Elsevier

Academic Pediatrics

Volume 9, Issue 6, November–December 2009, Pages 388-395
Academic Pediatrics

Science and Surveillance
Changes in the Oral Health of US Children and Adolescents and Dental Public Health Infrastructure Since the Release of the Healthy People 2010 Objectives

https://doi.org/10.1016/j.acap.2009.09.018Get rights and content

We examined progress in US children's oral health and dental public health infrastructure since the Healthy People 2010 Oral Health Objectives were issued. We summarize trends in the prevalence of dental caries and dental sealants on the basis of national and state-specific data. Trends in state oral health program activities, funding, and staffing were derived from annual surveys.

The prevalence of dental caries in primary teeth of children aged 2–4 years increased from 18% in 1988–1994 to 24% in 1999–2004. Racial disparities persisted in that age group, with caries significantly more prevalent among non-Hispanic black and Mexican American children than among non-Hispanic white children. Caries prevalence in primary teeth of non-Hispanic white children aged 6–8 years remained unchanged, but increased among non-Hispanic black and Mexican American children. State-specific prevalence of caries among third-graders ranged from 40.6% to 72.2%. Caries in permanent teeth declined among children and adolescents, while the prevalence of dental sealants increased significantly. State oral health programs' funding and staffing remained modest, although the proportion of states with sealant programs increased 75% in 2000 to 85% in 2007 and the proportion with fluoride varnish programs increased from 13% to 53%.

Progress toward improving the oral health of America during the past decade has been mixed. Greater attention to the oral health of young children is clearly needed, and child health professionals can be valuable partners in the effort. With continued high prevalence of a largely preventable disease, ongoing problems with access to basic oral health services, and increased national attention to health care reform, there is a clear need and opportunity for governments to make serious and sustained investments in dental public health.

Section snippets

Methods

Data for this study were drawn from several national and state sources. National data on dental caries and selected preventive services are from the National Health and Nutrition Examination Surveys (NHANES). Dental data were collected in 1988–1994 and again in 1999–2004. These data and details on their collection have been published previously,11 so this report presents just a few key findings. State data on dental caries and dental sealants are available from those states that have conducted

Healthy People 2010 Objectives on Oral Health

Table 1 presents the 10 Healthy People 2010 Objectives on Oral Health most relevant to children's oral health, their baseline levels, their target levels, and the most recent estimates available for each. The prevalence of dental caries experience (objective 21-1) and untreated decay (21-8) appear to be moving away from the target for children 8 years of age or younger. The prevalence of dental sealants (21-2) increased for children aged 8 or 14 years, although it remained substantially below

Discussion

Progress toward improving the oral health of America's children and adolescents since the Healthy People 2010 Objectives were released has been mixed. Dental caries in the permanent dentition generally declined between 1988–1994 and 1999–2004, although the largest declines occurred among non-Hispanic whites and among those living above 200% of federal poverty level. This decline in caries is perhaps directly related to the significant increase in the prevalence of dental sealants and the

Acknowledgments

We thank Drs William Maas and Wendy E. Mouradian for their helpful suggestions. We also thank Dr Kathy Phipps for her input on state infrastructure and surveillance activities.

References (23)

  • N. Tinanoff et al.

    Update on early childhood caries since the Surgeon General's Report

    Acad Pediatr

    (2009)
  • J. Beauchamp et al.

    American Dental Association Council on Scientific Affairs. Evidence-based clinical recommendations for the use of pit-and-fissure sealants: a report of the American Dental Association Council on Scientific Affairs

    J Am Dent Assoc

    (2008)
  • US Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville, Md: US...
  • McDonagh M, Whiting P, Bradley M, et al. A Systematic Review of Public Water Fluoridation. York, United Kingdom: NHS...
  • A. Azarpazhooh et al.

    Pit and fissure sealants in the prevention of dental caries in children and adolescents: a systematic review

    J Can Dent Assoc

    (2008)
  • A. Ahovuo-Saloranta et al.

    Pit and fissure sealants for preventing dental decay in the permanent teeth of children and adolescents

    Cochrane Database Syst Rev

    (2008)
  • A. Azarpazhooh et al.

    Fluoride varnish in the prevention of dental caries in children and adolescents: a systematic review

    J Can Dent Assoc

    (2008)
  • A. Hiiri et al.

    Pit and fissure sealants versus fluoride varnishes for preventing dental decay in children and adolescents

    Cochrane Database Syst Rev

    (2006)
  • S.L. Tomar

    An assessment of the dental public health infrastructure in the United States

    J Public Health Dent

    (2006)
  • US Department of Health and Human Services. Oral health. In: Healthy People 2010, With Understanding and Improving...
  • B.A. Dye et al.

    Trends in oral health status: United States, 1988–1994 and. 1999–2004

    Vital Health Stat

    (2007)
  • View full text