Oral health status of older rural adults in the United States

BACKGROUND: Little is known about the oral health care of older rural residents. The authors describe oral health indicators for the older adult population by place of residence in the United States. METHODS: The authors analyzed data from the Third National Health and Nutrition Examination Survey and the 1995, 1997 and 1998 National Health Interview Surveys. Oral health indicators included perceived oral health (self-reported dental status and unmet dental needs) and dental status (untreated caries; decayed, missing and filled permanent teeth, or DMFT; and edentulism). Dental care utilization and access were measured by number of dental visits, frequency of dental visits and dental insurance status. RESULTS: Older rural adults were more likely than their urban counterparts to be uninsured for dental care (72.1 percent versus 66.1 percent, respectively) and were less likely to report dental visits in the past year (46.9 percent versus 58.4 percent, respectively). A higher proportion of rural residents than urban residents were edentulous (36.7 percent versus 28.2 percent, respectively) and reported poor dental status (50.7 percent versus 42.2 percent, respectively). There were no differences in unmet dental needs, percentage of people with untreated caries or in mean DMFT by place of residence. CONCLUSIONS: Older rural residents inadequately utilize dental care and have less favorable oral health indicators than do older urban residents. CLINICAL IMPLICATIONS: This article shows the need for more dental practitioners in rural areas. With the low density of dentists per person and the high need for care, rural America offers an excellent opportunity for oral health professionals to provide much needed services.     

Oral health disparities in the United States

Oral health disparities refers to the existence of differences in the incidence, prevalence, mortality, and burden of oral diseases and other adverse health conditions, as well as the use of health care services, among specific population groups in the United States. Existence of disparities in oral health status, accessing and using the oral health care delivery system, and receiving treatment depending on gender, race or ethnicity, education, income, disability, geographic location, and sexual orientation have been documented. Different states have initiated a series of steps as tools to document, assess, develop strategies, and monitor progress in efforts to eliminate or reduce oral health disparities in the United States.     

Oral health status of people with intellectual disabilities in the southeastern United States

BACKGROUND: The U.S. surgeon general's report, Oral Health in America, stated that people living below the poverty level and those with mental retardation and/or physical disabilities have poorer oral health than the general population. METHODS: The calibrated examiners (volunteer dentists and dental students) assessed the oral health status of intellectually disabled people with or without a physical disability via screening examinations provided to 12,099 Special Olympics athletes at 53 sites, including 1891 people from seven states in the southeastern United States. Measurements of gingivitis, untreated decay, missing molars, sealants, restorations and treatment urgency were recorded. RESULTS: The authors found that athletes from the very poor southeastern states were 1.6 times (odds ratio [OR] = 1.64; 95 percent confidence interval [CI]: 1.10 to 2.46) more likely to have restorations and almost one-third as likely (OR = 0.35; 95 percent CI: 0.21 to 0.60) to have sealants than were athletes from the poor states, after restricting the analysis by age. CONCLUSIONS: Among intellectually disabled people in this study, oral health disparities were associated with poverty. Special Olympics athletes from the poorest states were significantly more likely to have restorations and less likely to have received preventive treatment.     

Oral health. Massachusetts versus the United States

Results from the National Oral Health Surveillance System (NOHSS) provide an overview (at the state and national levels) of the burden of oral disease and the use of oral health services. Compared to national averages, Massachusetts residents are doing very well in terms of some broad measures, but (1) only average in the rate of edentulism, (2) below average in the rank of states with regard to its population on public water supply systems with fluoridation, and (3) marked by wide variations between the many in-state population groups.     

Oral health needs and access to dental care of homeless adults in the United States: a review

The homeless population in the United States is one of great diversity that continues to increase in number. Although data on the oral health status of individuals who are homeless is limited, studies consistently report both the perception and clinical evidence of dental needs among this population as well as a low utilization rate for dental services. This article reviews the oral health needs of people who are homeless as reported in literature, barriers to receiving dental care, and methods used to deliver dental care to this population. Many rehabilitation centers for adults who are homeless consider the establishment and maintenance of a state of good general and oral health as a priority and a key factor in helping homeless adults to return to the workforce and mainstream society.     

Oral health status of children and adults in urban and rural areas of Burkina Faso, Africa

OBJECTIVES: To analyse the oral health status of children and adults in rural and urban areas of Burkina Faso; to provide epidemiological data for planning and evaluation of oral health care programmes. DESIGN: Cross-sectional survey including different ethnic and socio-economic groups. SAMPLE AND METHODS: Multistage cluster sampling of households in urban areas and random samples of participants selected based on the recent population census in rural areas. The final study population covered four age groups: 6 years (n = 424), 12 years (n = 505), 18 years (n = 492) and 35-44 years (n = 493). Clinical oral health data collected according to WHO methodology and criteria. RESULTS: At age 6, 38% of children had caries, with prevalence higher in urban than rural areas. At age 12, the mean DMFT was 0.7 with prevalence significantly higher among urban than rural children. Mean DMFT was 1.9 in 18-year-olds and 6.3 in 35-44-year-olds and figures were higher for women than men. In adults, no differences in caries experience were found by location whereas the caries index was significantly affected by ethnic group and occupation. CPI score 2 (gingivitis and calculus) was dominant for all ages: 6 years (58%), 12 years (57%), 18 years (58%), 35-44 years (49%). In addition, 10% of 35-44-year-olds had CPI score 4. Rural participants had more severe periodontal scores than did urban individuals. CONCLUSIONS: Health authorities should strengthen the implementation of community-based oral disease prevention and health promotion programmes rather than traditional curative care.     

Oral and general health of Hispanic children with disabilities in the United States

Hispanic residents are the fastest growing population of the U.S. Only recently have government agencies begun to identify the associated demographic facts and inequities which are specific to this population. In particular limited attention has been directed to Hispanic children with disabilities. Available government reports are used to provide a basic awareness of the oral and general health needs of this population of youngsters.