ORAL HEALTH
in Western North Carolina

Why is oral health a key health issue in western North Carolina?

WNC has a higher percent of kindergartners screened with decayed teeth (50%) than North Carolina (38%).

(NC DHHS, 2018)

The Keys to Oral Health, video courtesy of NC Oral Health Collaborative

North Carolina Oral Health Section 

Kindergarten Oral Health Assessment

Researchers have found that dental disease is linked with other health issues, including cardiovascular disease, stroke, bacterial pneumonia, and preterm and/or low-birth-weight infants.

(ADA, 2005)

What do the numbers say about oral health?

Western North Carolina (WNC) Data:

Only a little more than half (62%) of adults in WNC visited a dentist or dental clinic in the past year. 

(WNCHN – WNC Healthy Impact Community Health Survey, 2018)

Click on the counties listed in "Change Filter" on top of the chart to select which counties you want to view.

The following adult populations were significantly less likely to visit a dentist or dental clinic in the past year in 2018:

- Adults aged 18-39 years (55.5%)

- Very low income (42.4%) or low income (44.2%)

- Those identifying as either Black (45.4%) or Hispanic (42.9%)

(WNCHN – WNC Healthy Impact Community Health Survey, 2018)

Differences in health outcomes across social groups, economic status, and racial/ethnic identity are closely linked with disparities in social determinants of health, which disproportionately burden individuals and communities who experience systemic disadvantage and/ or discrimination. See our data story on the social determinants of health to learn more about how the conditions in which people are born, live, work, play, learn, worship, and age can influence their ability to achieve good health for themselves and their families. 

Oral health emergency department utilization rates are higher in NC (2.5%) than in US (1-2%). 

Dental-related emergency department visits are, on average, the twelfth most common reason people come to the ED across NC. Yet, for six hospitals in WNC, dental-related ED visits were within the top six reasons for visits in FFY 2013-2014.

(Cecil G. Sheps Center, 2018)


State & National Findings:

On a statewide survey, 39.8% of parents with children under 5 years of age reported that their children have never been to the dentist.

(N.C. State Center for Health Statistics, 2012)

In 2016, 64.4% of adults in the United States ages 18-64 reported that they had visited the dentist within the last year. 

(CDC, 2016)

The nation spends more than $124 billion each year on dental care. More than $45 billion of productivity is lost each year because people miss work to get the dental care that they need. 

(CDC, 2015)

What did the region say is the story behind the oral health numbers?

Source: WNCHN - Online Key Informant Survey, 2018

 The items below are paraphrased themes that emerged from a 2018 regional survey of key informants. These responses do not necessarily:

    •Reflect accurate or scientifically validated information about health determinants, outcomes, and/or strategies for change, 
    •Represent an exhaustive list of factors that can help or hurt efforts to address this key regional health issue.
The information in this section should be interpreted and used with care. It should be used only to help local health departments and agencies begin to understand community perceptions about local health issues. Communities are strongly encouraged to collect their own, local-level data to inform local planning and evaluation activities.

“Recent dental screening projects in elementary schools to gain more insights about levels of decay.” 

"I think the dental community is trying to get more involved with the children in the community and give them access to dental care.” 

"The need for affordable and good denture care. So many of our seniors have ill-fitting dentures. It increases their lack of healthy eating, socialization, and can bring on gum disease which sparks other health issues. Medicaid is only so helpful with the cost of dentures. An affordable or even free clinic, using dental students in the area, could improve the quality of care.”

How is the region prioritizing this issue?

The western North Carolina region includes 17 communities: 16 counties and Eastern Band of Cherokee Indians (EBCI)

In the 2018 CHA cycle, while no communities chose to prioritize oral health, oral health is linked with other health priorities in WNC such as cardiovascular disease, stroke and pre-term birth.

(ADA, 2005)

Learn more about how counties in western North Carolina work to determine their local community health priorities by watching the video (right). 

What is already happening regionally?

The list below represents a sample of what is happening in the region around this key health issue. Visit www.nc211.org for more resources. 

WNC Children’s Oral Health Initiative (Mission Children’s Hospital, WNC Health Network, The Duke Endowment)


ToothBus Program (Mission Health)


Oral Health Alliance Meetings in Region 1 and Region 2 (NCDHHS Oral Health Section)


Safety net dental services

The regional dataset (WNC Healthy Impact Community Health Survey and Online Key Informant Survey) is available thanks to contributions from hospitals in the 16-county region of western North Carolina. Thank you!