A quarter century of changes in oral health in the United States.

This paper provides an overview of the oral health status of Americans since the 1960s. Data from seven national surveys, conducted between 1960 and 1987, have been presented. Estimates of coronal and root caries, periodontal diseases, and tooth loss were reviewed. In addition, data on edentulism and oral cavity and pharyngeal cancer were included. Although the purpose of this paper is descriptive rather than analytical, some important trends have been noted: The number of children who were free from dental caries increased dramatically between 1963 and 1987. By 1987, almost one-half of school children between the ages of 5 and 17 were caries-free. Among those children with dental decay, the number of teeth affected has also declined. The oral health of adults also improved during the 27-year period included in this review. In particular, the mean number of missing teeth and the percentage of edentulous adults have declined substantially. Trends in periodontal diseases were difficult to determine due to changes in the measures of periodontal diseases utilized in the surveys. In the most recent survey of employed U.S. adults, approximately 44 percent were found to have gingivitis and slightly more than 13 percent had periodontal pockets 4-5 mm in depth. Approximately 30,000 new cases of oral cavity and pharyngeal cancer were diagnosed in 1993, resulting in approximately 8,000 deaths. African Americans have higher incidence and mortality rates than white Americans and also have a much lower five-year survival rate.