“You don’t have to floss all your teeth… Just the ones you want to keep.” – Anonymous
Oral health affects our ability to speak, smile, eat, and show emotions. It also affects self-esteem, school performance, and attendance at work and school. Oral diseases—which range from cavities to gum disease to oral cancer—cause pain and disability for millions of Americans. They also cost taxpayers billions of dollars each year1.
Cavities (also called tooth decay) are one of the most common chronic conditions in the United States. By age 34, more than 80% of people have had at least one cavity. More than 40% of adults have felt pain in their mouth in the last year. On average, the nation spends more than $113 billion a year on costs related to dental care. More than $6 billion of productivity is lost each year because people miss work to get dental care.
Oral health has been linked with other chronic diseases, like diabetes and heart disease. It is also linked with risk behaviors like using tobacco and eating and drinking foods and beverages high in sugar.
Public health strategies such as community water fluoridation and school dental sealant programs have been proven to save money and prevent cavities.
Oral health disparities are profound in the United States. Despite significant improvements in oral health for the population as a whole, oral health disparities exist for many racial and ethnic groups, by socioeconomic status, gender, age and geographic location.
Some social factors that can contribute to these differences are lifestyle behaviors such as tobacco use, the frequency of alcohol consumption, and poor dietary choices. Just like they affect general health, these behaviors can affect oral health. The economic factors that often relate to poor oral health include access to health services and an individual’s ability to get and keep dental insurance.
Jay Harold wrote a post on Oral Health for Seniors: 5 Questions and Answers in March of 2016. This post provides additional, updated information.
Adult Oral Health2
The baby boomer generation is the first where the majority of people will keep their natural teeth for their entire lifetime. This is largely because of the benefits of water fluoridation and fluoride toothpaste. However, threats to oral health, including tooth loss, continue throughout life.
The major risks for tooth loss are tooth decay and gum disease that may increase with age because of problems with saliva production; receding gums that expose “softer” root surfaces to decay-causing bacteria; or difficulties flossing and brushing because of poor vision, cognitive problems, chronic disease, and physical limitations.
Although more adults are keeping their teeth, many continue to need treatment for dental problems. This need is even greater for members of some racial and ethnic groups—about 3 in 4 Hispanics and non-Hispanic black adults have an unmet need for dental treatment, as do people who are poor. These individuals are also more likely to report having poor oral health.
In addition, some adults may have difficulty accessing dental treatment. For every adult aged 19 years or older without medical insurance, there are three who don’t have dental insurance.
Oral health problems in adults include the following:
- Untreated tooth decay. More than 1 in 4 (27%) adults in the United States have untreated tooth decay.
- Gum disease. Nearly half (46%) of all adults aged 30 years or older show signs of gum disease; severe gum disease affects about 9% of adults.
- Tooth loss. Complete tooth loss among adults aged 65-74 years has steadily declined over time, but disparities exist among some population groups.If left untreated, cavities (tooth decay) and periodontal (gum) disease lead to tooth loss.
- Oral cancer. Oral cancers are most common in older adults, particularly in people older than 55 years who smoke and are heavy drinkers.
- People treated for cancer who have chemotherapy may suffer from oral problems such as painful mouth ulcers, impaired taste, and dry mouth,
- Chronic diseases. Having a chronic disease, such as arthritis, heart disease or stroke, diabetes, emphysema, hepatitis C, a liver condition, or being obese may increase an individual’s risk of having missing teeth and poor oral health.
- Patients with weakened immune systems, such as those infected with HIV and other medical conditions (organ transplants) and who use some medications (e.g., steroids) are at higher risk for some oral problems.
- Chronic disabling diseases such as jaw joint diseases (TMD), autoimmune conditions such as Sjorgren’s Syndrome, and osteoporosis affect millions of Americans and compromise oral health and functioning, more often among women.
Disparities in Oral Health3
Some of the oral health disparities that exist include the following:
- Overall. Non-Hispanic blacks, Hispanics, and American Indians and Alaska Natives generally have the poorest oral health of any racial and ethnic groups in the United States.
- Children and Tooth Decay. The greatest racial and ethnic disparity among children aged 2–4 years and aged 6–8 years is seen in Mexican American and black, non-Hispanic children.
- Adults and Untreated Tooth Decay. Blacks, non-Hispanics, and Mexican Americans aged 35–44 years experience untreated tooth decay nearly twice as much as white, non-Hispanics.
- Tooth Decay and Education. Adults aged 35–44 years with less than a high school education experience untreated tooth decay nearly three times that of adults with at least some college education.
- In addition, adults aged 35–44 years with less than a high school education experience destructive periodontal (gum) disease nearly three times that of adults with a least some college education.
- Adults and Oral Cancer. The 5–year survival rate is lower for oral pharyngeal (throat) cancers among black men than whites (36% versus 61%).
- Adults and Periodontitis. 47.2% of U.S. adults have some form of periodontal disease. In adults aged 65 and older, 70.1% have periodontal disease.
- Periodontal Disease is higher in men than women, and greatest among Mexican Americans and Non-Hispanic blacks, and those with less than a high school education.
Morgan Freeman said, “I don’t get off on romantic parts. But I often think if I had had my dental work done early on, well, maybe.”
The data supports Morgan Freeman’s quote. Black Americans must pay more attention to their oral health.
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