent decrease in white, non-Hispanic populations.

2) A 64 percent increased use of dental sealants among children across all racial and ethic groups in teens aged 6 to 19 years. Sealants are painted on youngsters’ teeth and protect them against the consumption of sugary foods that cause decay.

3) Increased tooth retention in older adults, with only one-fourth of those aged 60 and older having lost all their teeth. This figure represents a 20 percent decrease from the previous survey that found nearly a third of older adults had lost all their teeth.

“The good news is that efforts to reduce and prevent cavities and dental disease are paying off. We are seeing an increase in the number of children, teens and adults who have never had a cavity in their permanent teeth,” said William R. Maas, D.D.S., M.P.H., director of the CDC division of oral health. “It’s also very encouraging to find the dental health of children in lower income areas improved. Thanks to programs in schools that promote tooth brushing and dental sealants, we’re reaching more children at high risk for tooth decay and helping them to avoid cavities and fillings.”

That said, the CDC/NHANES report cautions that “65 percent of adolescents aged 16 to 19 years have tooth decay or fillings in their permanent teeth.” It also cites problems in oral health status of the elderly, including adult populations of all ages that smoke. Fourteen percent of those older than 20 years who smoke had lost all their teeth. Compare that to the 4.6 percent of the same age class that does not smoke and the difference rings in close to 10 percent.

Further, the report addresses side-effects of fluoridation. Although fluoride is known to protect teeth from decay, a condition known as enamel fluorosis that spots, discolors, or pits teeth can arise. Researchers concluded, however, that the fluorisis seen in one-third of the children and adolescents surveyed was “very mild.” Moreover, experts stated that “moderate to severe fluorosis, where teeth are discolored and sometimes pitted, was found in less than 4 percent” of the group.

Economic class influences oral health

“This survey represents the oral heath of more than 256 million Americans,” said acting director of the division of clinical research and health promotion at NIH’s National Institute of Dental and Cranofacial Research, Bruce Pihlstrom, D.D.S. “While the findings are encouraging, the report clearly tells use that more effort is needed to improve the oral health of low-income Americans.”

Pihlstrom refers to disparities in untreated decay in children, youth and adults as well as the use of dental sealants. Generally, several percentage points separated the quality of oral health and access to preventative measures like sealants in Mexican-American and black populations, and their more affluent white counterparts. Similarly one third of the lower income adults surveyed had untreated tooth decay, as opposed to 16 percent of those in higher income brackets.

In 2000, the first-ever Surgeon General’s report on oral health responded to what pundits called a “silent epidemic.” According to then Surgeon General David Satcher, M.D., Ph.D., “During the last 50 years there have been dramatic improvements in oral health, and most middle-aged and younger Americans expect to retain their natural teeth over their lifetimes. However, this report illustrates profound disparities that affect those without the knowledge or resources to achieve good oral care. Those who suffer the worst oral health include poor Americans, especially children and the elderly. Members of racial and ethic groups also experience a disproportionate level of oral health problems. And, those with disabilities and complex health conditions are at greater risk for oral diseases that, in turn, further complicate their health.”

Satcher covered all the bases, and by virtue of its most recent report, it’s clear that government heeded the warning and used the last five years to work on the problem. Thus the statistics in the recent report reflect improvement in both overall oral health as well as more equitable access to education and measures aimed at helping all Americans keep their natural teeth in good condition as they age. For those who never did like spending their time off in the dental chair, it really is good news.

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