An oral health scoring system for promoting 8020 achievement in residents

The present study was undertaken to develop a self-scoring system which can be used by a resident to check lifestyle. The oral health scoring system which we used in Tobishima village, Aichi-ken, was named SAWAYAKA score. A total of 777 subjects were examined. The subjects responded to a questionnaire regarding their past individual lifestyles and dietary habits. Oral health conditions were also examined by dentists. The odds ratio and 95% confidence interval were calculated both from retained tooth numbers and the questionnaire. Questions with significant odds ratio were selected and the partial regression coefficients of quantification II method by Hayashi were calculated. The results are as follows; 1) Eleven questions showed a significant odds ratio between retained tooth numbers and past lifestyle and dietary habits. The questions involved the frequency of snack intake, tooth brushing frequency, having own tooth brush, smoking, drinking, having a hobby, having a family dentist, consulting a dentist before a problem got serious, gum bleeding, swollen gums and toothache caused by sensitivity to cold water. 2) The eleven items were analysed by using Hayashi's quantification II method. 3) The results showed that unswollen gums affected the retention of teeth by the range of 1.240. Toothache caused by sensitivity to cold water affected the retention of teeth by the range of 0.765. Having a hobby affected the retention of teeth by the range of 0.691. 4) The "SAWAYAKA" score was used to select important items, excluding drinking. 5) When results were analysed with the SAWAYAKA score, an average of 9.6 was obtained. It was concluded that the scoring list could be used for checking resident's lifestyles, and for promoting the preservation of more than 20 teeth at the age of 80.     

Relationship between lifestyle and oral health in Chinese elderly

OBJECTIVE: Oral health is very important particularly for elderly to live happily. The purpose of this study is to clarify the relationship between lifestyle and oral health in Chinese elderly. METHODS: The subjects were 96 men (mean +/- SD: 70.1 +/- 4.9) and 92 women (70.7 +/- 5.4). Oral health status was evaluated according to the numbers of remaining, intact, treated, and untreated teeth and score in WHO's CPI code. By carrying out a questionnaire survey, we evaluated lifestyle factors, such as stress (SCL-S), smoking habits, drinking habit, sleeping hours, sports, snack habit, and tooth brushing habit. Logistic regression analysis was used in analyzing the data. RESULTS: By multi-logistic regression analysis, men who smoke were more likely to have a lower CPI score than those who do not {odds ratio (OR) = 4.69, 95% confidence interval (95% CI) = 0.79-27.89, p < .10}. Men who brush their teeth less than once a day are less likely to have a lower CPI score than those who brush their teeth more than twice a day (OR = 0.33, 95% CI = 0.09-1.22, p < .10). On the other hand, women who experience much stress are more likely to have a lower CPI score than women who experience little stress (OR = 5.59, 95% CI = 1.29-24.15, p < .05). CONCLUSIONS: The study indicated that smoking may affect oral health conditions in men, whereas stress may affect oral health conditions in women. The reduction in stress and abstinence from smoking are important in maintaining good oral health in Chinese elderly.     

苏州市平江区某社区居民健康素养现状调查分析

目的了解全区居民的健康素养水平,分析与健康素养有关的因素。方法按随机数法分阶段抽样,抽取辖区内一个社区,采取方便抽样的形式由社区小组长陪同、两名调查员组成的"三人一组"主动入户询问的调查方式进行健康素养调查。结果对于各项健康相关内容,社区居民总体平均每项得分值为0.671,其中健康理念和基本知识平均每项得分值为0.681;健康生活方式与行为平均每项得分值为0.621;健康技能为平均每项得分值0.746。不论是健康理念和知识,还是健康生活方式与行为,还是健康技能,从文化程度方面看,大专、本科文化者均值最高,不识字或识字很少者均值最低;家庭常住人口方面看,5口之家者均值最高,1口之家者均值最低;从家庭年平均收入水平方面看,收入小于500元者均值最低,5000～9999元间者均值最高。结论该社区居民健康素养水平偏低,文化程度、家庭收入及家庭常住人口数是明显影响健康素养的因素。     

