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By Craig Palmer

ADA and dental public health officials hailed a study reporting gains in the nation's oral health over the last decade.

"The American Dental Association is encouraged by the good news from the Centers for Disease Control and Prevention and National Institutes of Health that reported improvements in the oral health of Americans," said ADA President Richard Haught. "It tells us that preventive measures such as dental sealants, water fluoridation, regular dental visits and programs to promote good oral hygiene practices are having a positive impact on the nation's overall oral health."

The CDC surveillance for dental caries, dental sealants, tooth retention, edentulism and enamel fluorosis assesses trends based on data from 1988-1994 and 1999-2002 surveys.

"The good news is that efforts to reduce and prevent cavities and dental disease are paying off," said Dr. William R. Maas, director of the CDC division of oral health. "We are seeing an increase in the number of children, teens and adults who have never had a cavity in their permanent teeth. It's also very encouraging to find the dental health of children in lower income areas improved."

"This survey represents the oral health of more than 256 million Americans," said Dr. Bruce Pihlstrom, acting director of the division of clinical research and health promotion at the National Institute of Dental and Craniofacial Research. "While the findings are encouraging, the report clearly tells us that more effort is needed to improve the oral health of low-income Americans."

The report documented improvements in the oral health of the civilian population and cited "important differences in disease prevalence and severity by sociodemographic characteristics that public health officials, the dental profession, and the community should consider in implementing interventions to prevent and control disease and to reduce the disparities observed."

In conclusion, the authors listed seven "important findings":

• The decline in the prevalence and severity of dental caries in permanent teeth, reported in previous national surveys, continued during 1988-1994 and 1999-2002. This decline occurred in both crowns and roots, across sex, race/ethnicity, poverty status, education level and smoking status. It has benefited children, adolescents and adults.
• A notable proportion of untreated tooth decay observed was observed across all age groups and sociodemographic characteristics.
• No reductions were observed in the prevalence and severity of dental caries in primary teeth.
• The use of dental sealants among children and adolescents increased substantially. This increase was probably the result of both public and private efforts and denotes a continuing interest in using dental sealants for the prevention of tooth decay.
• Older adults are retaining more of their teeth and fewer are losing all their teeth.
• Despite the decrease in caries prevalence and severity in the permanent dentition and the increase in the proportion of children and adolescents who benefit from dental sealants, disparities remain. Racial/ethnic minorities, those with lower income, lower education level and current smokers across all age groups have larger unmet needs compared with their counterparts.
• Prevalence of enamel fluorosis has increased in cohorts born since 1980. This increase should be evaluated in the context of total fluoride exposure.