Focus Area 21: Oral Health Progress Review

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Focus Area 21 Oral HealthProgress Review
Richard J. KleinNational Center for Health
Statistics February 7, 2008
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Oral Health

• According to the 2000 Surgeon Generals Report on
  Oral Health, oral health is essential to the
  general health and well-being of all Americans.
• Dental caries is the most common chronic disease
  in children.
• Despite increases in coverage, nearly 3 times as
  many children lacked dental insurance compared to
  those lacking medical insurance in both 1995 and
  2003-04.
• Americans without dental insurance are more
  likely to have unmet dental needs compared to
  those with insurance.

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Highlighted Objectives
21-1a-c Dental Caries Experience 21-4 Complete
Tooth Loss 21-5b Destructive Periodontal Disease
21-8a Dental Sealants, Children 8 years
21-9 Community Water Fluoridation 21-10 Annual
Dental Visits 21-12 Preventive Dental Services
Among Low-Income youth 21-14 Community Health
Centers with Oral Health Service Component
21-17a,b Dental Public Health Infrastructure
Improving
Getting worse
Little or no progress
Target met
Percent of targeted change achieved is between
-10 and 10, or change not statistically
significant.
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Ever Had Caries in Permanent Teeth Adolescents 15
Years
Decrease desired
1988-94
1999-2004
2010 Target 51
Percent
100 75 50 25 0
Total White Black
Mexican Female Male

American
Note I 95 confidence interval. Respondents
were asked to select only one race prior to 1999.
For 1999 and later years, respondents were asked
to select one or more races. For all years, the
categories black and white include persons who
reported only one racial group and exclude
persons of Hispanic origin. Persons of
Mexican-American origin may be any race. Source
National Health and Nutrition Examination Survey,
NCHS, CDC.
Obj. 21-1c
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Ever Had Caries Children 6-8 Years
Decrease desired
1988-94
1999-2004
2010 Target 42
Percent
100 75 50 25 0
Total White Black
Mexican Female Male

American
In primary or permanent teeth. Note I 95
confidence interval. Respondents were asked to
select only one race prior to 1999. For 1999 and
later years, respondents were asked to select one
or more races. For all years, the categories
black and white include persons who reported only
one racial group and exclude persons of Hispanic
origin. Persons of Mexican-American origin may be
any race. Source National Health and Nutrition
Examination Survey, NCHS, CDC.
Obj. 21-1b
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Ever Had Caries in Primary Teeth Children 2-4
Years
Decrease desired
1988-94
1999-2004
2010 Target 11
Percent
100 75 50 25 0
Total White Black
Mexican Female Male

American
Note I 95 confidence interval. Respondents
were asked to select only one race prior to 1999.
For 1999 and later years, respondents were asked
to select one or more races. For all years, the
categories black and white include persons who
reported only one racial group and exclude
persons of Hispanic origin. Persons of
Mexican-American origin may be any race.
Source National Health and Nutrition
Examination Survey, NCHS, CDC.
Obj. 21-1a
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Residents Served with Community Water
Fluoridation
Percent 0-24 25-49 50-74 75-100
Increase desired
2010 Target 75
2006 69
1992 62
Note Proportion of persons receiving optimally
fluoridated water from public systems among
resident population served by public water
systems. Source CDC Fluoridation Census,
NCCDPHP, CDC
Obj. 21-9
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Use of Dental Sealants Children 8 Years
Increase desired
75 50 25 0
2010 Target 50
1988-94
1999-2004
Percent
Total White Black
Mexican Female Male

American
Note I 95 confidence interval. Respondents
were asked to select only one race prior to 1999.
For 1999 and later years, respondents were asked
to select one or more races. For all years, the
categories black and white include persons who
reported only one racial group and exclude
persons of Hispanic origin. Persons of
Mexican-American origin may be any race. Source
National Health and Nutrition Examination Survey,
NCHS, CDC.
Obj. 21-8a
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Annual Preventive Dental Services Low Income
Youth Under 19 Years
Increase desired
75 50 25 0
2010 Target 66
1996
2004
Percent

Total White Black Hispanic
American Asian Female Male

Indian

Note I 95 confidence interval. Data
statistically unreliable. Low income is less than
200 of Federal poverty level. Preventive
services include examination, dental sealant
application, fluoride treatment, cleaning, or
X-ray examination in the past year. The
categories black and white exclude persons of
Hispanic origin. Persons of Hispanic origin may
be any race. Respondents were asked to select
only one race prior to 2003. For 2003 and later
years, respondents were asked to select one or
more races. Data for the single race categories
shown are for persons who reported only one
racial group. American Indian includes Alaska
Native, and Asian includes Pacific
Islander. Source Medical Expenditure Panel
Survey, AHRQ.
Obj. 21-12
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Annual Dental Visits 2 Years and Older
Increase desired
75 50 25 0
Age-adjusted Percent
2010 Target 56
1996
2004
Total White Black Hispanic American
Asian lt 12 yr 12 yr 12 yr