Social inequality in perceived oral health among adults in Australia

OBJECTIVE: To establish population estimates of self-assessed tooth loss and subjective oral health and describe the social distribution of these measures among dentate adults in Australia. METHODS: Self-report data were obtained from a nationally representative sample of 3,678 adults aged 18-91 years who participated in the 1999 National Dental Telephone Interview Survey and completed a subsequent mail survey. Oral health was evaluated using (1) self-assessed tooth loss, (2) the 14-item Oral Health Impact Profile, and (3) a global six-point rating of oral health. RESULTS: While the absolute difference in tooth loss across household income levels increased at each successive age group (18-44 years, 45-64 years, 65+ years) from 0.7 teeth to 6.1 teeth, the magnitude of the difference was approximately twofold at each age group. For subjective oral health measures, the magnitude of difference across income groups was most pronounced in the 18-44 years age group. In multivariate analysis, low household income, blue-collar occupation, and high residential area disadvantage were positively associated with social impact from oral conditions and pathological tooth loss. Speaking other than English at home (relative to English), low household income (relative to high income), and vocational relative to tertiary education were each associated with more than twice the odds of poor self-rated oral health. CONCLUSIONS: Significant social differentials in perceived oral health exist among dentate adults. Inequalities span the socio-economic hierarchy. IMPLICATIONS: In addition to improving overall levels of oral health in the adult community, goals and targets should aim to reduce social inequalities in the distribution of outcomes.     

环境砷污染区人群健康危害经济损失分析

目的 探索对环境污染所致的健康危害经济损失分析的实用方法,评价当地环境砷污染的人群健康危害经济损失。方法 以人群健康调查资料为基础,通过补充收集1995年当地的人口数、国民经济净产值、年度个人收入、人群年度急性病发病率、因病缺勤和陪护情况、慢性病患病率、1985-1995年当地人群年龄别死亡率和人口数,结合简易寿命表,选择了3个可量化的指标,估算了环境砷污染区人群健康危害经济损失。结果 以1995年当地GDP和人均收入计算,砷污染区人群归因砷污染的经济损失为:(1)污染区劳动人群减寿对当地GDP损失为50.52元/(人·a),个人收入损失43.71元/(人·a);(2)与对照人群相比,污染区人群平均每年多支出医疗费56.30元/(人·a);(3)砷污染区劳动年龄人群健康生活日损失对GDP的损失为74.14元/(人·a),对劳动者个人收入损失为64.23元/(人·a)。三项经济损失之和:国家经济损失为180.96元/(人·a);个人经济损失(包括多支医疗费用)164.27元/(人·a)。结论该方法基本可用于估算环境污染健康危害的经济损失。     

Influence of social class on clinical reasons for tooth loss

In order to determine the influence of social class on clinical reasons for tooth loss in Maceió, the Alagoas State capital in Northeast Brazil, a cross-sectional study was conducted of 466 adults whose ages ranged from 18 to 76 years. Socioeconomic and demographic data were collected through a questionnaire. Clinical examinations determined the reason for extracting teeth, recording the DMF-T of all patients, who were divided into social classes on the basis of the data gathered from the questionnaire: 54.1% of the subjects were female with a mean age of 33.73 +/- 13.68 years; 369 (79.2%) of them had not completed their secondary education and 385 (82.6%) had family incomes no more than four times the official minimum wage (mean 3.4 +/- 5.4). The main reason for the loss of permanent teeth was caries. The patients presented an average of 16.59 +/- 6.96 decayed, lost or filled teeth and most of them (219 - 47%) had a DMF-T of 11 to 20 teeth. A statistically significant difference was noted between reasons for tooth loss and social class (P<0.001), leading to the conclusion that social class significantly influenced clinical reasons for tooth loss.     

Incidence of tooth loss among elderly Iowans.

This study investigated the 18-month incidence of tooth loss in a random sample of 451 dentate noninstitutionalized Iowans aged 65 and older residing in two rural counties. They had a mean of 19.0 teeth at baseline and lost an average of 0.4 teeth during the subsequent 18 months. Twenty-one per cent of the population lost at least one tooth. Four people had all their teeth extracted. Of the teeth present at baseline, 1.9 per cent subsequently were extracted. The highest incidence of tooth loss occurred among mandibular molars (3.7 per cent), followed by maxillary premolars and canines (3.1 per cent each). The best predictors of tooth loss were previous coronal and root caries.     

