Why Develop, Expand, Integrate, or Enhance Community Oral Health Programs?

In May 2000, Surgeon General David Satcher released Oral Health in America: A Report of the Surgeon General,³ the first Surgeon General’s report on oral health. The report identifies the need for a national effort to improve oral health among all Americans and stresses the relationship between oral health and general health. The overarching message of Oral Health in America is that oral health means much more than healthy teeth and that it is integral to general health and well-being. Therefore, oral health must be included in the provision of health care and in the design of community programs. The report calls for an increase in quality and years of life and for the elimination of health disparities through a national partnership that would provide opportunities for individuals, communities, and the health professions to work together to maintain and improve the nation’s oral health.

The Surgeon General’s report describes a “silent epidemic” of oral diseases affecting the health of Americans. For example,

• 78% of 17-year-olds have had tooth decay, with an average of 7 affected tooth surfaces.
• 98% of 40–44-year-olds have had tooth decay, with an average of 45 affected tooth surfaces.
• Three out of every 10 Americans over age 65 have no teeth at all.

Those who suffer the worst oral health include Americans with low incomes—especially children and the elderly, members of racial and ethnic minority groups, and individuals with disabilities and complex health conditions. The 108 million Americans who lack dental insurance also experience particularly poor oral health. This group includes uninsured children, who are 2.5 times more likely than insured children to suffer from untreated oral disease.

In 2003, the Surgeon General’s National Call to Action to Promote Oral Health⁶ was released. The National Call to Action further describes the burden of oral diseases and disorders and puts forth a series of action steps to promote oral health. These steps stress the need to change perceptions of oral health; overcome barriers to oral health by replicating effective programs and proven efforts; build the science base to better understand diseases and accelerate the transfer of science into public health and private practice; increase the capacity, diversity, and flexibility of the oral health work force; and increase collaboration between the private and public sectors to effect disease prevention and oral health promotion.