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Prevention & Collaboration: Keys to Solving our Oral Health Crisis

baby smileThink of this – every infant is born free of dental decay! Yet, dental caries is the most prevalent childhood disease, affecting more than 25% of U.S. children aged 2-5 and 50% of those aged 12 to 15 (CDC, 2013). According to the American Academy of Pediatric Dentistry (2014): 1) early childhood tooth decay is increasing and can cause lasting harm to the child’s oral and general health, and social and intellectual development; 2) only 25% of parents bring their children to see a dentist in the first year of life as recommended; 3) nearly 1 in 5 parents and caregivers put their child to bed with a bottle of milk or juice, increasing the risk of early childhood caries, baby bottle tooth decay, and choking; and 4) 38% of parents and caregivers allow toddlers to brush without supervision (not recommended until a child is 7 to 8 years old).

Unfortunately, dental disease does not improve with age: 28% of those 35 to 44 years of age and 18% of adults 65 and older have untreated tooth decay; nearly half of adults over age 30 suffer from some form of gum disease. Tooth decay affects minorities and low-income populations disproportionately creating a “dental divide”. Nearly half of lower income adults report not having visited a dentist in one year or longer, while 70% of middle or high income adults have. For many American Indian communities, the occurrence of early childhood caries is approximately 3 times higher than in the U.S. overall.


Further, education level, age, language barriers, cultural factors, oral health literacy, ability to perform daily oral health care, chronic disease, insurance status and geography contribute to dental disease, often in combination with one another. Finally, unhealthy behaviors such as neglecting to brush and floss, using tobacco and alcohol, and eating poorly also adversely affects dental health (2013).

waterMost experts agree that the most cost-effective way to ensure optimal dental health in children and adults is through prevention, education and behavioral modifications. Community water fluoridation is a proven, prevention strategy. The estimated average cost for a community to fluoridate its water ranges from approximately 50 cents/year/person in large communities to approximately $3/year/person in small communities. By one estimate, the cost of providing fluoridated water throughout someone’s life is less than the cost of a single filling (2013).

adult smiles


Just in time for Dental Health Month, the American Dental Association (ADA)  released its latest paper, Action for Dental Health: Bringing Disease Prevention into Communities (2013). This follows on the heels of their May, 2013 launch of the Action for Dental Health: Dentists Making a Difference campaign which aims to reduce the number of adults and children with untreated dental disease, by providing oral health education, prevention, and treatment to those who need care. Key actions of the campaign include:

  • Providing care to people who are suffering, including the elderly in nursing homes, children from low-income families, and the uninsured, who are more likely to visit an emergency room for relief from dental pain;
  • Strengthening the public/private dental safety net to dramatically increase its capacity to deliver care; and
  • Focusing on disease prevention and oral health education through community water fluoridation, the use of Community Dental Health Coordinators, stronger collaboration between dentistry and other health professions, and public health programs in schools and other public and private settings.

collaboration1Collaboration is vitally necessary for improving oral health. The U.S. National Oral Health Alliance provides the platform for a diverse network of stakeholders to forge common ground to create viable solutions for improved oral health through prevention and treatment  for vulnerable populations across our country. The DentaQuest Foundation has funded 20 states through its Oral Health 2014 project  that emphasizes prevention and improved collaborations among dentistry and primary care medicine, faith-based organizations, public health and social service groups. More than two dozen philanthropic organizations meet quarterly as the Funders Oral Health Policy Group to advocate for innovative public-private partnerships for better oral health in communities across the US.  Finally, many states  and local communities have forged coalitions to address the oral health needs of their populations. These collaborations can work to ensure all Americans understand the connection between their dental and overall health, so we can solve this crisis.


ADA Launches Nationwide Campaign to Address US Dental Crisis. May 15, 2013. http://www.orthodonticproductsonline.com/orp-orthodontic-news/15594-ada-launches-nationwide-campaign-to-address-us-dental-crisis

American Dental Association. (2013) Action for Dental Health: Bringing Disease Prevention into Communities. http://www.ada.org/sections/advocacy/pdfs/ADA_AfDH_Prevention.pdf

American Academy of Pediatric Dentistry. (2014). State of the Little Teeth Report. http://www.sacbee.com/2014/01/28/6107174/americas-pediatric-dentists-bite.html

Centers for Disease Control and Prevention (CDC). 2013 http://www.cdc.gov/OralHealth/publications/factsheets/childrens_oral_health/index.htm


American Academy of Pediatric Dentistry. http://www.mychildrensteeth.org/

U.S. National Oral Health Alliance. http://usnoha.org/home

American Dental Association. http://www.ada.org/