TOWARD IMPROVING THE ORAL HEALTH OF AMERICANS - AN OVERVIEW OF ORAL HEALTH-STATUS, RESOURCES, AND CARE DELIVERY

Dental and oral diseases may well be the most prevalent and preventabl e conditions affecting Americans. More than 50 percent of U.S. childre n, 96 percent of employed U.S. adults, and 99.5 percent of Americans 6 5 years and older have experienced dental caries (also called cavities ). Millions of Americans suffer from periodontal diseases and other or al conditions, and more than 17 million Americans, including 10 millio n Americans 65 years or older, have lost all of their teeth. Preventiv e dental services are known to be effective in preventing and controll ing dental diseases. Unfortunately, groups at highest risk for disease -the poor and minorities-have lower rates of using dental care than th e U.S. average. Cost is the principal barrier to dental care for many Americans. Of the $38.7 billion spent for dental services in 1992, pub lic programs, including Medicaid, paid for less than 4 percent of dent al expenditures. More than 90 percent of care was paid for either out- of-pocket by dental consumers or through private dental insurance. Ame ricans are at risk for other oral health problems as well. Oropharynge al cancer strikes approximately 30,000 Americans each year and results in an estimated 8,000 deaths annually. Underlying medical or handicap ping conditions, ranging from rare genetic diseases to more common chr onic diseases, affect millions of Americans and can lead to oral healt h problems. Among persons with compromised immune systems, oral diseas es and conditions can have a significant impact on health. Oral diseas es and conditions, though nearly universal, can be prevented easily an d controlled at reasonable cost. Prevention and early, regular primary dental care are the best strategies to improve the oral health and qu ality of life of all Americans.