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A Mouthful of Trouble

U.S. to draft plan for improving Americans' oral health

WEDNESDAY, Jan. 30, 2002 (HealthDayNews) -- There's little to smile about in a new report on the state of America's dental health, except for the finding that matters are slowly improving.

In its "2001-2002 Report Card," Oral Health America (OHA) gives the nation an overall grade of "C" this year, up from a C-minus last year.

In an attempt to further improve the oral health of Americans, the federal government will sponsor public meetings throughout the country in the next few months to identify the roadblocks to better dental health, and to develop a comprehensive battle plan.

"We will hold a series of five hearings in various locations starting March 5 in San Diego to draft a template of a national oral health plan," says Dr. Caswell Evans, director of the National Oral Health Initiative for the National Institutes of Health. "Concerned advocates and the public are invited to provide comment."

Other meeting dates are March 8 in Denver, March 21 in Atlanta, March 22 in Chicago and April 30 in Boston, according to Evans.

A national oral health plan was one of the actions suggested in Surgeon General David Satcher's report, Oral Health in America, which was released in May 2000.

OHA's report card is an outgrowth of the surgeon general's report.

"We wanted to keep the momentum [from the surgeon general's report] going," says Elizabeth Rogers, director of communications for Oral Health America in Chicago. "We wanted to raise awareness of oral health among public and policy leaders."

Apparently, much still needs to be done. One of the biggest problems, according to Rogers, is access to care. Almost one-third of U.S. adults didn't see a dentist at all last year, according to the federal statistics that were used in compiling the new report.

This was due to several factors, Rogers adds.

One is financial. "A lot of people simply can't afford to go to the dentist," she says, pointing out that more than 100 million Americans don't have dental insurance.

Also, in many rural areas, there just aren't enough dentists. "There may be only one dentist to serve a few thousand people in rural areas," says Rogers.

Oral health isn't just a cosmetic issue.

"If your mouth isn't healthy, it can have an effect on your overall health," Rogers says. People with poor oral health can have trouble eating, sleeping and paying attention at work or at school. Also, there are many studies that suggest a link between oral health problems and other medical problems, such as heart disease, diabetes and pre-term birth, according to Rogers.

"Oral health is an integral part of overall health," says Dr. Greg Chadwick, president of the American Dental Association.

The OHA report also found that more than 2 million work days are lost each year because of poor dental health.

And tooth decay is the most common childhood disease -- it is five times more prevalent than asthma, the report says. Fifty percent of first graders already have signs of tooth decay, while 80 percent of 17 year olds have it, the report finds.

Another area of concern is oral cancer. Every year, 30,000 cases of oral or throat cancer are diagnosed and 8,000 people die annually from these cancers, according to the Centers for Disease Control and Prevention. If people don't visit the dentist, they heighten their risk for these cancers.

Dentist and hygenists are the "first line of defense in spotting oral cancer," the OHA report says.

The report examined each state's performance in four areas: prevention, access to care, "oral health leadership" and residents' "oral health status." The data was gathered mostly from government databases.

Four states -- California, Mississippi, New Hampshire and New Jersey -- flunked prevention. And, in 10 states, less than 50 percent of the population has access to fluoridated drinking water, a known way to prevent cavities.

Only four states managed to get a B-minus -- Connecticut, Hawaii, Iowa and Utah.

None scored higher.

What To Do

"We're dealing with a disease that is very prevalent, but it is preventable," Chadwick says of oral health problems. Fluoride, sealants, proper dental hygiene and regular dental visits can go a long way in reducing cavities, he says.

If you'd like to read Oral Health America's report, go to the group's Web site. (You'll need the Adobe Acrobat Reader to view the report; if you don't have one, you can download it free clicking here.)

Here's what the CDC has to say on improving oral health.

SOURCES: Interviews with Elizabeth Rogers, director of communications, Oral Health America, Chicago; Caswell Evans, D.D.S., M.P.H., director, National Oral Health Initiative, National Institutes of Health, Bethesda, Md.; Greg Chadwick, D.D.S., president, American Dental Association, Chicago; Oral Health America Report Card 2001-2002
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