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Improving Oral Health for All Ages: Progress Review & Objectives

Explore the current oral health challenges in the U.S. and efforts to address them, including disparities in care, with a focus on key objectives such as reducing decay and promoting early detection of oral diseases.

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Improving Oral Health for All Ages: Progress Review & Objectives

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  1. Focus Area 21: Oral HealthProgress Review March 17, 2004

  2. The Burden of Oral Disease • Estimated new cases of oral/pharyngeal cancers in U.S. will affect 28,000 +persons in 2004 • Profound disparities exist in disease levels and receipt of care • 100+ millionAmericans lack dental insurance

  3. Progress: • Reduction in decay among U.S. teens in the 1990s (NHANES 1988-94 to 1999-2000) saved more than 30 million teeth from decay and almost $3 billion in treatment costs

  4. Oral Health Objectives 21-1 Dental caries experience 21-8 Dental sealants Children 2-4 years Children 6-8 years Adolescents 15 years Children 8 years Adolescents 14 years 21-9 Community water fluoridation 21-2 Untreated dental decay 21-10 Use of oral health care system Children 2-4 years Children 6-8 years Adolescents 15 years Adults 35-44 years 21-11 Use of oral health system by long- term care facilities residents 21-12 Dental services of for low-income children 21-3 No permanent tooth loss 21-13 School-based health centers with oral health components 21-4 Complete loss 21-5 Periodontal diseases 21-14 Health centers with oral health service components 21-6 Early detection of oral and pharyngeal cancers 21-15 Referral for cleft lip or palate 21-7 Annual exams for oral and pharyngeal cancers 21-16 Oral and craniofacial State-based surveillance system 21-17 Tribal, State & local programs Improving Getting worse Cannot assess (limited data)

  5. Oral Health Objectives Oral Health Objectives 21-1 Dental caries experience 21-8 Dental sealants Children 2-4 years Children 6-8 years Adolescents 15 years Children 8 years Adolescents 14 years 21-9 Community water fluoridation 21-2 Untreated dental decay 21-10 Use of oral health care system Children 2-4 years Children 6-8 years Adolescents 15 years Adults 35-44 years 21-11 Use of oral health system by long- term care facilities residents 21-12 Dental services of for low-income children 21-3 No permanent tooth loss 21-13 School-based health centers with oral health components 21-4 Complete loss 21-5 Periodontal diseases 21-14 Health centers with oral health service components 21-6 Early detection of oral and pharyngeal cancers 21-15 Referral for cleft lip or palate 21-7 Annual exams for oral and pharyngeal cancers 21-16 Oral and craniofacial State-based surveillance system 21-17 Tribal, State & local programs Improving Getting worse Cannot assess (limited data)

  6. Oral Health Objectives 21-1 Dental caries experience 21-8 Dental sealants Children 2-4 years Children 6-8 years Adolescents 15 years Children 8 years Adolescents 14 years 21-9 Community water fluoridation 21-2 Untreated dental decay 21-10 Use of oral health care system Children 2-4 years Children 6-8 years Adolescents 15 years Adults 35-44 years 21-11 Use of oral health system by long- term care facilities residents 21-12 Dental services of for low-income children 21-3 No permanent tooth loss 21-13 School-based health centers with oral health components 21-4 Complete loss 21-5 Periodontal diseases 21-14 Health centers with oral health service components 21-6 Early detection of oral and pharyngeal cancers 21-15 Referral for cleft lip or palate 21-7 Annual exams for oral and pharyngeal cancers 21-16 Oral and craniofacial State-based surveillance system 21-17 Tribal, State & local programs Improving Getting worse Cannot assess (limited data)