Tooth loss and chewing capacity among older adults in Adelaide

Abstract: This study aimed to identify sociodemographic factors associated with edentulism (loss of all teeth) and the average number of teeth lost, and to investigate relationships between tooth loss and chewing capacity. Data were obtained in 1991–92 from a cross-sectional oral epidemiological survey of Adelaide residents aged 60+ years. Interviews with 1160 participants provided information on edentulism while oral examinations among 560 dentate participants and 313 edentulous participants provided information on the number of missing teeth. People were asked if they could chew or bite six common foods. Some 41.1 per cent of persons were edentulous, and nearly half the natural teeth (mean 15.2) were missing among dentate people. Multivariate analyses revealed higher rates of edentulism ( P ≤ 0.05) for people who were older, female, Australian-born, or holders of pensioner health benefit cards, and for people who left school at an early age, or who did not own their residence. Among dentate people there were more ( P ≤ 0.05) missing teeth among those who were older, Australian-born, health benefit card holders, and who left school at an early age. Some 37.9 per cent of people reported difficulty chewing at least one food, although 57 per cent of dentate people and virtually all edentulous people wore dentures. Difficulty chewing was associated with tooth loss: 6.1 per cent of people with fewer than nine missing teeth reported difficulty compared with S8.6 per cent of edentulous people ( P < 0.01). The findings show substantially compromised oral health among older adults, particularly the oldest-old and disadvantaged groups.     

Cohort study of the effects of dietary habit on changes of BMI in middle-aged women

OBJECTIVES: The Lifestyle Study Group of the Life Planning Center developed the "Lifestyle Survey for Prevention of Cardiovascular Diseases (LPC Lifestyle Questionnaire) in 1982, and conducted a baseline study (questionnaire survey of lifestyle, physical measurements, blood pressure measurement and blood tests) in two cohorts residing in an agricultural/fishing village and an urban area in 1991. Based on the baseline data of 1991, the present study aimed to elucidate the effect of dietary lifestyle on changes of BMI in a cohort of a total of 173 persons residing in the agricultural/fishing village and the urban area. METHODS: Discriminant analysis was conducted using delta BMI as a dependent variable, and the 1991 scores of six dietary lifestyle scales, age, BMI and region as independent variables. The following results were obtained. RESULTS: 1. When the mean scores of 6 dietary lifestyle scales, age and BMI in the 1991 survey were compared among three sub-groups classified by the changes of BMI, significant intergroup differences were observed in sugar content score (tendency of high intake of snacks and juice), age and BMI. Compared to the -1 < or = delta BMI < +1 and -5 < or = delta BMI < -1 groups, the +1 < or = delta BMI < group had the highest sugar content score and the lowest age within group. BMI was the lowest in the group with -1 < or = delta BMI < +1. 2. When discriminant analysis was conducted using delta BMI as a dependent variable, and the scores of six dietary lifestyle scales, age, BMI in the 1991 survey and region as independent variables, the results showed that sugar content score, cooking initiative score (interest in new dishes and modifying cooking for health), age and BMI were statistically significant for the discrimination. CONCLUSIONS: The findings suggest that even in young subjects with low BMI, if the sugar content score and cooking initiative score are high, there is a high possibility of increased BMI in the future.     

Socio-demographic risk indicators for tooth mortality in rural Sri Lankans

To explore the socio-demographic factors associated with tooth loss in rural inhabitants of Sri Lanka, a random sample of 2178 males aged 20-60 years was selected using multi-stage cluster sampling procedure. The number of missing and present teeth was recorded excluding third molars and the subjects were interviewed to elicit socio-demographic information as well as oral hygiene and tobacco consumption habits. The mean number of teeth lost in the sample was 5.17 +/- 5.43. Tooth loss increased significantly with age. Sinhalese had significantly fewer lost teeth (5.05 +/- 5.38) compared to Tamils (6.54 +/- 6.18) and Muslims (6.02 +/- 5.21) whereas education, income, oral hygiene practices and tobacco use were significantly associated with tooth loss in the bivariate analysis. A forward stepwise multiple regression analysis revealed that age, Muslim ethnicity and quantified tobacco use were positively associated with tooth loss while better socio-economic conditions and good oral hygiene habits were negatively linked with tooth mortality independent of other factors. Age, Muslim ethnicity, quantified tobacco use, income, education, brushing frequency and substance used for cleaning had significantly affected tooth loss. Quantified tobacco use and oral hygiene may be regarded as modifiable socio-demographic risk indicators associated with tooth mortality in Sri Lankans.     

