Data suggests mixed progress in reducing tooth decay rates among young

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

Photo: Joseph Bartmann via Flickr

Tooth decay remains the most prevalent chronic health problem of children in the United States. Since the late 1980s, roughly one in four U.S. children have had tooth decay, a rate that has remained relatively stable over the decades, according to a new study based on extensive federal data.

While the study reveals recent progress in reducing and treating disease among preschool children, the prevalence of decay in the permanent teeth of older children and adolescents has remained static.

“Although it is laudable that more younger children are receiving dental treatment for caries, what we would really like to see is more children remaining caries-free through childhood,” Bruce Dye, the study’s lead author and the dental epidemiological officer at the National Institute of Dental and Craniofacial Research, told the American Dental Association’s ADA News.

Overall, untreated tooth decay remains a widespread problem among U.S. children, Dye and his fellow researchers concluded.

Nearly 18 percent of 5- to 18-year-olds had untreated caries in the years 2011 to 2012, according to the paper, published in the August issue of the Journal of the American Dental Association.

In comparison, asthma affected nearly 9 percent of American children 18 years and younger and obesity affected 17 percent of children in 2014, the authors observed.

Their study, “Trends in dental caries in children and adolescents according to poverty status in the United States from 1999 through 2004 and from 2011 through 2014,” is based on data from the National Health and Nutrition Examination Survey (NHANES.)

In the most hopeful trend contained in the report, data from 2011 to 2014 indicate that preschoolers received more dental care and suffered less disease during those years than similar children studied in the previous decade.

“We found that this transition occurred regardless of poverty status, which suggests that activities to improve access to care have been effective for many preschool aged children in the United States,” the authors wrote.

Bruce Dye

Among poor preschoolers, decay experience decreased from nearly 42 percent to 35 percent, and untreated decay fell from 31 to 18 percent, during the time periods included in the study.

The decline in tooth decay among poor preschoolers parallels an apparent decline in obesity rates in the same group reflected in NHANES data for 2008-2011, the researchers noted.

It is unclear what factors may have contributed to these reductions in tooth decay and obesity among young low-income children, the researchers wrote. However, they suggested that policy efforts aimed at improving the oral and overall health of small children in recent years may have played a role.

Such measures have included campaigns to encourage parents and caregivers to begin getting routine dental care for babies by their first birthday. These include:

  • The 2009 reauthorization of the Children’s Health Insurance Program, which expanded coverage to an additional 4 million children;
  • Access to healthy foods afforded by federal nutrition programs;
  • Many states have begun reimbursing physicians to provide dental screenings and early preventive care (such as fluoride treatments) for babies and preschoolers who are Medicaid beneficiaries.

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