  7. Oral Health Objectives Oral Health Objectives 21-1 Dental caries experience 21-8 Dental sealants Children 2-4 years Children 6-8 years Adolescents 15 years Children 8 years Adolescents 14 years 21-9 Community water fluoridation 21-2 Untreated dental decay 21-10 Use of oral health care system Children 2-4 years Children 6-8 years Adolescents 15 years Adults 35-44 years 21-11 Use of oral health system by long- term care facilities residents 21-12 Dental services of for low-income children 21-3 No permanent tooth loss 21-13 School-based health centers with oral health components 21-4 Complete loss 21-5 Periodontal diseases 21-14 Health centers with oral health service components 21-6 Early detection of oral and pharyngeal cancers 21-15 Referral for cleft lip or palate 21-7 Annual exams for oral and pharyngeal cancers 21-16 Oral and craniofacial State-based surveillance system 21-17 Tribal, State & local programs Improving Getting worse Cannot assess (limited data)

  8. Highlighted Objectives 21-1 Dental caries experience in children 21-3 No permanent tooth loss in adults 21-6 Early detection of oral and pharyngeal cancers 21-8 Sealants 21-10 Use of oral health care system 21-12 Dental services of for low-income children 21-14 Health centers with oral health services

  9. Highlighted Objectives 21-1 Dental caries experience in children 21-3 No permanent tooth loss in adults 21-6 Early detection of oral and pharyngeal cancers 21-8 Sealants 21-10 Use of oral health care system 21-12 Dental services of for low-income children 21-14 Health centers with oral health services 5-15 Dental visits among persons with diabetes

  10. Adolescents 12-18 Years Who Ever Had Caries in Permanent Teeth, 1988-94 Percent 2010 Target 1988-94 Female Male Total White Black Mexican American Note: Target is for adolescents 15 years old. Black and white 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

  11. Adolescents 12-18 Years Who Ever Had Caries in Permanent Teeth, 1988-94 and 1999-2000 Percent 1999-2000 2010 Target 1988-94 Female Male Total White Black Mexican American Note: Target is for adolescents 15 years old. Black and white 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

  12. Children 2-4 Years Who Have Ever Had Caries in Primary Teeth, 1988-94 Percent 1988-94 2010 Target Female Male Total White Black Mexican American Note: Black and white 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

  13. Children 2-4 Years Who Have Ever Had Caries in Primary Teeth, 1988-94 and 1999-2000 Percent 1999-2000 1988-94 2010 Target Female Male Total White Black Mexican American Note: Black and white 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

  14. Early Childhood Caries (ECC) in American Indian/Alaska Native Children 0-4 Years 1991 Note: from Niendorff & Jones, JPHD 2000: 60: 245. Data are for IHS service areas. Source: 1991 Patient Survey, IHS.

  15. Early Childhood Caries (ECC) in American Indian/Alaska Native Children 0-4 Years Less than 2% of all U.S. children 1-2 years in 1988-94 had ECC 1991 Note: from Niendorff & Jones, JPHD 2000: 60: 245. and Kaste et al., JPHD 1999; 59: 199. Source: 1991 Patient Survey, IHS; National Health and Nutrition Examination Survey, NCHS, CDC.

  16. Dental Sealants

  17. Dental Sealants: 1988-94 1988-94 1988-94 Percent 2010 Targets Total White Black Mexican American Total White Black Mexican American 6-11 Years 12-18 Years Note: Targets are for children 8 years and 14 years. Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race. Source: National Health and Nutrition Examination Survey, NCHS, CDC. Obj. 21-8

  18. Unreliable estimate, relative standard error >30%. Dental Sealants: 1988-94 and 1999-2000 1988-94 1988-94 1999-2000 1999-2000 Percent 2010 Targets Total White Black Mexican American Total White Black Mexican American 6-11 Years 12-18 Years Note: Targets are for children 8 years and 14 years. Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race. Source: National Health and Nutrition Examination Survey, NCHS, CDC. Obj. 21-8

  19. No Permanent Tooth Loss in Adults 35-44 Years: 1988-94 Percent 1988-94 2010 Target Female Male Total White Black Mexican American Note: Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race. Source: National Health and Nutrition Examination Survey, NCHS, CDC. Obj. 21-3

