Oral Health Across the Lifespan: What the CDC's Surveillance Tells Us

Oral health refers to the health of the teeth, gums, and the entire oral-facial system that allows us to smile, speak, and chew. The most common diseases affecting the mouth are tooth decay and gum disease — and both are largely preventable.

According to the Centers for Disease Control and Prevention (CDC), oral diseases affect Americans across the lifespan, but their burden is not distributed equally. People with low incomes, those without dental insurance, certain racial and ethnic minority groups, people with disabilities, and people living in rural areas all experience disproportionately higher rates of oral disease.

• Cavities are the most common chronic disease of childhood in the United States — five times more common than asthma.
• About 1 in 5 children ages 5 to 11 has at least one untreated decayed tooth.
• About 1 in 7 adolescents ages 12 to 19 has at least one untreated decayed tooth.
• Dental sealants (a protective coating placed on the chewing surfaces of back teeth) can prevent up to 80% of cavities in back teeth. Despite this, only about 4 in 10 children ages 6 to 11 from low-income families have sealants.
• Children from lower-income families are about twice as likely to have cavities, compared with children from higher-income households.

What works for children

• Community water fluoridation
• School-based dental sealant programs
• Brushing with fluoride toothpaste starting when the first tooth appears
• Regular dental visits beginning by the first birthday

• More than 1 in 4 adults aged 20 to 64 currently has cavities.
• About 46% of adults aged 30 years or older show signs of gum disease; severe gum disease affects about 9% of adults.
• About 1 in 6 adults aged 65 or older has lost all of their teeth.
• Severe tooth loss (8 or fewer remaining teeth) affects about 1 in 4 adults aged 65 or older.
• Adults who currently smoke are about twice as likely to have gum disease compared with people who have never smoked.

What works for adults

• Twice-daily brushing with fluoride toothpaste
• Daily flossing or interdental cleaning
• Routine dental visits
• Smoking cessation
• Diabetes management (people with poorly controlled diabetes are at higher risk for gum disease)

Older adults face unique oral health challenges:

• About 1 in 5 adults aged 65 or older has untreated tooth decay.
• About 2 in 3 adults aged 65 or older have gum disease.
• Oral cancer is primarily diagnosed in older adults — median age at diagnosis is 62.
• Most older Americans take both prescription and over-the-counter drugs. Many of these medications can cause dry mouth, which raises the risk of cavities.

Every year in the U.S., about 54,000 new cases of oral and pharyngeal cancers are diagnosed, and more than 11,000 people die from these diseases.

Major risk factors include:

• Tobacco use of any kind, including cigarettes, cigars, pipes, smokeless tobacco
• Heavy alcohol use
• Combination of tobacco and alcohol — a much greater risk than either substance alone
• Human papillomavirus (HPV) infection — strongly associated with oropharyngeal cancers (cancers of the back of the throat, the base of the tongue, and the tonsils)
• Sun exposure (for cancers of the lip)
• A diet low in fruits and vegetables

When detected and treated in its earliest stages, oral cancer has a 5-year survival rate of more than 80%. Routine dental visits include an oral-cancer screening.

Research is uncovering associations between chronic oral inflammation and systemic conditions including cardiovascular disease, diabetes complications, and adverse pregnancy outcomes. While more research is needed to establish causality, the evidence is clear that good oral hygiene and regular dental care are essential components of overall health.

The mouth is a window to overall health, and many systemic diseases have oral signs and symptoms. Taking care of your mouth is taking care of your body.

The CDC has identified evidence-based interventions that prevent oral disease at scale:

Most oral disease is preventable. The interventions are inexpensive, well-established, and effective. The challenge — and the opportunity — is making sure they reach everyone.

This article is adapted from public-domain content published by the U.S. Centers for Disease Control and Prevention (CDC) and the National Institute of Dental and Craniofacial Research (NIDCR).