Although dental cavities (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 (15%).
Once established, the disease requires treatment. A cavity only grows larger and more expensive to repair the longer it remains untreated.
Less than 1 of 3 children enrolled in Medicaid received at least one preventive dental service in a recent year. Many states provide only emergency dental services to Medicaid-eligible adults.
Many adults also have untreated tooth decay (28% – 35 to 44 yrs., 18% – 65 & older).
1) Children receiving dental sealants in school-based programs have 60% fewer new decay in the pit and fissure surfaces of back teeth. (90% of decay is in pits and fissures).
2) 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 twice the number of untreated decay in their permanent teeth, but only receive about half as many dental sealants.
3) Thirty-six states reported dental sealant programs serving 258,000 children. This number, however, represents only about 8% of lower income children who could receive sealants.
Fact Resource > CDC Preventing dental caries with community Programs/Meeting Healthy people 2010 Objectives.
1) About 1 in 4 non-elderly adults have untreated tooth decay. The rate among low-income adults is twice that for adults with more income (41% versus 19%).
2) Employed adults lose over 164 million hours of work a year related to oral health problems or dental visits.
3) For every adult without health insurance, an estimated three lack dental insurance.
4) Dental benefits are mandatory for children in Medicaid, but adult dental services are covered at state option. Most states provide some adult dental benefits, but half restrict their coverage to emergency services, and adult dental benefits are frequently cut or eliminated when states face budget pressures.
5) In 2010, 22% of low-income adults had gone five years or more without a dental visit, or had never had a visit.
1) Medicare does not provide coverage for routine dental care. Some beneficiaries have dental coverage through private plans, or through Medicaid, but the scope of coverage varies widely.
2) One in four Medicare beneficiaries have no natural teeth. This condition can often lead to other health issues, including nutritional deficiencies.
3) Nearly half (44%) of all Medicare beneficiaries report no dentist visit in the past year, and 22% report they have not seen a dental provider in the last five years. Among lower-income beneficiaries, one in three has not visited a dental provider in five years.
4) Medicare beneficiaries who used any dental services in 2008 spent, on average, $672 out-of-pocket for dental care.
Fact Resource > Kaiser Family Foundation
Elderly and Military Veterans
1) December 2006 – Older Americans make up a growing percentage of the U.S. population; according to the 2000 U.S. Census, nearly 35 million are 65 years or older. By 2050, that number is expected to increase to 48 million. Oral diseases and conditions are common among these Americans who grew up without the benefit of community water fluoridation and other fluoride products.
2) Older Americans with the poorest oral health are those who are economically disadvantaged, lack insurance, and are members of racial and ethnic minorities. Being disabled, homebound, or institutionalized also increases the risk of poor oral health.
3) Medicaid, the jointly-funded Federal-State health insurance program for certain low-income and needy people, funds dental care for low income and disabled elderly in some states, but reimbursements for this care are low. Medicare, which provides health insurance for people over age 65 and people with certain illnesses and disabilities, was not designed to provide routine dental care.
4) About 25 percent of adults 60 years old and older no longer have any natural teeth. Interestingly, toothless Americans vary greatly by state. Roughly 42 percent of Americans over age 65 living in West Virginia are toothless, compared to only 13 percent of those living in California. Having missing teeth can affect nutrition, since people without teeth often prefer soft, easily chewed foods. Because dentures are not as efficient for chewing food as natural teeth, denture wearers also may choose soft foods and avoid fresh fruits and vegetables.
5) Periodontal (gum) disease or tooth decay (cavities) are the most frequent causes of tooth loss. Older Americans continue to experience dental decay on the crowns of teeth (coronal caries) and on tooth roots (because of gum recession). In fact, older adults may have new tooth decay at higher rates than children.
6) Severity of periodontal (gum) disease increases with age. About 23 percent of 65 to 74 year-olds have severe disease, which is measured by 6mm loss of attachment of the tooth to the adjacent gum tissue. At all ages men are more likely than women to have more severe disease. At all ages, people at the lowest socioeconomic level have the most severe periodontal disease.
7) Oral and pharyngeal cancers, which are diagnosed in some 31,000 Americans each year, result in about 7,400 deaths each year. These cancers are primarily diagnosed in the elderly. Prognosis is poor. The five-year survival rate for white patients is 56 percent and for African American patients is only 34 percent.
8) Many older Americans take both prescription and over-the-counter drugs. Over 400 commonly used medications can be the cause of a dry mouth. Reduction of the flow of saliva increases the risk for oral disease, since saliva contains antimicrobial components as well as minerals that help rebuild tooth enamel attacked by decay-causing bacteria. Individuals in long-term care facilities—about 5 percent of the elderly—take an average of eight drugs each day.
Fact Resources > Vargas CM, Kramarow EA, Yellowitz JA.The Oral Health of Older Americans, Aging Trends, No. 3. Hyattsville, MD: National Center for Health Statistics, 2001
Oral Health Care Begins With Our Children
1) Pediatric dental disease is 5 times more common than asthma and 7 times more common than hay fever.
2) Left untreated, pediatric dental disease can lead to malnourishment, bacterial infections, required emergency surgery and even death.
3) Pain and infection caused by tooth decay can lead to problems in eating, speaking and learning.
4) Dental disease has been linked to heart disease, stroke, diabetes, pneumonia, poor pregnancy outcomes and dementia.
Children’s Oral Health Crisis
1) Dental care is the most prevalent unmet health need of children in the United States
2) An estimated 17 million children in America go without dental care each year
3) More than 51 million school hours and 164 million work hours are lost each year due to dental disease, leading to increased educational disparities and decreased productivity
4) Approximately 43% of America’s lack dental insurance, including more than 20 million children, almost 3 times the population lack medical coverage
5) For every $1 spent on oral health preventive measures, American taxpayers are saved as much as $50 in restorative and emergency procedures for the under and uninsured
6) Only 1.5% of 1 year olds have had a dental office visit compared with 89% who have had an office-based visit with their physician
7) 52% of new recruits have oral health problems needing urgent attention that would delay overseas deployment
8) More than 25% of children aged 2-5 years and 50% of those aged 12-15 years suffer from tooth decay.
Fact Resources > CDC Centers For Disease Control, ADA American Dental Association, NCOH National Children’s Oral Health.