Federal report notes improvements in oral health care

Aug. 26, 2005
CDC and NIH data indicate more children and teens with less caries.

The oral health status of Americans has significantly improved during the past decade, according to a report released today by the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). The report uses data from the National Health and Nutrition Examination Survey (NHANES) and provides the most current estimates of dental conditions such as cavities, use of dental sealants to prevent cavities, and tooth loss.

Among the major findings are improvements since 1994 in the percentage of children and teens who have never had tooth decay in their permanent teeth; increased use of dental sealants (a thin plastic coating applied to the chewing surfaces of back teeth to prevent decay); and increased tooth retention among older adults.

"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 Dr. William R. Maas, DDS, MPH, director, 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."

However, the report does find that 65 percent of adolescents aged 16 to 19 years have had tooth decay or fillings in their permanent teeth.

"This survey represents the oral health of more than 256 million Americans," said Dr. Bruce Pihlstrom, DDS, acting director of the division of clinical research and health promotion at NIH's National Institute of Dental and Craniofacial Research. "While the findings are encouraging, the report clearly tells us that more effort is needed to improve the oral health of low-income Americans."

Other key findings of the report include:

• There was a 15 percent decrease in the prevalence of tooth decay in permanent teeth for children and adolescents aged 6 to19 years. This ranged from a 4 percent decrease in decay for Mexican-American children/adolescents to an 18 percent decrease in white, non-Hispanic children and adolescents.

• There was a 64 percent increase in the use of dental sealants among children and adolescents aged 6 to19 years, with one in three children having at least one dental sealant on their permanent teeth. This increase was found across all racial and ethnic groups and for children of all income levels.

• One-quarter of adults aged 60 and older had lost all their teeth — a decrease of nearly 20 percent from the previous survey, which found that nearly a third of all older adults had lost all their teeth.

• Smokers had a greater chance of being toothless. Fourteen percent of current smokers older than 20 years had lost all their teeth, compared with only 4.6 percent of people who had never smoked.

• About one-third of children and adolescents 6 to 19 years had enamel fluorosis of their teeth, although most was very mild. Enamel fluorosis happens when the teeth absorb too much fluoride as they develop beneath the gums. In its mildest form, fluorosis shows up as white spots on the teeth. Moderate to severe fluorosis, where teeth are discolored and sometimes pitted, was found in less than 4 percent of children and adolescents.

Despite improvements in tooth decay levels, increased dental sealant use, and greater retention of teeth among adults, disparities in oral health remain. For instance, 32 percent of Mexican-American and 27 percent of non-Hispanic black children aged 2 to 11 years had untreated decay in their primary (baby) teeth, compared to 18 percent of non-Hispanic white children.

Although there were increases in the use of dental sealants for children of all racial and income groups, a larger percentage of non-Hispanic white children (37.9 percent) had at least one sealed tooth, compared with Mexican-American (23.4 percent) or non-Hispanic black (22.6 percent) children.

Disparities in oral health also were seen among adults. Among higher income adults, 16 percent had untreated tooth decay, compared to more than one-third of lower income adults.

The full report, "Surveillance for Dental Caries, Dental Sealants, Tooth Retention, Edentulism and Enamel Fluorosis — United States, 1988-1994 and 1999-2002," is available at www.cdc.gov.