Toward improving the oral health of Americans: an overview of oral health status, resources, and care delivery. Oral Health Coordinating Committee, Public Health Service.

Dental and oral diseases may well be the most prevalent and preventable conditions affecting Americans. More than 50 percent of U.S. children, 96 percent of employed U.S. adults, and 99.5 percent of Americans 65 years and older have experienced dental caries (also called cavities). Millions of Americans suffer from periodontal diseases and other oral conditions, and more than 17 million Americans, including 10 million Americans 65 years or older, have lost all of their teeth. Preventive dental services are known to be effective in preventing and controlling dental diseases. Unfortunately, groups at highest risk for disease--the poor and minorities--have lower rates of using dental care than the 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, public programs, including Medicaid, paid for less than 4 percent of dental expenditures. More than 90 percent of care was paid for either out-of-pocket by dental consumers or through private dental insurance. Americans are at risk for other oral health problems as well. Oropharyngeal cancer strikes approximately 30,000 Americans each year and results in an estimated 8,000 deaths annually. Underlying medical or handicapping conditions, ranging from rare genetic diseases to more common chronic diseases, affect millions of Americans and can lead to oral health problems. Among persons with compromised immune systems, oral diseases and conditions can have a significant impact on health. Oral diseases and conditions, though nearly universal, can be prevented easily and controlled at reasonable cost. Prevention and early, regular primary dental care are the best strategies to improve the oral health and quality of life of all Americans.