Indian
Education
Note I 95 confidence interval. Data are age
adjusted to the 2000 standard population.
Education estimates are based on persons aged 25
years and over. The categories black and white
exclude persons of Hispanic origin. Persons of
Hispanic origin may be any race. Respondents were
asked to select only one race prior to 2003. For
2003 and later years, respondents were asked to
select one or more races. Data for the single
race categories shown are for persons who
reported only one racial group. American Indian
includes Alaska Native, and Asian includes
Pacific Islander. Source Medical Expenditure
Panel Survey, AHRQ.
Obj. 21-10
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Complete Tooth Loss Older Adults 65-74 Years
Decrease desired
50 25 0
1988-94
1999-2004
2010 Target 22
Percent
Total White Black Mexican
lt 12 yr 12 yr 12 yr

American
Education
Note I 95 confidence interval. Education
estimates are based on persons aged 25 years and
over. Respondents were asked to select only one
race prior to 1999. For 1999 and later years,
respondents were asked to select one or more
races. For all years, the categories black and
white include persons who reported only one
racial group and exclude persons of Hispanic
origin. Persons of Mexican-American origin may be
any race. Source National Health and Nutrition
Examination Survey, NCHS, CDC.
Obj. 21-4
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Destructive Periodontal Disease Adults 35-44 Years
Decrease desired
50 25 0
1988-94
1999-2004
2010 Target 14
Percent
Total White Black
Mexican Female Male

American
Note I 95 confidence interval. Respondents
were asked to select only one race prior to 1999.
For 1999 and later years, respondents were asked
to select one or more races. For all years, the
categories black and white include persons who
reported only one racial group and exclude
persons of Hispanic origin. Persons of
Mexican-American origin may be any race. Source
National Health and Nutrition Examination Survey,
NCHS, CDC.
Obj. 21-5b
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Community Health Centers with Onsite Dental
Services
Increase desired
Dental Services at Center
Health Centers
Percent 100 80 60 40 20 0
2010 Target 75
Number 1,000 800 600 400 200 0
1997 1998 1999 2000 2001 2002 2003
2004 2005 2006
Obj. 21-14
Source Bureau of Primary Health Care, HRSA.
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Dental Programs Directed by Public Health Dental
Professionals
Increase desired
200 150 100 50 0
2010 Target 41
Number
State and local dental programs serving 250,000
Program directed by a dental professional with
public health training
152
123
51
39
2003 2006
Obj. 21-17a
Source Association of State and Territorial
Dental Directors.
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Dental Programs Directed by Public Health Dental
Professionals
50 25 0
Increase desired
2010 Target 9
Number
Indian Health Service and Tribal dental programs
serving 30,000 Program directed by a dental
professional with public health training
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10
9
2003 2006
Obj. 21-17b
Source Division of Oral Health, IHS.
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Progress Toward 2010 Targets
Target Met 21-17a State and local dental
programs 21-17b Indian Health Service and Tribal
dental programs
Little or No Progress 21-1b Dental caries, 68
yrs 21-1c Dental caries, 15 yrs
21-2a-d Untreated dental decay,2-4, 6-8, 15 and
35-44 yrs 21-4 Complete tooth loss, 65-74 yrs
21-6 Early detection of oral and pharyngeal
cancers 21-8a Dental sealants, 8 yrs
21-8b Dental sealants, 14 yrs 21-10 Dental
visits, 2 yrs
Moved Toward Target 21-3 No permanent tooth loss,
35-44 yrs 21-5b Destructive periodontal
disease, 35-44 yrs 21-9 Community water
fluoridation 21-12 Preventive dental services
among low-income youth under 19 yrs
21-14 Community health centers with oral health
service component 21-15 Cleft lip or palate
referral
Baseline Only 21-5a Gingivitis, 35-44
yrs 21-7 Annual exam for oral and pharyngeal
cancers, 40 yrs 21-11 Use of oral health care by
long-term care residents 21-13a,b School-based
health centers with oral health
component 21-16 Oral and craniofacial state-based
surveillance
Moved Away from Target 21-1a Dental caries, 2-4
yrs
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Summary

• Most oral health objectives moved toward their
  2010 targets, although some of the improvements
  were not statistically significant.
• Dental caries in preschool children moved away
  from the 2010 target.
• Use of dental sealants among children increased.
• Oral health continues to improve in the adult
  population.
• Disparities by race/ethnicity and education
  persist for many objectives.

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Acknowledgements
FA21 Interagency Workgroup Jay Anderson,
HRSA Laurie Barker, CDC Patrick Blahut, IHS Bruce
Dye, CDC Tim Iafolla, NIDCR Gina Thornton-Evans,
CDC Office of Disease Prevention and Health
Promotion Christopher Barrett
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Progress review data and slides can be found on
the web at
http//www.cdc.gov/nchs/hphome.htm