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Preventing Dental Caries with Community Programs
The Reality
- Although dental caries (tooth decay) is largely preventable, it
remains the most common chronic disease of children aged 6 to 11 years
(25%) and adolescents aged 12 to 19 years (59%). Tooth decay is four
times more common than asthma among adolescents aged 14 to 17 years (59%
compared with 15%).
- 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 3 children enrolled in Medicaid received at least
one preventive dental service in the past year. Many states provide only
emergency dental services to Medicaid-eligible adults.
- Many adults also have untreated tooth decay—28% of those aged 35 to
44 years and 18% of those aged 65 years and older.
Community-Based
Strategies Prevent Tooth Decay
Community Water
Fluoridation
- Community water fluoridation has been ranked as 1 of the 10 great
public health achievements in the 20th century.
- Although community water fluoridation prevents tooth decay, people
also get fluoride from other sources, such as toothpaste, rinses, and
other topical applications at the dental office.
- At present, 69% of individuals on public water systems—more than 184
million people—are receiving the benefits of community
water fluoridation.
(A text
version of this graphic is also available.)
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 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 from
low-income families who otherwise might not receive them. Children of
racial and ethnic minority groups have twice as much untreated decay in
their permanent teeth, but only receive about half as many dental
sealants as non-Hispanic white children.
- Thirty-six states reported dental sealant programs serving 258,000
children. This number, however, represents only about 8% of children
from low-income families who could receive sealants.
Community-Based
Strategies to Prevent Tooth Decay Save Money
- Depending on the size of the community, every dollar spent for
community water fluoridation saves from $8 to $49 in treatment costs.
Savings are greatest in large communities.
- Fluoridated water saves more than $4.6 billion annually in dental
costs in the United States.
- 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 about the value of
school sealant programs. Healthy Smiles for Wisconsin, a CDC-supported
statewide effort to improve the oral health of Wisconsin children
through school and community partnerships, began in October 2000. This
program helped to establish new community-based sealant programs, and in
2007–2008, these programs provided sealants to 9,202 children in 19
counties.
- 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
Compared with their parents, many Americans now enjoy markedly better
oral health. However, certain segments of the population (e.g., those
who have low incomes, are members of racial or ethnic minority groups,
or are older) have severe dental decay, much of which remains untreated.
Healthy People 2010 objectives seek to eliminate these
disparities, so that all Americans receive the benefits of good oral
health. Community-based programs, such as community water fluoridation
and school-based dental sealant programs, are cost-effective ways to
achieve this goal. For example, if half of the children at high risk for
tooth decay participated in school sealant programs, half of the caries
that these children otherwise would develop would be prevented.
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 statewide percentage of 8-year-olds
who have dental sealants has increased steadily, from 11% in
1987–1988, to 30% in 1998–1999, and most recently to 43% in 2007.
Although this percentage still falls short of the Healthy People
2010 objective of 50% of the state’s 8-year-olds having sealants,
children from all demographic groups in schools with sealant
programs have achieved or exceeded the objective.
The Ohio program has shown that school-based programs could
potentially reduce or eliminate racial and economic disparities by
reaching children at high risk for tooth decay.
For more information and references supporting these facts,
please visit
www.cdc.gov/nccdphp. |
Department of
Health and Human Services
Centers for Disease Control and Prevention |
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Page last reviewed: May 22, 2009
Page last modified: May 22, 2009
Content source: National Center for
Chronic Disease Prevention and Health Promotion
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