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Focus Area 21 : Oral Health Progress Review

Focus Area 21 : Oral Health Progress Review. Richard J. Klein National Center for Health Statistics February 7, 2008. Oral Health. According to the 2000 Surgeon General’s Report on Oral Health, oral health is essential to the general health and well-being of all Americans.

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Focus Area 21 : Oral Health Progress Review

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

  2. Oral Health • According to the 2000 Surgeon General’s 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.

  3. Highlighted Objectives 21-1a-c Dental Caries Experience 21-4Complete Tooth Loss 21-5b Destructive Periodontal Disease 21-8a Dental Sealants, Children 8 years 21-9 Community Water Fluoridation 21-10 Annual Dental Visits 21-12Preventive Dental Services Among Low-Income youth 21-14 Community Health Centers with Oral Health Service Component 21-17a,b Dental Public Health Infrastructure Target met Improving Little or no progress* Getting worse *Percent of targeted change achieved is between -10% and 10%, or change not statistically significant.

  4. EverHad 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

  5. EverHad 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

  6. EverHad 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

  7. 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

  8. 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

  9. 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

  10. 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 < 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

  11. Complete Tooth Loss Older Adults 65-74 Years Decrease desired 50 25 0 Percent 1988-94 1999-2004 2010 Target: 22 Total White Black Mexican < 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

  12. Destructive Periodontal DiseaseAdults 35-44 Years Decrease desired 50 25 0 Percent 1988-94 1999-2004 2010 Target: 14 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

  13. 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.

  14. 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.

  15. 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 34 32 10 9 2003 2006 Obj. 21-17b Source: Division of Oral Health, IHS.

  16. 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 21-1bDental caries, 6–8 yrs 21-1cDental caries, 15 yrs 21-2a-d Untreated dental decay,2-4, 6-8, 15 and 35-44 yrs 21-4Complete tooth loss, 65-74 yrs 21-6 Early detection of oral and pharyngeal cancers 21-8aDental sealants, 8 yrs 21-8bDental sealants, 14 yrs 21-10 Dental visits, 2+ yrs Moved Toward Target 21-3 No permanent tooth loss, 35-44 yrs 21-5bDestructive periodontal disease, 35-44 yrs 21-9 Community water fluoridation 21-12Preventive 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 21-1aDental caries, 2-4 yrs

  17. Summary • Most oral health objectives moved toward their2010 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 andeducation persist for many objectives.

  18. 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

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

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