Oral Health

Goal

Prevent and control oral and craniofacial diseases, conditions, and injuries, and improve access to preventive services and dental care.

Overview

The health of the mouth and surrounding craniofacial (skull and face) structures is central to a person’s overall health and well-being.1, 2 Oral and craniofacial diseases and conditions include:

• Dental caries (tooth decay)
• Periodontal (gum) diseases
• Cleft lip and palate
• Oral and facial pain
• Oral and pharyngeal (mouth and throat) cancers1, 2, 3, 4, 5

The significant improvement in the oral health of Americans over the past 50 years is a public health success story. Most of the gains are a result of effective prevention and treatment efforts. One major success is community water fluoridation, which now benefits about 7 out of 10 Americans who get water through public water systems.5

However, some Americans do not have access to preventive programs.1, 2, 3 People who have the least access to preventive services and dental treatment have greater rates of oral diseases.1, 2, 3, 4, 5, 6 A person’s ability to access oral health care is associated with factors such as education level, income, race, and ethnicity.1

Objectives in this topic area address a number of areas for public health improvement, including the need to:

• Increase awareness of the importance of oral health to overall health and well-being.
• Increase acceptance and adoption of effective preventive interventions.
• Reduce disparities in access to effective preventive and dental treatment services.

Why Is Oral Health Important?

Oral health is essential to overall health. Good oral health improves a person’s ability to speak, smile, smell, taste, touch, chew, swallow, and make facial expressions to show feelings and emotions.1, 2

However, oral diseases, from cavities to oral cancer, cause pain and disability for many Americans.

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Understanding Oral Health

Good self-care, such as brushing with fluoride toothpaste, daily flossing, and professional treatment, is key to good oral health.1, 2, 3, 4 Health behaviors that can lead to poor oral health include:

• Tobacco use
• Excessive alcohol use
• Poor dietary choices1, 4, 5

Barriers that can limit a person’s use of preventive interventions and treatments include:1, 2, 3

• Limited access to and availability of dental services
• Lack of awareness of the need for care
• Cost
• Fear of dental procedures

There are also social determinants that affect oral health. In general, people with lower levels of education and income, and people from specific racial/ethnic groups, have higher rates of disease.2, 3, 4, 5, People with disabilities and other health conditions, like diabetes, are more likely to have poor oral health.1

Community water fluoridation and school-based dental sealant programs are 2 leading evidence-based interventions to prevent tooth decay.

• Community water fluoridation is the most effective way to deliver the benefits of fluoride to a community. Studies show that it prevents tooth decay by 18 to 40 percent.
• School-based dental sealant programs, which focus on sealing permanent molar teeth, usually target schools that serve children from low-income families. Dental sealants can prevent up to 60 percent of tooth decay in the treated teeth.
  

Emerging Issues in Oral Health

Major improvements have occurred in the Nation’s oral health, but some challenges remain and new concerns have emerged. One important emerging oral health issue is the increase of tooth decay in preschool children. A recent Centers for Disease Control and Prevention (CDC) publication reported that, over the past decade, dental caries (tooth decay) in children ages 2 to 5 have increased.4

Lack of access to dental care for all ages remains a public health challenge. This issue was highlighted in a 2008 Government Accountability Office (GAO) report that described difficulties in accessing dental care for low-income children.6 In addition, the Institute of Medicine (IOM) has convened an expert panel to evaluate factors that influence access to dental care.

Potential strategies to address these issues include:

• Implementing and evaluating activities that have an impact on health behavior.
• Promoting interventions to reduce tooth decay, such as dental sealants and fluoride use.
• Evaluating and improving methods of monitoring oral diseases and conditions.
• Increasing the capacity of State dental health programs to provide preventive oral health services.
• Increasing the number of community health centers with an oral health component.
  

References

1US Department of Health and Human Services, Public Health Service, Office of the Surgeon General. Oral health in America: A report of the Surgeon General. Rockville, MD: National Institutes of Health, National Institute of Dental and Craniofacial Research; 2000, p. 33-59.

2US Department of Health and Human Services, Public Health Service, Office of the Surgeon General. Oral health in America: A report of the Surgeon General. Rockville, MD: National Institutes of Health, National Institute of Dental and Craniofacial Research; 2000, p. 155-88.

3US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention. A national call to action to promote oral health, Rockville (MD): National Institutes of Health, National Institute of Dental and Craniofacial Research; May 2003, p. 1 -53. (NIH Publication; no. 03-5303).

4Dye BA, Tan S, Smith V, et al. Trends in oral health status: United States, 1988–1994 and 1999–2004, Vital Health Stat. 2007 Apr;11(248):1-92.

5US Department of Health and Human Services, Centers for Disease Control and Prevention (CDC). Oral health: Preventing cavities, gum disease, tooth loss, and oral cancers: At a glance 2010 [Internet]. Atlanta: CDC; c2010 [cited 2010 March 8]. Available from: http://www.cdc.gov/chronicdisease/resources/publications/AAG/doh.htm#aag

6US Government Accountability Office (GAO). Medicaid: Extent of dental disease in children has not decreased and millions are estimated to have untreated tooth decay. 2008 Sep. 46 p. (GAO-08-1211).

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