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Challenges Remain in the Fight to Improve Americans' Oral Health

May 07, 2012

In 2000, a historic report from the U.S. Surgeon General titled Oral Health in America described the poor oral health of our nation as a "silent epidemic." Twelve years later, progress is being made, but the prevalence of oral diseases nationwide remains. As countless numbers of Americans continue to suffer in silence from avoidable and treatable oral diseases, the U.S. Department of Health and Human Services (HHS) is struggling with the challenge of how to improve oral health and oral healthcare in the nation.

Dental caries, commonly known as tooth decay, is one of the most common diseases worldwide, and in the U.S. it remains a common chronic disease. It is said to be more than five times as common as asthma among kids ages 5 to 17. Tooth decay is also linked to numerous health concerns, including adverse pregnancy outcomes, respiratory disease, cardiovascular disease and diabetes. However, despite the prevalence of tooth decay, its health risks and its highly preventable nature, many individuals, including healthcare professionals, still don't fully appreciate how oral health affects overall health and well-being.

Inadequate oral health literacy is just one contributor to poor oral health. Other factors include uneven and limited access to oral healthcare and dental coverage, especially among individuals whose income falls below the federal poverty level; lack of appropriate standards designed to determine the overall quality of oral healthcare in the U.S.; and a general lack of attention to oral health among primary care providers who have not been educated or trained to recognize oral diseases or teach patients about oral health hygiene.

Over the years, the U.S. Department of Health and Human Services (HHS) has made attempts to improve the state of oral health and oral healthcare via a variety of channels, including dental education, workforce demonstrations and recruitment of healthcare professionals to work in underserved areas. However, the priority and financial support placed on these initiatives have historically been inconsistent.

In 2010, HHS launched an Oral Health Initiative, a cross-agency effort designed to improve oral healthcare nationwide and convey the message that oral health is integral to overall health. This initiative is now being augmented by an additional set of recommendations from the Institute of Medicine (IOM) known as the New Oral Health Initiative (NOHI), which is designed to build on HHS earlier efforts. Through its work, the IOM has identified three key goals needed for successfully maintaining oral health as a priority issue: strong leadership, sustained interest and the involvement of multiple stakeholders.

The IOM suggests that HHS can play a vital role in improving oral health and oral healthcare in the U.S. HHS must be focused on presenting consistent messages for patients and healthcare professionals about the importance of oral health, while also maintaining consistent messaging within its own organization that oral health is a priority.

With so many Americans continuing to suffer from oral diseases, the IOM is urging HHS to seize the current opportunity that exists to strengthen its commitment to oral health, work to make the topic a national priority and unite various stakeholders to effect change in oral healthcare. Only time will tell how HHS utilizes these recommendations. With the oral health of the nation on the line, much work remains to be done.

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