|
|
|
|
|
|
Preventing Chronic Disease: Investing Wisely in Health
Preventing Dental Caries (PDF–25K)
Learn more about
PDFs. |
|
|
Preventing Dental Caries
The Reality
- Although dental
caries (tooth decay) is largely preventable, it remains the most
common chronic disease of children aged 5 to 17 years—5 times more
common than asthma (59% versus 11%).
- Once established,
the disease requires treatment. A cavity only grows larger and more
expensive to repair the longer it remains untreated.
- Fewer than 1 in 5
Medicaid-covered children received at least one preventive dental
service in a recent year; many states provide only emergency dental
services to Medicaid-eligible adults.
- Poor children have
nearly 12 times more restricted-activity days because of
dental-related illness than children from higher-income families. Pain
and suffering due to untreated tooth decay can lead to problems in
eating, speaking, and attending to learning.
- Many adults also
have untreated dental caries (e.g., 27% of those 35 to 44 years old
and 30% of those 65 years and older).
Community-Based
Strategies Prevent Tooth Decay
Community Water
Fluoridation
- Community water
fluoridation has been ranked one of 10 great public health
achievements in the 20th century.
- Community water
fluoridation effectively prevents dental caries in communities with
varying disease prevalence. Children in communities with water
fluoridation experienced 29% fewer cavities.
- At present, 66% of
individuals on public water systems— over 162 million people—are
receiving the benefits of community water fluoridation.
School-Based Sealant
Programs
- Children receiving
dental sealants in school-based programs have 60% fewer new decayed
pit and fissure surfaces in back teeth for up to 2 to 5 years after a
single application. Among children, 90% of decay is in pits and
fissures.
- School-based sealant
programs provide sealants to children unlikely to receive them
otherwise (e.g., children in low-income households). Children of
racial and ethnic minority groups have about three times more
untreated decay and teeth missing due to caries but are about
one-third as likely to receive sealants.
- Although 29 states
reported dental sealant programs serving 193,000 children, this number
represents only about 3% of poor children who could receive sealants.
Meeting
Healthy People 2010 Objectives
*There is no Healthy
People 2010 objective for adult caries; 94% of adults who have one or more
natural teeth have experienced tooth decay.
Source: U.S. Department of Health and Human Services. Healthy People
2010, vol II. 2nd ed. Washington, DC: U.S. Government
Printing Office, 2000:21-11 to 21-15.
(A text
version of this graphic is also available.)
Community-Based
Strategies to Prevent Tooth Decay Save Money
- Every dollar spent
on community water fluoridation saves from $7 to $42 in treatment
costs depending on the size of the community. Savings are greatest in
large communities.
- At least 60% of the
U.S. population on public water systems has received fluoridated water
since 1990, translating to savings in dental treatment costs of over
$25.7 billion in the past decade
- School-based dental
sealant programs are cost saving when delivered to populations at
high-risk for tooth decay, such as children in low-income
households.
Effective
Strategies
- Community and school
partnerships raise awareness of the value of school sealant programs. Healthy
Smiles for Wisconsin, a CDC-supported state-wide effort to improve
the oral health of Wisconsin children through school and community
partnerships, began in October 2000; it helped to establish 40 new
community-based sealant programs during the 2000-2001 school year.
During that year, more than 4,500 children in 40 counties received
dental sealants.
- Community coalitions
are essential for gaining approval for community water fluoridation.
During the past decade, broad-based citizen coalitions in several
large U.S. cities have educated residents about the benefits of water
fluoridation. Water fluoridation was approved in many of these
jurisdictions, including Los Angeles and Sacramento, CA; Manchester,
NH; Las Vegas, NV; San Antonio, TX; and Salt Lake City, UT.
Hope for the
future
Many Americans now
enjoy markedly better oral health than their parents did. However, certain
segments of the population (e.g., those who are poor, who are members of
racial or ethnic minority groups, or who are elderly) still have severe
dental decay, much of which remains untreated. Healthy People 2010 seeks
to eliminate these disparities, so that all Americans receive the benefits
of good oral health. Community-based programs are a particularly
cost-effective way to help achieve this goal. For example, extending
fluoridated water to the remaining 34% of the population on public water
systems would save over $1.5 billion dollars per year. Increasing the
percentage of children at high risk for tooth decay who participate in
school sealant programs to 50% would prevent over half of the caries that
these children would otherwise have and save public health dollars.
State
Programs in Action: Ohio
School-based
sealant programs in Ohio began in 1984 with a single demonstration
program in one city. By 2000, 34 of Ohio’s 88 counties had
programs. These programs target children who are at high risk for
tooth decay and least likely to receive dental care.
As
the program has expanded, the percentage of 8-year-olds statewide
who have dental sealants has increased steadily, from 11% in 1987–88
to 30% in 1998–99. Although this percentage still falls short of
the Healthy People 2010 objective of 50%, children from all
demographic groups in schools with sealant programs have achieved or
exceeded the objective.
- Among children
eligible for the free and reduced-cost lunch program, 54% of
those in schools with sealant programs have sealants, compared
with 19% of those in schools without programs.
- Among children
covered by Medicaid, 58% in schools with sealant programs have
sealants, compared with 22% in schools without programs.
- In schools
with sealant programs, the same proportion of children on
Medicaid (58%) have sealants as those with private dental
insurance, thus eliminating a common disparity.
Although the Ohio
program has met only a portion of the need for dental sealants, it
has shown that school-based programs can reach children at high risk
for tooth decay with this effective preventive measure. |
For more information and references supporting these facts, visit
www.cdc.gov/nccdphp. For
additional copies of this document, E-mail
cdcinfo@cdc.gov.
Department of
Health and Human Services
Centers for Disease Control and Prevention |
|
Page last reviewed: November 25, 2005
Page last modified: November 25, 2005
Content source: National Center for
Chronic Disease Prevention and Health Promotion
|
|