上海市黄浦区社区居民健康大讲坛活动效果评价

目的评价以健康俱乐部为载体开展健康大讲坛活动对提高社区居民健康意识、相关预防和控制慢性病知识、改善不良行为方式所起的作用。方法采用现场调查、专题小组讨论和问卷调查的方法调查6家社区健康俱乐部的健康大讲坛的活动效果。结果共调查219名参与健康大进坛活动的社区居民,他们对健康大讲坛效果满意率为100%,参加健康大讲坛后,糖尿病相关知识得分均分为84.95分,合格率为84.48%,高血压相关知识得分均分为78.50分,合格率为93.20%,活动后社区居民慢性病知识知晓率均有所提高,与干预前比较具有统计学差异（P〈0.01）。结论健康俱乐部的健康大讲坛活动有助于人们较系统地获得相关健康知识和保健技能,并在管理者的指导下,逐步形成了健康生活方式。     

Impact of low frequency transcutaneous electrical nerve stimulation on symptomatic diabetic neuropathy using the new Salutaris device

In a double blind, randomised study, 19 patients suffering from mild-to-moderate symptomatic diabetic neuropathy (Total Symptom Score, NTSS 4-16) received either treatment with the new transcutaneous electrical nerve stimulation (TENS) device "Salutaris" (verum group) or a placebo treatment with an identical but electrically inactive device (placebo group). Stimulation pads were placed at the anatomical localisation of the peroneal nerve and stimulation was performed using a low frequency mode. At baseline (V1), after 6 (V2), and 12 (V3) wk of treatment, the patients' symptoms were registered using the new total symptom score (NTSS-6) and a visual analogue scale (VAS). In addition, sensory nerve thresholds (temperature, vibration, pain) and microvascular function were measured at the lower limb at baseline and after 12 wk of treatment. Active TENS-treatment resulted in a significant improvement in NTSS-6 score after 6 wk (-42%) and after 12 wk (-32%) of treatment (baseline: 10.0+/-3.3, 6 wk: 5.8+/-5.0, p<0.05; 12 wk: 6.8+/-3.9, p=0.05; placebo group: baseline: 7.6+/-3.1; 6 wk: 8.1+/-5.1, n.s.; 12 wk: 6.5+/-6.1, n.s.). Subanalysis of the different qualities of the NTSS-score revealed an improvement in numbness (2.2+/-1.0 to 1.6+/-1.3; p<0.03); lancinating pain (1.6+/-1.1 to 0.6+/-0.9; p<0.02) and allodynia (1.4+/-1.6 to 0.5+/-1.0; p<0.05). Also, a significant improvement in the VAS rating was found after 6 wk of TENS therapy (19.8+/-5.0 to 14.4+/-9.6; p<0.05), while no change was observed in the placebo arm. In conclusion, our study indicates that the new TENS device "Salutaris" is a convenient, non-pharmacological option for primary or adjuvant treatment of painful diabetic neuropathy.     

Improving diet, physical activity and other lifestyle behaviours using computer-tailored advice in general practice: a randomised controlled trial

ABSTRACT: BACKGROUND: The adoption and maintenance of healthy behaviours is essential in the primary prevention of chronic non-communicable diseases. This study evaluated the effectiveness of a minimal intervention on multiple lifestyle factors such as diet, physical activity, smoking and alcohol, delivered through general practice, using computer-tailored feedback. METHODS: Adult patients visiting 21 general practitioners in Brisbane, Australia, were surveyed about ten health behaviours that are risk factors for chronic, non-communicable diseases. Those who completed the self-administered baseline questionnaire entered a randomised controlled trial, with the intervention group receiving computer-tailored printed advice, targeting those health behaviours for which respondents were not meeting current recommendations. The primary outcome was change in summary lifestyle score (Prudence Score) and individual health behaviours at three months. A repeated measures analysis compared change in these outcomes in intervention and control groups after adjusting for age and education. RESULTS: 2306 patients were randomised into the trial. 1711 (76%) returned the follow-up questionnaire at 3 months. The Prudence Score (10 items) in the intervention group at baseline was 5.88, improving to 6.25 at 3 months (improvement = 0.37), compared with 5.84 to 5.96 (improvement = 0.12) in the control group (F = 13.3, p = 0.01). The intervention group showed improvement in meeting recommendations for all individual health behaviours compared with the control group. However, these differences were significant only for fish intake (OR 1.37, 95% CI 1.11-1.68), salt intake (OR 1.19, 95% CI 1.05-1.38), and type of spread used (OR 1.28, 95% CI 1.06-1.51). CONCLUSION: A minimal intervention using computer-tailored feedback to address multiple lifestyle behaviours can facilitate change and improve unhealthy behaviours. Although individual behaviour changes were modest, when implemented on a large scale through general practice, this intervention appears to be an effective and practical tool for population-wide primary prevention.Trial RegistrationThe Australian New Zealand Clinical Trials Registry: ACTRN12611001213932.     

