WASHINGTON (AP) – From cavities to mouth cancer, a “silent epidemic” of oral diseases afflicts minorities and low-income Americans even as most of the nation benefits from healthier teeth and gums, the U.S. surgeon general said today.
Thanks to fluoridated drinking water and better dental care, most Americans middle-age or younger can expect to keep their teeth for life.
Yet dental diseases still threaten the health of low-income people, who are more likely to lose their teeth, said David Satcher, the nation’s top doctor.
“Those who suffer the worst oral health are found among the poor of all ages, with poor children and poor older Americans particularly vulnerable,” Satcher said in a report. “Members of racial and ethnic minority groups also experience a disproportionate level of oral health problems.”
The government’s first-ever comprehensive look at oral health in America showed that a combination of social and economic factors – lack of dental insurance, poor diets, tobacco use, a dearth of minority dentists and lack of awareness of the importance of healthy teeth – contribute to poor oral health.
Nearly half of all poor blacks and Hispanics have untreated tooth decay, compared with 27 percent of poor whites, the study showed. Oral problems begin early – more than a third of low-income children have at least one untreated decayed tooth by the time they are 9 years old, compared with 17 percent of kids living above the poverty line.
The disparity gets even greater the older kids get. Over 43 percent of poor kids have tooth decay by age 17 compared to 23 percent of kids who are better off, according to government studies cited in the report.
Meanwhile, tooth problems often go unchecked because children lack insurance coverage. Uninsured kids are two-and-a-half times less likely to get dental checkups compared to kids with insurance. Experts estimate that as many as 26 million American children have no insurance coverage for dental care.
Even poor kids who have dental insurance are not getting the care they need, the report said. The government estimates that 80 percent of Medicaid eligible kids don’t receive dental care because few dentists take Medicaid patients and dental care isn’t a priority for poor families.
“Low income kids have very high levels of coverage because of Medicaid, but they have very few dentist visits,” said Burton Edelstein, a pediatric dentist and director of the Childrens’ Dental Health Project in Washington.
The report, an amalgamation of clinical and epidemiological studies, also looked at disparities in people suffering from oral and throat cancers, which affects over 30,000 Americans each year and kills more than 8,000. Tobacco and alcohol use are the primary risk factors for oral cancers. Men are more likely to have these cancers than women, and black men have a much higher rate of oral cancer – 20.8 cases per 100,000 males a year, versus 14.9 cases for white males. Blacks are less likely to have these cancers caught at early stages, so their survival rates are not as good as for whites.
The report calls for more screening for oral cancers and more studies of dental health disparities, as well as anti-smoking and water fluoridation projects in communities that don’t have them. And, of course, it urges Americans to brush and floss daily.