Oral Health

Background

Oral health affects our physical and mental health, our ability to speak, smile, eat, and to show our emotions. Oral health is associated with chronic diseases, like heart disease and diabetes, and also affects self-esteem, school performance, and attendance at both work and school. Oral diseases—which range from cavities to oral cancer—cause pain and disability for millions of Americans. Every year over 34 million school hours are lost and over $45 billion in productivity due to unplanned emergency dental care [1].

In 2017, about 64% of adults (ages 18-64) and 84.6% of children (ages 2-17) in the US have had a dental visit within the past year [2]. On average, by age 34, over 80% of US adults have had at least one cavity [2]. As of 2014, almost one in three US adults and almost one in five children have untreated dental caries. While the share of children and adolescents who receive preventive dental care has increased over time to 84.6%, dental caries is still the most prevalent chronic disease observed among this population [2].

The DC Healthy People 2020 goals related to oral health include:

         1. Oral and craniofacial diseases, conditions, and injuries are prevented and controlled.
         2. All residents have access to and utilize educational, preventive, and therapeutic oral healthcare services.
         3. Residents accept and adopt effective preventive oral health interventions.

Oral Health Infrastructure

The District of Columbia is currently working to build its oral health surveillance capabilities, including data related to childhood caries, sealants, and access to oral healthcare. The 2017 DC Oral Health Surveillance System identified there are 736 dentists practicing in the District, 542 dental hygienists and 641 dental assistants licensed to practice. Currently, six of the eight Federally Qualified Health Centers (FQHCs provide dental services in the District at 26 locations [3]. Of dentists practicing in the District, 30.5% report treating individuals with intellectual or developmental disabilities and 31.7% report accepting DC Medicaid patients [3]. In the 2016-17 school year, all seven of DC School-Based Health Centers provided oral health services.

Source: DC Health, School Health Center Data, SY 2016-2017
*SBHC is a School-Based Health Center 

Dental Emergency Department Visits by Ward and Dental Health Professional Shortage Areas & Services, District of Columbia, 2017.

Source: HRSA. Health Professional Shortage Areas Data, 2017

Preventive Dental Care

Preventive dental care is vital over the life course to maintain oral health and improve quality of life. In 2015, nearly 1 in 4 District adults failed to access preventive dental care the previous year [4]. There are not only barriers to access to preventive dental care for certain groups, but African American residents, Hispanic residents, and those living in poverty are all disproportionately affected by untreated dental caries. Several chronic and communicable conditions, such as diabetes, HIV and cardiovascular conditions, have oral manifestations; regular and comprehensive dental exams aid in the early diagnosis of these conditions.

Oral Cancer

Oral cancer includes cancers of the mouth, such as the tongue or the tissue lining the mouth and guns, and cancers in the area at the back of the throat [5]. The survival rate for these cancers in the US is approximately 59%, though mortality is nearly twice as high in racial/ethnic minorities (especially in Black men) compared to Whites [6]. Oral cancer most often occurs in people over the age of 40 and affects more than twice as many men as women. Most oral cancers are related to tobacco use, alcohol use (or both), or infection by the human papilloma virus (HPV) [5].

Assets and Resources

Community Resources

Oral Health Guide

•  Oral Health Toolkit and Dentist Locator

School-based oral health program fact sheet

Senior Dental Services Program

Promising Practices & Policies

• Enforce school-based oral health assessment reporting to include annual dental visits, untreated tooth decay, dental caries, and dental sealants.

• Increase referrals from physicians who identify patients with oral health conditions to dentists.

• Enhance population health monitoring related to emerging indicators, such as emergency department dental visits and perinatal oral health visits.

• Oral Health Basics and Best Practices

Citations & Additional Data Resources

1. CDC. Oral Health Basics. 2019

2. CDC. Oral and Dental Health. 2017

3. DC Health. Oral Health Infrastructure in the District of Columbia Fact Sheet. 2017

4. DC BRFSS 2012-2015

5. National Institute of Dental and Craniofacial Research. Oral Cancer. 2019

6. CDC. Oral Health Conditions. 2019

Photo Credit: 

Photo by Alex on Unsplash