Oral Health 101

The oral health status of Americans has significantly improved during the past decade, according to the August 2005 report titled, "Surveillance for Dental Caries, Dental Sealants, Tooth Retention, Edentulism and Enamel Fluorosis - United States, 1988-1994 and 1999-2002."

Among the 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. However, the report does find that 65 percent of adolescents ages 16 to 19 years have had tooth decay or fillings in their permanent teeth. And despite improvements in tooth decay levels, increased dental sealant use, and greater retention of teeth among adults, disparities in oral health remain.

Members of racial and ethnic minority groups experience a disproportionate level of oral health problems. More specifically, African Americans, Hispanics, American Indians, and Alaska Natives generally have the poorest oral health of any of the racial and ethnic groups in the U.S. population. Fewer people have dental insurance than have medical insurance, and routine use of dental services is relatively low among racial and ethnic minorities.

Preventing Oral Health Problems

Mouth and throat diseases, which range from cavities to cancer, cause pain and disability for millions of Americans. This fact is disturbing because almost all oral diseases can be prevented.

For children, cavities are a common problem that begins at an early age. Tooth decay affects more than one-fifth of U.S. children aged 2-4, half of those aged 6-8, and nearly 60 percent of those aged 15. Low-income children are hardest hit: about one-third have untreated decay. Untreated cavities may cause pain, dysfunction, absence from school, underweight, and poor appearance-problems that can greatly reduce a child's capacity to succeed in life.

Tooth decay is also a problem for U.S. adults, especially for the increasing number of older adults who have retained most of their teeth. Despite this increase in tooth retention, tooth loss remains a problem among older adults. One fourth of adults over age 60 have lost all of their teeth, primarily because of tooth decay, which affects 95 percent of all adults, and advanced gum disease, which affects about 1 in 4 adults. Tooth loss has more than cosmetic effects-it may contribute to nutrition problems by limiting the types of food that a person can eat.

In addition, oral cancers pose a threat to the health of American adults. Each year, about 28,000 people learn that they have mouth and throat cancers, and nearly 7,200 die of these diseases.

Oral Health is Associated with Other Diseases and Conditions

According to the Surgeon General's 2000 Fact Sheet on Oral Health:

• Mouth lesions and other oral conditions may be the first sign of HIV infection, and are used to determine the stage of infection and to follow its progression to AIDS.
• Studies in post-menopausal women suggest that bone loss in the lower jaw may precede the skeletal bone loss seen in osteoporosis.
• Gum infections have been called "the sixth complication of diabetes," because people with diabetes are more likely to have periodontal disease.
• Recent studies point to an increased risk of heart disease and stroke in people with gum infections; the risk increases with the severity of the oral infection. However, there is not yet enough evidence to establish oral infection as an independent risk factor for heart disease or stroke.
• Some studies have found that mothers of preterm, low birth weight infants tend to have more severe gum disease than mothers of normal birth weight babies. More research is needed to determine if gum infections do indeed contribute to babies being born too soon and too small.

What You Can Do to Maintain Good Oral Health

• Drink fluoridated water and use a fluoride toothpaste. Fluoride's protection against dental decay works at all ages.
• Take care of your teeth and gums. Thorough tooth brushing and flossing to reduce dental plaque can prevent gingivitis - the mildest form of gum disease.
• Avoid tobacco. In addition to the general health risks posed by tobacco, smokers have 7 times the risk of developing gum disease compared to non-smokers. Tobacco use in any form -- cigarette, pipes, and smokeless (spit) tobacco -- increases the risk for gum disease, oral and throat cancers, and oral fungal infection (candidiasis). Spit tobacco containing sugar increases the risk of tooth decay.
• Limit alcohol. Heavy use of alcohol is also a risk factor for oral and throat cancers. When used alone, alcohol and tobacco are risk factors for oral cancers, but when used in combination the effects of alcohol and tobacco are even greater.
• Eat wisely. Avoiding sugars and starches when snacking applies to adults as well as children. Limit the number of snacks eaten throughout the day. The recommended five-a-day helping of fiber-rich fruits and vegetables stimulates salivary flow to aid re-mineralization of tooth surfaces with early stages of tooth decay.
• Visit the dentist regularly. Check-ups can detect early signs of oral health problems and can lead to treatments that will prevent further damage and in some cases reverse the problem. Professional tooth cleaning also is important for preventing oral problems, especially when self-care is difficult.
• Diabetic patients should work to maintain control of their disease. This will help prevent the complications of diabetes, including an increased risk of gum disease.
• If medications produce a dry mouth, ask your doctor if there are other drugs that can be substituted.
• Have an oral health check-up before beginning cancer treatment. Radiation to the head or neck and/or chemotherapy may cause problems for your teeth and gums. Treating existing oral health problems before cancer therapy may help prevent or limit oral complications or tissue damage.

For more information on oral health:

National Institute of Dental and Craniofacial Research
http://www.nidcr.nih.gov

Centers for Disease Control and Prevention - Division of Oral Health
http://www.cdc.gov/OralHealth