Focus Area 21: Oral Health: Objectives and Subobjectives

As a result of the Healthy People 2010 Midcourse Review, changes were made to the Healthy People 2010 objectives and subobjectives. These changes are specific to the following situations:

Changes in the wording of an objective to more accurately describe what is being measured.
Changes to reflect a different data source or new science.
Changes resulting from the establishment of a baseline and a target (that is, when a formerly developmental objective or subobjective became measurable).
Deletion of an objective or subobjective that lacked a data source.
Correction of errors and omissions in Healthy People 2010.

Revised baselines and targets for measurable objectives and subobjectives do not fall into any of the above categories and, thus, are not considered a midcourse review change.¹

When changes were made to an objective, three sections are displayed:

In the Original Objective section, the objective as published in Healthy People 2010 in 2000 is shown.
In the Objective With Revisions section, strikethrough indicates text deleted, and underlining is used to show new text.
In the Revised Objective section, the objective appears as revised as a result of the midcourse review.

Details of the objectives and subobjectives in this focus area, including any changes made at the midcourse, appear on the following pages.

¹See Technical Appendix for more information on baseline and target revisions.

NO CHANGE IN OBJECTIVE

21-1.

Reduce the proportion of children and adolescents who have dental caries experience in their primary or permanent teeth.

21-1a. Reduce the proportion of young children with dental caries experience in their primary teeth.

Target: 11 percent.

Baseline: 18 percent of children aged 2 to 4 years had dental caries experience in 1988–94.

Target setting method: Better than the best.

Data sources: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS; Oral Health Survey of Native Americans, 1999, IHS; California Oral Health Needs Assessment of Children, Dental Health Foundation, 1993–94.

21-1b. Reduce the proportion of children with dental caries experience in their primary and permanent teeth.

Target: 42 percent.

Baseline: 52 percent of children aged 6 to 8 years had dental caries experience in 1988–94.

Target setting method: Better than the best.

Data sources: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS; Oral Health Survey of Native Americans, 1999, IHS; California Oral Health Needs Assessment of Children, 1993–94, Dental Health Foundation; Hawai’i Children’s Oral Health Assessment, 1999, State of Hawaii Department of Health.

21-1c. Reduce the proportion of adolescents with dental caries experience in their permanent teeth.

Target: 51 percent.

Baseline: 61 percent of adolescents aged 15 years had dental caries experience in 1988–94.

Target setting method: Better than the best.

Data sources: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS; Oral Health Survey of Native Americans, 1999, IHS; California Oral Health Assessment of Children, 1993–94, Dental Health Foundation.

NO CHANGE IN OBJECTIVE

21-2.

Reduce the proportion of children, adolescents, and adults with untreated dental decay.

21-2a. Reduce the proportion of young children with untreated dental decay in their primary teeth.

Target: 9 percent.

Baseline: 16 percent of children aged 2 to 4 years had untreated dental decay in 1988–94.

Target setting method: Better than the best.

Data sources: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS; Oral Health Survey of Native Americans, 1999, IHS; California Oral Health Needs Assessment of Children, 1993–94, Dental Health Foundation.

21-2b. Reduce the proportion of children with untreated dental decay in primary and permanent teeth.

Target: 21 percent.

Baseline: 29 percent of children aged 6 to 8 years had untreated dental decay in 1988–94.

Target setting method: Better than the best.

Data sources: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS; Oral Health Survey of Native Americans, 1999, IHS; California Oral Health Needs Assessment of Children, 1993–94, Dental Health Foundation; Hawai’i Children’s Oral Health Assessment, 1999, State of Hawaii Department of Health.

21-2c. Reduce the proportion of adolescents with untreated dental decay in their permanent teeth.

Target: 15 percent.

Baseline: 20 percent of adolescents aged 15 years had untreated dental decay in 1988–94.

Target setting method: Better than the best.

Data sources: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS; Oral Health Survey of Native Americans, 1999, IHS; California Oral Health Needs Assessment of Children, 1993–94, Dental Health Foundation.

21-2d. Reduce the proportion of adults with untreated dental decay.

Target: 15 percent.

Baseline: 27 percent of adults aged 35 to 44 years had untreated dental decay in 1988–94.

Target setting method: Better than the best.

Data sources: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS; Oral Health Survey of Native Americans, 1999, IHS.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

21-3.

Increase the proportion of adults who have never had a permanent tooth extracted because of dental caries or periodontal disease.

Target: 40¹ percent.

Baseline: 30² percent of adults aged 35 to 44 years had never had a permanent tooth extracted because of dental caries or periodontal disease in 1988–94.

Target setting method: Better than the best.

Data sources: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS; Oral Health Survey of Native Americans, 1999, IHS.

¹ Target revised from 42 because of baseline revision after November 2000 publication.
² Baseline revised from 31 after November 2000 publication.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

21-4.

