oral health in america: a report of the surgeon general

Oral Health in America:

A Report of the Surgeon General

THE CHARGE

Define, describe, and evaluate the interaction between oral health and general health and well being, through the life span in the context of changes in society

Oral Health in America: A Report of the Surgeon General ~ DHHS 2000Oral Health in America: A Report of the Surgeon General ~ DHHS 2000

REPORT ORGANIZATIONWhat is oral health?

What is the status of oral health in America?

What is the relationship between oral health and general health and well-being?

How is oral health promoted and maintained and how are oral diseases prevented?

What are the needs and opportunities to enhance oral health?


More than 51 million school hours are lost each year to dental-related illness. Poor children suffer nearly 12 times more restricted-activity days than children from higher-income families

Children


For each child without medical insurance, there are at least 2.6 children without dental insurance

Uninsured children are 2.5 times less likely than insured children to receive dental care


Cleft lip/palate, one of the most common birth defects, is estimated to affect 1 out of 600 live births for whites and 1 out of 1,850 live births for African Americans


Dental caries (tooth decay) is the single most common chronic childhood disease--5 times more common than asthma and 7 times more common than hay fever Poor children suffer twice as much dental caries as their more affluent peers, and their disease is more likely to be untreated


Over 50 percent of 5- to 9-year-old children have at least one cavity or filling, and that proportion increases to 78 percent among 17-year-oldsTobacco-related oral lesions are prevalent in adolescents who currently use smokeless (spit) tobacco

Unintentional and intentional injuries commonly affect craniofacial tissues


Adults & Older Adults For every adult 19 years or older without medical insurance, there are three without dental insurance


Severe periodontal disease (measured as 6 millimeters of periodontal attachment loss) affects about 14 percent of adults aged 45 to 54Twenty-three percent of 65- to 74-year-olds have severe periodontal disease About 30 percent of adults 65 years and older are edentulous, compared to 46 percent 20 years ago


Oral and pharyngeal cancers are diagnosed in about 30,000 Americans annually; 8,000 die from these diseases each year

Oral and Pharyngeal Cancer


Males have higher incidence rates of oral and pharyngeal cancers than females

8.8

10.2

11.6

14.9

20.8

3.5

4.8

6.0

6.0

0 10 20 30

Rate per 100,000

FemaleMale

Black

White

Asian &

Pacific Islander

American Indian & Alaskan native

Hispanic*

Note: Age adjusted to the 1970 U.S. standard

*Data unavailable for Hispanic females

Source: Adapted from Wingo et al., 1999; SEER Program, 1990-96, Ries et al 1999


REPORT ORGANIZATIONWhat is oral health?

What is the status of oral health in America?

What is the relationship between oral health and general health and well-being?

How is oral health promoted and maintained and how are oral diseases prevented?

What are the needs and opportunities to enhance oral health?


THEMESOral health includes healthy teeth, but means much more

You cannot be healthy without oral health

Safe and effective disease prevention measures exist that everyone can adopt to improve oral health and prevent disease

Risk factors common to many diseases and conditions, such as tobacco and alcohol use and poor dietary practices, also affect craniofacial health


MAJOR MESSAGES

Oral health is essential to the general health and well-being of all Americans and can be achieved

However, not all Americans are able to take that message to heart

In spite of safe and effective means of maintaining oral health many experience needless pain and suffering, devastating complications, and financial and social costs that significantly diminish the quality of life


Actions at all levels of society, from individuals and neighborhoods to the nation as a whole, are required to maintain the health and well-being of Americans already enjoying good oral health and to address the gaps in oral health status of others

A coordinated effort can overcome the educational, environmental, social, health systems, and financial barriers that have created vulnerable populations whose oral health is at risk


8 MAJOR FINDINGS

Oral diseases and disorders in and of themselves affect health and well-being throughout life Range from birth defects to chronic

disabling conditions and cancer Interfere with vital functions Cause other health problems Undermine social interaction, self-

esteem Incur fiscal and social costs


The mouth reflects general health and well-being Diagnostic role Portal, as well as a barrier, for

infections Saliva, buccal cells and other oral

components have additional diagnostic potential


Oral diseases and conditions are associated with other health problems

Diabetes Heart disease Adverse pregnancy outcomes Respiratory infections Osteoporosis HIV infection


