THE U.S. SURGEON GENERAL’S REPORT
ON THE STATUS OF ORAL HEALTH IN AMERICA

Summary of Findings

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On May 25, 2000 U.S. Surgeon General David Satcher, the nation’s top doctor, released a report addressing a silent epidemic of dental decay and wide disparities among populations in the levels of oral health in America.  He cited community water fluoridation as a way to fight this growing problem. 

  Here is a summary of his key findings:

  FLUORIDATION BENEFITS

Ø     Community water fluoridation is a safe, effective, economical, and ideal public health measure, which benefits individuals of all ages and socioeconomic strata.  

Ø     Fluoride prevents dental caries.

·       Researchers in the 1930s discovered that people living in communities with naturally fluoridated water supplies had less dental caries than people drinking unfluoridated water. Since then, the efficacy of community water fluoridation to drastically reduce the incidence of dental disease has been documented in study after study.

Ø     More than one-third of the U.S. population (100 million people) has no access to community water fluoridation.

Ø     The American Medical Association, the Centers for Disease Control, National Institutes of Health, the Food and Drug Administration and the World Health Organization are among a myriad of major state, national and international health service organizations that strongly endorse the use of fluoridated water.

 

LINKS TO OVERALL HEALTH

Ø     Good oral health and general health are inseparable.

·       Recently, research findings have pointed to associations between chronic oral infections and diabetes, heart and lung diseases, stroke, and low-birth-weight, premature births.

 

SOCIO-ECONOMIC IMPACT

  Ø     Water fluoridation is a bargain for those who wish to have better overall health, including better oral health.

  ·        It would cost a range of $0.68 per year per person for those served by large water systems (50,000 or more people served), compared to $3.00 per year per person served by small systems (10,000 or less served).

 

Ø     Approximately one-third of adults have not visited a dentist in the past 12 months.

·        Those with incomes at or above the poverty level are twice as likely to report a dental visit in the past 12 months as those who are below the poverty level.

 

Ø     Those who suffer the worst oral health include poor Americans, especially children and the elderly.

Ø     Members of racial and ethnic groups also experience a disproportionate level of oral health problems.

Ø     Those with disabilities and complex health conditions are at greater risk for oral diseases that, in turn, further complicate their health.

Ø     Employed adults lose more than 164 million hours of work each year due to dental disease or dental visits.

Ø     Expenditures for dental services alone made up 4.7 percent of the nation’s health expenditures in 1998 - $53.8 billion out of $1.1 trillion.

Ø     The national health expenditure for dental services is expected to exceed $60 billion in 2000.

 

LACK OF ACCESS

Ø     Fewer people have dental insurance than have medical insurance, and it is often lost when individuals retire.

Ø     For every adult 19 years or older without medical insurance, there are three without dental insurance.

Ø     Over 108 million children and adults lack dental insurance, which is over 2.5 times the number who lack medical insurance.

Ø     An estimated 25 million individuals reside in areas lacking adequate dental care services, as defined by Health Professional Shortage Area (HPSA) criteria.

 

DENTAL DISEASE REACHING EPIDEMIC PROPORTIONS

Ø     More than 50 percent of 5- to 9-year-old children have at least one cavity or filling, and that proportion increases to 78 percent among 17- year-olds.

Ø     Most adults show signs of periodontal or gingival diseases.  Severe periodontal disease affects about 14 percent of adults aged 45 to 54.

Ø     Oral and pharyngeal cancers are diagnosed in about 30,000 Americans annually.

·     8,000 die from these diseases each year.

·     These diseases are primarily diagnosed in the elderly with the main causes attributed to tobacco use and alcohol consumption.