Reduce the proportion of older adults who have had all their natural teeth extracted.

Target: 22¹ percent.

Baseline: 29² percent of adults aged 65 to 74 years had lost all of their natural teeth
in 1997.

Target setting method: Better than the best.

Data sources: National Health and Nutrition Examination Survey (NHANES),³ CDC, NCHS; Oral Health Survey of Native Americans, 1999, IHS.

¹ Target revised from 20 because of baseline revision after November 2000 publication.
² Baseline revised from 26 after November 2000 publication.
³ Data source revised from National Health Interview Survey (NHIS) after November 2000 publication.

NO CHANGE IN OBJECTIVE

21-5.

Reduce periodontal disease.

Target and baseline:

Objective	Reduction in Periodontal Disease in Adults Aged 35 to 44 Years	1988–94 Baseline Percent	2010 Target Percent
21-5a.	Gingivitis	48	41
21-5b.	Destructive periodontal disease	22	14

Target setting method: Better than the best.

Data sources: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS; Oral Health Survey of Native Americans, 1999, IHS.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

21-6.

Increase the proportion of oral and pharyngeal cancers detected at the earliest stage.

Target: 51¹ percent.

Baseline: 36² percent of oral and pharyngeal cancers (stage I, localized) were detected in 1990–95.

Target setting method: Better than the best.

Data source: Surveillance, Epidemiology, and End Results (SEER), NIH, NCI.

¹ Target revised from 50 because of baseline revision after November 2000 publication.
² Baseline revised from 35 after November 2000 publication.

NO CHANGE IN OBJECTIVE

21-7.

Increase the proportion of adults who, in the past 12 months, report having had an examination to detect oral and pharyngeal cancers.

Target: 20 percent.

Baseline: 13 percent of adults aged 40 years and older reported having had an oral and pharyngeal cancer examination in 1998 (age adjusted to the year 2000 standard population).

Target setting method: Better than the best.

Data source: National Health Interview Survey (NHIS), CDC, NCHS.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

21-8.

Increase the proportion of children who have received dental sealants on their molar teeth.

Target and baseline:

Objective	Increase in Children Receiving Dental Sealants on Their Molar Teeth	1988–94 Baseline Percent	2010 Target Percent
21-8a.	Children aged 8 years	23	50
21-8b.	Adolescents aged 14 years	15	50

Target setting method: Better than the best.

Data sources: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS; Oral Health Survey of Native Americans, 1999, IHS; Hawai’i Children’s Oral Health Assessment, 1999, State of Hawaii Department of Health.

NO CHANGE IN OBJECTIVE
21-9.	Increase the proportion of the U.S. population served by community water systems with optimally fluoridated water. Target: 75 percent. Baseline: 62 percent of the U.S. population was served by community water systems with optimally fluoridated water in 1992. Target setting method: 21 percent improvement. Data source: CDC Fluoridation Census, CDC, NCCDPHP.

NO CHANGE IN OBJECTIVE

21-10.

Increase the proportion of children and adults who use the oral health care system each year.

Target: 56 percent.

Baseline: 44 percent of persons aged 2 years and older in 1996 visited a dentist during the previous year (age adjusted to the year 2000 standard population).

Target setting method: Better than the best.

Data source: Medical Expenditure Panel Survey (MEPS), AHRQ.

NO CHANGE IN OBJECTIVE

21-11.

Increase the proportion of long-term care residents who use the oral health care system each year.

Target: 25 percent.

Baseline: 19 percent of all nursing home residents received dental services in the past month in 1997.

Target setting method: 32 percent improvement. (Better than the best will be used when data are available.)

Data source: National Nursing Home Survey, CDC, NCHS.

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

21-12.

Increase the proportion of low-income children and adolescents who received any preventive dental service during the past year.

Target: 66¹ percent.

Baseline: 25² percent of children and adolescents under age 19 years at or below 200 percent of the Federal poverty level received any preventive dental service in 1996.

Target setting method: Better than the best.

Data source: Medical Expenditure Panel Survey (MEPS), AHRQ.

¹ Target revised from 57 because of baseline revision after November 2000 publication.
² Baseline revised from 20 after November 2000 publication.

ORIGINAL OBJECTIVE

21-13.

(Developmental) Increase the proportion of school-based health centers with an oral health component.

Potential data source: School Health Policies and Programs Study (SHPPS), CDC, NCCDPHP.

OBJECTIVE WITH REVISIONS

21-13.

~~(Developmental)~~ Increase the proportion of school-based health centers with an oral health component.

Target and baseline:

Objective	Increase in the Proportion of School-Based Health Centers With an Oral Health Component	2001–02 Baseline Percent	2010 Target Percent
21-13a.	Dental sealants	12	15
21-13b.	Dental care	9	11

Target setting method: 25 percent improvement.