Disparities in edentulism and tooth loss between Māori and non-Māori New Zealand women

Objectives: Tooth loss and edentulism are important negative health outcomes; however, there is little current information about the prevalence of these conditions among adults in New Zealand (NZ). This study describes the dentate status of Maori and non-Maori NZ women with regard to tooth loss, edentulism and denture-wearing, and investigates ethnic and sociodemographic disparities within the sample. Associations between dentate status, socio-demographic and health-related factors are described.
Methods: Participants were 1,817 women who were screened for participation in a randomised controlled trial.
Results: 9.0% of women were edentulous and 30.3% wore a denture (partial or complete). The mean number of teeth present was 24.2, and older women had fewer teeth on average. Socio-demographic and ethnic disparities in tooth loss and edentulism were observed. Maori ethnicity was strongly associated with edentulism and tooth loss, with Maori women five times more likely than NZ European women to be edentulous. These associations held after controlling for age, education, smoking, diabetes, cardiovascular disease history, and BMI.
Conclusions: Marked ethnic disparities in edentulism and tooth loss exist in New Zealand. Effective targeted programmes are needed to reduce the public health impact of poor oral health among Maori.     

Disparities in edentulism and tooth loss between Māori and non-Māori New Zealand women.

OBJECTIVES: Tooth loss and edentulism are important negative health outcomes; however, there is little current information about the prevalence of these conditions among adults in New Zealand (NZ). This study describes the dentate status of Maori and non-Maori NZ women with regard to tooth loss, edentulism and denture-wearing, and investigates ethnic and sociodemographic disparities within the sample. Associations between dentate status, socio-demographic and health-related factors are described. METHODS: Participants were 1,817 women who were screened for participation in a randomised controlled trial. RESULTS: 9.0% of women were edentulous and 30.3% wore a denture (partial or complete). The mean number of teeth present was 24.2, and older women had fewer teeth on average. Socio-demographic and ethnic disparities in tooth loss and edentulism were observed. Maori ethnicity was strongly associated with edentulism and tooth loss, with Maori women five times more likely than NZ European women to be edentulous. These associations held after controlling for age, education, smoking, diabetes, cardiovascular disease history, and BMI. CONCLUSIONS: Marked ethnic disparities in edentulism and tooth loss exist in New Zealand. Effective targeted programmes are needed to reduce the public health impact of poor oral health among Maori.     

精神分裂症患者口腔卫生健康状况调查

目的了解并分析不同住院时间精神分裂症患者的口腔卫生保健状况。方法随机选择100例长期住院的精神分裂症患者,住院时间1～5年和5年以上患者各50例。采用WHO推荐的龋病、牙周病调查标准,对两组患者进行口腔健康调查研究。结果两种住院时间精神分裂症患者的口腔保健和口腔卫生习惯均较差。住院时间5年及5年以下患者患龋率、人均失牙、牙列完整率,均好于5年以上组。结论长期住院的精神分裂症患者的口腔卫生状况很差,龋病、牙周病和牙缺失情况较严重。对于长期住院的精神分裂症患者的口腔卫生状况,医疗机构积极的治疗和预防措施是必要的,也希望得到家庭和社会的关注。     

How do residents prioritize smoking cessation for young "high-risk" women? Factors associated with addressing smoking cessation

BACKGROUND: Sixty-seven percent of physicians report advising their smoking patients to quit. Primary care residents' priorities for preventive health for a young "high-risk" female are unknown. Factors related to residents addressing smoking also need examining. METHODS: One hundred residents completed a survey about preventive health issues for a woman in her 20s "who leads a high-risk lifestyle." Residents indicated which topics they would address, and the likelihood that they would address each of 12 relevant preventive health topics, their outcome expectancies that the patient would follow their advice on each topic, their confidence that they could address the topic, and perceived barriers for addressing the topic. RESULTS: Residents listed STD prevention most frequently. Drug use and smoking cessation were second and third most frequently listed. Residents who believed that the patient would follow their advice were more likely to list smoking cessation than residents who had lower outcome expectancies for that patient. Higher barriers were negatively related to addressing smoking cessation. CONCLUSIONS: When time is not a barrier, residents are likely to address smoking cessation. Teaching residents how to incorporate this subject into their clinical practice is needed. Raising residents' outcome expectancies may increase their likelihood of addressing smoking cessation.     

