Preventing Cavities, Gum Disease,
At A Glance
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“Oral health is essential to general health and
well-being at every stage of life.”
A National Call to Action to Promote Oral Health
Office of the U.S. Surgeon General
Oral Health Problems: Painful, Costly, and Preventable
Mouth and throat diseases, which range from cavities to cancer, cause
pain and disability for millions of Americans each year. This fact is
disturbing because almost all oral diseases are largely preventable.
For children, cavities are a common problem that begins at an early age.
Tooth decay affects more than one-fourth of U.S. children aged 2–5 and half
of those aged 12–15. Low-income children are hardest hit: about two-thirds
of those aged 12–19 have had decay. Untreated cavities can cause pain,
dysfunction, absence from school, and poor appearance—problems that can
greatly affect a child’s quality of 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 65 have lost all of their
teeth—primarily because of tooth decay, which affects more than 90% of
adults over age 40, and advanced gum disease, which affects 5%–11% of
adults. Tooth loss can affect self-esteem, and 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 U.S. adults. In
2007, an estimated 34,000 people will learn that they have mouth or throat
cancer, and more than 7,550 will die of these diseases.
In 2007, Americans made about 500 million visits to dentists, and an
estimated $98.6 billion was spent on dental services. Yet many children and
adults still go without measures that have been proven effective in
preventing oral diseases and reducing dental care costs. For example, over
100 million Americans still do not have access to water that contains enough
fluoride to protect their teeth, even though the per capita cost of water
fluoridation over a person’s lifetime is less than the cost of one dental
description of this map is also available.]
CDC’s National Leadership to Improve Oral Health
CDC is committed to ensuring that all people, especially those at
greater risk for health disparities, will achieve their optimal lifespan
with the best possible quality of health in every stage of life. With
agency-wide health protection goals that support healthy people in
healthy places across all life stages, CDC is setting the agenda to
enable people to enjoy a healthy life by delaying death and the onset of
illness and disability by accelerating improvements in public health.
In addition, CDC is the lead federal agency responsible for promoting
oral health through public health interventions. With fiscal year 2008
funding of $12.4 million, CDC
- Helps states strengthen their oral health programs, reach people
hardest hit by oral diseases, and expand the use of measures proven
effective in preventing oral diseases.
- Promotes oral health in communities, schools, and health care
- Supports research to strengthen prevention efforts at the community
- Evaluates the cost-effectiveness of prevention strategies.
Building Capacity in States
CDC provides 16 states with funds, technical assistance, and training to
build strong oral health programs. With CDC support, states can better
promote oral health, monitor oral health behaviors and problems, and
conduct and evaluate prevention programs. This funding also allows
states to enhance coordination and management of community water
fluoridation programs and school-based dental sealant programs. CDC also
works with the Association of State and Territorial Dental Directors to
guide states on oral health issues, improve state oral health program
standards, and help states develop the expertise to assess oral health
needs and conduct effective prevention programs.
Encouraging Effective Use of Fluoride
CDC provides national leadership in assessing the appropriate use of
various forms of fluoride. CDC also works with state and national
partners to improve the quality of water fluoridation and to implement
water fluoridation in new communities. Over the past 60 years, the
damage caused by tooth decay has been drastically reduced, primarily
through the use of fluoride. The most cost-effective way to deliver the
benefits of fluoride to all residents of a community is through water
fluoridation—that is, adjusting the fluoride in the public water supply
to the right level for decay prevention.
A peer-reviewed CDC study found that, in communities with more than
20,000 residents, every $1 that is invested in community water fluoridation
yields about $38 in savings each year from fewer cavities treated. The Task
Force on Community Preventive Services, which strongly recommends community
water fluoridation, concluded that tooth decay in American children has
decreased by 30%–50% because of fluoridation. CDC activities for promoting
fluoride include the following:
- Issuing Recommendations for Using Fluoride to Prevent and Control
Dental Caries in the United States.
- Providing fluoridation training to state drinking water system
engineers, dental directors, and other public health staff members.
- Managing a Web-based system that helps states monitor the quality of
fluoridated water systems.