~~Potential d~~Data source: School ~~Health Policies and Programs Study (SHPPS), CDC, NCCDPHP~~-Based Health Care Census, National Assembly of School-Based Health Care.

REVISED OBJECTIVE

21-13.

Increase the proportion of school-based health centers with an oral health component.

Target and baseline:

Objective	Increase in the Proportion of School-Based Health Centers With an Oral Health Component	2001–02 Baseline Percent	2010 Target Percent
21-13a.	Dental sealants	12	15
21-13b.	Dental care	9	11

Target setting method: 25 percent improvement.

Data source: School-Based Health Care Census, National Assembly of School-Based Health Care.

ORIGINAL OBJECTIVE
21-14.	Increase the proportion of local health departments and community-based health centers, including community, migrant, and homeless health centers, that have an oral health component. Target: 75 percent. Baseline: 34 percent of local jurisdictions and health centers had oral health components in 1997. Target setting method: 19 percent improvement. Data source: HRSA, Bureau of Primary Health Care (BPHC).
OBJECTIVE WITH REVISIONS
21-14.	Increase the proportion of local health departments and community-based health centers, including community, migrant, and homeless health centers, that have an oral health component. Target: 75 percent. Baseline: 3452 percent of local jurisdictions and health centers had oral health components in 1997. Target setting method: ~~19 percent improvement~~Expert opinion. Data source: HRSA, Bureau of Primary Health Care (BPHC).
REVISED OBJECTIVE
21-14.	Increase the proportion of local health departments and community-based health centers, including community, migrant, and homeless health centers, that have an oral health component. Target: 75 percent. Baseline: 52 percent of local jurisdictions and health centers had oral health components in 1997. Target setting method: Expert opinion. Data source: HRSA, Bureau of Primary Health Care (BPHC).

NO CHANGE IN OBJECTIVE
(Data updated and footnoted)

21-15.

Increase the number of States and the District of Columbia that have a system for recording and referring infants and children with cleft lips, cleft palates, and other craniofacial anomalies to craniofacial anomaly rehabilitative teams.

Target: All States and the District of Columbia.

Baseline: 16 States and the District of Columbia had systems for recording and referring children with craniofacial anomalies in 2003.¹

Target setting method: Total coverage.

Data source: Association of State and Territorial Dental Directors.²

¹ Baseline revised from 23 after November 2000 publication.
² Data source revised from Survey of State Dental Directors, Illinois State Health Department, after November 2000 publication.

NO CHANGE IN OBJECTIVE

21-16.

Increase the number of States and the District of Columbia that have an oral and craniofacial health surveillance system.

Target: All States and the District of Columbia.

Baseline: No States or the District of Columbia had oral and craniofacial health surveillance systems in 1999.

Target setting method: Total coverage.

Data source: Association of State and Territorial Dental Directors.

ORIGINAL OBJECTIVE

21-17.

(Developmental) Increase the number of Tribal, State (including the District of Columbia), and local health agencies that serve jurisdictions of 250,000 or more persons that have in place an effective public dental health program directed by a dental professional with public health training.

Potential data sources: Association of State and Territorial Dental Directors; IHS.

OBJECTIVE WITH REVISIONS

21-17.

~~(Developmental)~~ Increase the number of ~~Tribal, State (including the District of~~ ~~Columbia), and local~~ health agencies that ~~serve jurisdictions of 250,000 or more~~ ~~persons that~~ have ~~in place an effective~~ a public dental health program directed by a dental professional with public health training.

Target and baseline:

Objective	Increase in the Number of Health Agencies That Have a Public Dental Health Program Directed by a Dental Professional With Public Health Training	2003 Baseline Number	2010 Target Number
21-17a.	For State (including the District of Columbia) and local health agencies that serve jurisdictions of 250,000 or more persons (out of 191)	39	41
21-17b.	For Indian Health Service Areas and Tribal health programs that serve jurisdictions of 30,000 or more persons (out of 27)	9	9

Target setting method: 5 percent improvement.

~~Potential d~~Data sources: Association of State and Territorial Dental Directors; Division of Oral Health, IHS.

REVISED OBJECTIVE

21-17.

Increase the number of health agencies that have a public dental health program directed by a dental professional with public health training.

Target and baseline:

Objective	Increase in the Number of Health Agencies That Have a Public Dental Health Program Directed by a Dental Professional With Public Health Training	2003 Baseline Number	2010 Target Number
21-17a.	For State (including the District of Columbia) and local health agencies that serve jurisdictions of 250,000 or more persons (out of 191)	39	41
21-17b.	For Indian Health Service Areas and Tribal health programs that serve jurisdictions of 30,000 or more persons (out of 27)	9	9

Target setting method: 5 percent improvement.

Data sources: Association of State and Territorial Dental Directors; Division of Oral Health, IHS.

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