农村基层医疗卫生机构视力检查服务提供与利用

目的:分析农村基层医疗卫生机构视力检查服务的可及性对居民视力检查服务利用的影响。方法:利用医疗卫生机构和农户调查数据,采用描述统计和多元回归分析。结果:样本中33.2%的居民自报告视力不良,22.1%的居民曾做过视力检查,86%样本乡镇的卫生院和44%样本村的村卫生室可以提供视力检查服务;回归结果显示,乡镇卫生院提供视力检查服务将显著增加居民进行视力检查的可能性,但村卫生室是否提供视力检查服务对居民视力检查的利用没有显著影响。结论:农村居民对视力检查服务需求很大,但是利用率低。基层医疗卫生机构服务供给不足可能是导致农村居民服务利用率低的重要因素。建议国家继续推进基本公共卫生服务,加强基层医疗卫生服务机构开展基本视力检查的能力,促进农村居民对视力检查服务的利用,改善农村居民视力健康水平。     

Tooth Loss in Appalachia and the Mississippi Delta Relative to Other Regions in the United States, 1999–2010

Objectives. We examined regional variation in tooth loss in the United States from 1999 to 2010.Methods. We used 6 waves of the Behavioral Risk Factor Surveillance System and data on county characteristics to describe regional trends in tooth loss and decompose diverging trends into the parts explained by individual and county components.Results. Appalachia and the Mississippi Delta had higher levels of tooth loss than the rest of the country in 1999. From 1999 to 2010, tooth loss declined in the United States. However, Appalachia did not converge toward the US average, and the Mississippi Delta worsened relative to the United States. Socioeconomic status explained the largest portion of differences between regions in 1999, but a smaller portion of the trends. The Mississippi Delta is aging more quickly than the rest of the country, which explains 17% of the disparity in the time trend.Conclusions. The disadvantage in tooth loss is persistent in Appalachia and growing in the Mississippi Delta. The increasing disparity is partly explained by changes in the age structure but is also associated with behavioral and environmental factors.People in Appalachia have worse oral health than other Americans.1–4 West Virginia, the only state entirely located in Appalachia, has the highest rate of people missing 6 or more teeth (65.6%) and the second highest rate of complete tooth loss (37.8%) for people aged 65 years and older.5,6 The Mississippi Delta, another economically disadvantaged region, also has poor oral health. Mississippi, which falls mostly in the Mississippi Delta, follows West Virginia with the second highest rate of people missing 6 or more teeth (58.2%) and the fourth highest rate of complete tooth loss (27.3%) among those aged 65 years and older.5,6 Of the 5 states with the highest rate of people missing 6 or more teeth, 4 fall in the Mississippi Delta or Appalachia.Numerous studies have examined the causes of poor oral health in Appalachia and the Mississippi Delta. Studies have highlighted the importance of both individual attributes and broader elements that affect Appalachian communities. Individual attributes include socioeconomic status (SES), genetics, oral bacteria, tobacco use, knowledge of health behaviors, and dental insurance.1,2,4,7–9 Broader elements include fluoride in the water supply, cultural importance placed on oral health, presence of coal mining, and number of dentists and dental hygienists per capita.1,2,4,10,11 Less research has been done on oral health in the Mississippi Delta, although this region also has high rates of tooth loss. Studies that have analyzed this region have highlighted the roles of race, private dental insurance, parental oral health, parental health behaviors, and diet.12–15Oral health in the United States has significantly improved in the past 4 decades. The number of decayed, missing, and filled teeth; prevalence of untreated caries; edentulous rate; and rate of periodontal disease have all declined.16–22 The overall improvement in oral health outcomes in the United States raises the question of whether all areas of the United States are improving equally or whether there are persistent regional disparities in oral health outcomes. Previous reports from the Centers for Disease Control and Prevention have provided raw data on tooth loss in each state,5,6 but data on regional disparities is lacking. Moreover, without microdata it is impossible to discern whether divergent regional trends are attributable to relatively innocuous differences, such as the age structure of the regions, or driven by more concerning disparities, such as poverty and access to oral health care.To address this gap, we used data from the Behavioral Risk Factor Surveillance System (BRFSS) to examine regional variation in the level and improvement in the rate of tooth loss from 1999 to 2010. Our regions of interest, Appalachia and the Mississippi Delta, are defined as groups of counties. We analyzed the association between tooth loss and individual characteristics, individual behavior, and county factors.We tested 3 hypotheses: (1) The Mississippi Delta and Appalachia will have had less improvement in oral health than the rest of the country in the past decade, (2) the age profile of the regions will explain a portion of the regional differences, and (3) individual characteristics, individual behavior, and county characteristics will explain a portion of the regional differences.