- Educating people throughout the country on the appropriate use of
Promoting Use of Dental Sealants
Dental sealants—a plastic coating applied to the chewing surfaces of the
back teeth—are a safe, effective way to prevent cavities among
schoolchildren. In some cases, sealants can even stop tooth decay that
has already started. Sealants significantly reduce a child’s risk for
Although progress has been made toward the national Healthy People
2010 objective, which calls for half of all U.S. children to have dental
sealants, only about one-third of children aged 6–19 do. Children in some
racial and ethnic groups and who live in low-income households are less
likely to have sealants. For example, fewer than 1 in 4 African American and
Mexican American children have sealants.
The Task Force on Community Preventive Services strongly recommends
school-based or school-linked sealant programs as an effective way to
prevent and control cavities. CDC researchers also have evaluated several
strategies and found that delivering sealants to all children attending
low-income schools was a cost-effective strategy for reducing disparities in
sealant use. By offering school-based or school-linked programs, some
communities have already reached the Healthy People 2010 objective
for dental sealants. CDC currently is working with experts to revise the
guidelines for school-based dental sealant programs.
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Helping States Improve Oral Health
Focusing on Adult Oral Health
CDC continues to expand activities that support a range of community
approaches to promote adult oral health and reduce oral disease. These
approaches include monitoring oral health status, expanding
partnerships, supporting prevention research, and increasing public and
professional awareness of common oral conditions, risk factors, and
CDC has provided several State-based Examples of Network, Innovation,
Opportunity, and Replication (SENIOR) grants to help states identify unmet
oral health needs among older adult populations at high risk for oral
diseases, as well as to devise community strategies to address these needs.
Lessons learned from grant-funded projects are being shared with
stakeholders involved in aging, public health, and dental public health
Guiding Infection Control in Dentistry
Infection control in dental offices is essential to ensuring the
public’s safety and retaining its confidence. To help minimize the risk
of transmitting infectious diseases in dental environments, CDC
published an updated Guidelines for Infection Control in Dental
Health-Care Settings—2003 (MMWR 2003;52[RR-17]; available at
CDC recommendations guide infection control practices in dental offices
nationally and globally and provide direction for the public, policy makers,
and dental practitioners. These recommendations also affect technology
development in the dental industry. In addition, CDC investigates disease
transmission in dental offices and identifies emerging problems.
Supporting Prevention Research
CDC supports research to enhance the effectiveness of interventions to
prevent oral diseases. Research activities include reviewing scientific
evidence to see which interventions have been successful and conducting
studies to assess the cost-effectiveness of successful interventions,
identify the most efficient ways of delivering them, and evaluate their
ability to prevent and control oral disease.
CDC staff also have developed computer software that allows state and
local programs to assess the impact of providing sealants, including the
estimated reduction in the cost of treating oral diseases.
Monitoring Oral Health in America
Routine surveys provide a wealth of information about the oral health of
Americans—for instance, what are the most serious oral health problems,
how many people are receiving preventive services, which oral diseases
are on the rise, and which groups of people are most at risk. Currently,
CDC is leading a panel of experts in developing self-reported measures
of gum (periodontal) health status.
CDC also supports Web-based systems that bring together oral health data
from many sources and make this information widely available to public
health professionals and consumers. For example, the National Oral Health
Surveillance System (available at http://www.cdc.gov/nohss) links oral
health data from various state-based systems, including state oral health
surveys and the Behavioral Risk Factor Surveillance System.
In addition, the annual State Dental Program Synopses (available at
http://apps.nccd.cdc.gov/synopses/index.asp) present state population
demographics and information about the activities and funding levels of
state dental programs.
CDC also manages the Data Resource Center, a joint project with the
National Institute of Dental and Craniofacial Research, which assembles oral
health data and other information needed to support research, policy
development, and program evaluation (http://drc.hhs.gov).
In addition, CDC helps health departments collect, interpret, and share
oral health data specific to their areas. States and communities use the
data to monitor their progress in meeting Healthy People 2010 goals
for oral health, target limited resources to people with the greatest needs,
and compare their oral health problems with those of other states and the
nation as a whole.
CDC will continue to help states strengthen their oral health programs
and develop effective interventions. CDC also will continue to seek
opportunities to work with partners in oral health research,
surveillance, education, and evaluation in order to develop and extend
prevention interventions to additional communities.
For more information please contact
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion,
4770 Buford Highway NE, Mail Stop F–10, Atlanta, GA 30341-3717
Telephone: 770-488-6054 • E-mail:
firstname.lastname@example.org • Web:
Page last reviewed: September 25, 2008
Page last modified: September 25, 2008
Content source: National Center for
Chronic Disease Prevention and Health Promotion