  20. No Permanent Tooth Loss in Adults 35-44 Years: 1988-94 and 1999-2000 Percent 1999-2000 1988-94 2010 Target Female Male Total White Black Mexican American Note: Black and white exclude persons of Hispanic origin. Persons of Mexican-American origin may be any race. Source: National Health and Nutrition Examination Survey, NCHS, CDC. Obj. 21-3

  21. Early Detection of Oral and Pharyngeal Cancers: 1990-95 1990-95 Percent 2010 Target Female Male Total White Black Hispanic Note: Data are for Stage 1 (localized) tumors, excluding Kaposi Sarcoma tumors. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: Surveillance, Epidemiology, and End Results Program, NIH, NCI. Obj. 21-6

  22. Early Detection of Oral and Pharyngeal Cancers: 1990-95 and 1996-2000 1996-2000 1990-95 Percent 2010 Target Female Male Total White Black Hispanic Note: Data are for Stage 1 (localized) tumors, excluding Kaposi Sarcoma tumors. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: Surveillance, Epidemiology, and End Results Program, NIH, NCI. Obj. 21-6

  23. Receipt of Preventive Services by Low Income Children 1996 2010 Target = 57% Note: Data are for children under 19 years. Low income is less than 200% of poverty level. Preventive services include examinations, cleaning, x-rays, fluoride treatments and sealant applications. Source: Medical Expenditure Panel Survey, AHRQ. Obj. 21-12

  24. Receipt of Preventive Services by Low Income Children 1996 2000 2010 Target = 57% Note: Data are for children under 19 years. Low income is less than 200% of poverty level. Preventive services include examinations, cleaning, x-rays, fluoride treatments and sealant applications. Source: Medical Expenditure Panel Survey, AHRQ. Obj. 21-12

  25. Annual Dental Visits: 1996 1996 Percent 2010 Target White Black Hispanic Total Race/ethnicity Note: Data are for ages 2 years and over, age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: Medical Expenditure Panel Survey, AHRQ. Obj. 21-10

  26. Annual Dental Visits: 1996 1996 Percent 2010 Target White Black With Hispanic Without Total Race/ethnicity Disability status Note: Data are for ages 2 years and over, age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: Medical Expenditure Panel Survey, AHRQ. Obj. 21-10

  27. Annual Dental Visits: 1996 and 2000 2000 1996 Percent 2010 Target White Black With Hispanic Without Total Race/ethnicity Disability status Note: Data are for ages 2 years and over, age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: Medical Expenditure Panel Survey, AHRQ. Obj. 21-10

  28. Community Health Centers with Onsite Dental Services Number Health Centers Dental Services at Center 2001 2002 1999 2000 1997 1998 Obj. 21-14 Source: Bureau of Primary Health Care, HRSA.

  29. Community Health Centers with Onsite Dental Services Number Percent Health Centers Dental Services at Center 2010 Target 2001 2002 1999 2000 1997 1998 Obj. 21-14 Source: Bureau of Primary Health Care, HRSA.

  30. Annual Dental Visits for Personswith Diabetes: 2002 Percent Persons with diabetes 2010 Target Urban Rural Total White Black Hispanic <100 100-199 >200 Race/ethnicity Urbanicity Poverty level (%) Note: Data are for ages 2 years and over, age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: National Health Interview Survey, NCHS, CDC. Obj. 5-15

  31. Annual Dental Visits for Personswith and without Diabetes: 2002 Percent Persons with diabetes Persons without diabetes 2010 Target Urban Rural Total White Black Hispanic <100 100-199 >200 Race/ethnicity Urbanicity Poverty level (%) Note: Data are for ages 2 years and over, age adjusted to the 2000 standard population. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: National Health Interview Survey, NCHS, CDC. Obj. 5-15

  32. Annual Dental Visits for Personswith and without Diabetes: 1997-2002 Percent 2010 Target Persons without diabetes Persons with diabetes Note: Data are for ages 2 years and over, age adjusted to the 2000 standard population. Source: National Health Interview Survey, NCHS, CDC. Obj. 5-15

  33. Progress review data and slides can be found on the web at: http://www.cdc.gov/nchs/hphome.htm

  34. 12 IHS Service Areas

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