Lifestyle behaviors that affect general health, such as tobacco use, excessive alcohol use and poor dietary choices, affect oral and craniofacial health as well


There are safe and effective measures to prevent the most common dental diseases—dental caries and periodontal diseases Community water fluoridation Other fluoride measures and dental

sealants Personal oral hygiene and use of a fluoride

dentifrice Cessation/prevention of tobacco use


There are profound and consequential oral health disparities within the American population Disparities relate to income, age,

gender, race/ethnicity

Disparities due to lack of information or access to preventive measures


More information is needed to improve America’s oral health and eliminate disparitiesScientific research is key to further reduction in the burden of disease and disorders that affect the face, mouth and teeth


A FRAMEWORK FOR ACTION

To eliminate health disparities and improve quality of life for all Americans, the report calls for the development of a National Oral Health Plan, that includes collaborations among individuals, health care providers, communities, and policy-makers


PLAN COMPONENTS

Change perceptions regarding oral health and disease so that oral health becomes an accepted/understood component of general healthRemove known barriers that stand between people and oral health servicesUse public-private partnerships to improve the oral health of those who suffer disproportionately


Accelerate building the science and evidence base and apply science effectively to improve oral healthBuild effective health infrastructure that meets the oral health needs of all Americans and integrates oral health effectively into overall health


ACTIONS ARE BEING TAKEN BY:

American Dental Education AssociationOral Health AmericaAmerican Association of Women DentistsAmerican Dental Trade AssociationNational Governor's AssociationDental Manufacturers of AmericaAdvocacy and community groupsAmerican Academy of General DentistryProctor and Gamble

…and…

Partnership for PreventionColgate PalmoliveGrantmakers in HealthAmerica College of DentistsFriends of the Surgeon General’s Report on Oral HealthNational Association of Dental PlansNational Dental AssociationHispanic Dental AssociationAnd Several States

NATIONAL PLAN FOR ORAL HEALTH

GOALS

STRATEGIES

TARGETS

PLAYERS

NATIONAL ACTION PLAN FOR ORAL HEALTH

GOALS

Eliminate Oral Health DisparitiesIncrease Quality of Life

TARGETS

NATIONAL

STATE

LOCAL

PLAYERS

Federal agencies State

organizations Grant makers Business Professions Academics Researchers Public

STRATEGIES

Change perceptions of oral healthRemove known barriers that stand between people and oral health servicesUse public-private partnerships to improve the oral health of those who suffer disproportionately from oral diseasesAccelerate building and application of scienceBuild effective health infrastructure

Change perceptions of oral health regarding oral health and disease so that oral health becomes an accepted and understood component of general health

• Change public perceptions• Change policy-makers’ perceptions• Change health providers’ perceptions

Remove known barriers that stand between people and oral health services

• Increase insurance coverage • Increase reimbursement for services • Prepare workforce to address needs of

individuals with disabilities• Enhance knowledge, attitudes and

behaviors of the public towards oral health • Assess distribution and supply of providers

Use public-private partnerships to improve the oral health of those who suffer disproportionately from oral diseases

• Promote trans-, multi-, inter-disciplinary efforts

• Build alliances to address common risk factors

• Take advantage of existing initiatives

Accelerate building the science and evidence base and apply science effectively to improve oral health

• Support clinical trials, health services research, demonstration programs, etc.

• Develop risk assessment and management approaches, diagnostic measures, etc.

• Promote adoption of research findings into practice

Build an effective health infrastructure that meets the oral health needs of all Americans and integrates oral health effectively into overall health

• Focus on public health infrastructure• Increase diversity of workforce• Recruit and retain faculty and

researchers

Broad-based Broad-based Public/Private Public/Private PartnershipPartnership

National Oral Health Plan – Creating a Shared Vision

A National Oral Health Plan Can Be Developed

What can you do? What can your organization(s)

do?

USE THE MOMENTUM AND SEIZE THE

MOMENT

oral health in america: a report of the surgeon general

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