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1993.11.29 : Dental Decay

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
FOR IMMEDIATE RELEASE       Contact: Bill Grigg
Nov. 29, 1993               (202) 690-6867

The U.S. Public Health Service's oral health coordinating committee
reported today that dental decay -- despite a 20-year decline
resulting primarily from fluoride use -- probably remains the most
common yet easily preventable disease of American children.

The PHS committee said that by the time they graduate from high
school, 84 percent of young people have had one or more caries, or
"cavities", in their permanent teeth.

Furthermore, the committee said, infections of gum tissue
(gingivitis and periodontal disease) occur widely in children as
well as adults, affecting about half of all Americans. 

Robert J. Collins, DMD, MPH, PHS chief dental officer, chaired the
committee. He and other committee members report these findings in
the November-December Public Health Reports, the journal of the
PHS, which was published today. The findings are based on national
surveys by PHS agencies (the National Institute of Dental Research
and the Centers for Disease Control and Prevention) and by the
Health Care Financing Administration. 

The committee said that while fluorides protect smooth surfaces of
the teeth, caries in the pits and fissures of teeth continue to
occur.

Dental sealants, a plastic coating, can prevent most of these
caries on the biting surfaces of teeth but, the committee said, in
a recent year less than 11 percent of children had this relatively
inexpensive preventive.

Other findings include:

-- In 1992, an estimated 30,000 new cases of mouth and throat
cancer were diagnosed and more than 8,000 deaths occurred, making
this disease -- which often can be spotted in early stages during
a dental exam -- more common than such cancers as leukemia,
Hodgkin's disease, melanoma of the skin, or cancer of the brain,
cervix, ovary, liver, pancreas, bone, thyroid, testes or stomach.

-- African-American and other minority children as well as those
from low-income families had higher levels of untreated dental
disease. These are the groups with the least access to primary
dental care.

__ In some children, a rampant decay results from the frequent or
prolonged use of baby bottles containing milk, sugared water, fruit
juice or other sugary beverages during the day and night, sometimes
used to quiet infants outside of ordinary feeding times. 

Correction of the baby bottle decay can be costly, traumatic and
even risky, the committee said, since the restorative work may have
to be done under general anesthesia.

The report says dental problems wear down children's stamina,
sometimes produce constant pain, often have a significant impact on
general health and may indirectly result in death. (Dental and oral
diseases and the treatment required can result, for example, in
infective endocarditis, an infection of the lining membrane of the
heart with a 50 percent mortality rate.)

The PHS committee said, "One of the principal barriers to dental
care is cost. More than 150 million Americans have no dental
insurance coverage. Public programs pay for less than 3 percent of
all dental services and eligibility for these programs is highly
variable."

Philip R. Lee, M.D., HHS assistant secretary for health and
director of the Public Health Service, said, "The committee's
report shows how much the dental benefits for children under
President Clinton's Health Security Act could mean. The Health
Security Act would provide the sealants and other preventive
treatments that the committee said are needed by our children --
and would produce a corresponding improvement in their health,
their strength and even their scholarship."

The PHS committee said that in 1991 and 1992, fiscal crises in many
states resulted in cuts in assistance to the poor that were deeper
than any since the early 1980s. The committee said, "Further
improvement of the oral and general health of Americans can be
accelerated by ensuring improved access to primary preventive and
early intervention services."

The 20-year decline in cavities that has occurred, the committee
said, resulted from community water fluoridation, increased use of
toothpastes containing fluorides, the use of fluoride supplements
and rinses, fluorides in prepared foods and beverages and changes
in diet, such as decreased sugar consumption.