Dental Hygiene | Beauty and Wellness - Class 6 PDF Download

Oral health affects our ability to eat, speak, smile, and show emotions. Oral health also affects a person’s self-esteem, school performance, and attendance at work or school. Oral diseases—which range from cavities and gum disease to oral cancer—cause pain and disability for millions of Americans and cost taxpayers billions of dollars each year.

Children's Oral Health

Overview
Cavities (also known as caries or tooth decay) are one of the most common chronic diseases of childhood in the United States. Untreated cavities can cause pain and infections that may lead to problems with eating, speaking, playing, and learning. Children who have poor oral health often miss more school and receive lower grades than children who don’t.

• About 1 of 5 (20%) children aged 5 to 11 years have at least one untreated decayed tooth. 
• 1 of 7 (13%) adolescents aged 12 to 19 years have at least one untreated decayed tooth.
• Children aged 5 to 19 years from low-income families are twice as likely (25%) to have cavities, compared with children from higher-income households (11%).

The good news is that cavities are preventable. Fluoride varnish can prevent about one-third (33%) of cavities in the primary (baby) teeth. Children living in communities with fluoridated tap water have fewer cavities than children whose water is not fluoridated.3 Similarly, children who brush daily with fluoride toothpaste will have fewer cavities.
Dental sealants can also prevent cavities for many years. Applying dental sealants to the chewing surfaces of the back teeth prevent 80% of cavities.

What Parents and Caregivers Can Do

(i) For Babies

• Wipe gums twice a day with a soft, clean cloth in the morning after the first feeding and right before bed to wipe away bacteria and sugars that can cause cavities.
• When teeth come in, start brushing twice a day with a soft, small‑bristled toothbrush and plain water.
• Visit the dentist by your baby’s first birthday to spot signs of problems early.
• Talk to your dentist or doctor about putting fluoride varnish on your child’s teeth as soon as the first tooth appears.

For children younger than 2, consult first with your doctor or dentist regarding the use of fluoride toothpaste.
(ii)  For Children

• Brush their teeth twice a day with fluoride toothpaste.
• Drink tap water that contains fluoride.
• Ask your child’s dentist to apply dental sealants when appropriate.

If your child is younger than 6, watch them brush. Make sure they use a pea-sized amount of toothpaste and always spit it out rather than swallow. Help your child brush until they have good brushing skills.
To see if your community’s water is fluoridated, you can view your water system on CDC’s My Water’s Fluoride website. You can also call your water utility company and request a copy of the utility’s most recent “Consumer Confidence Report.” This report provides information on the level of fluoride in your drinking (tap) water.
If your drinking water does not have enough fluoride to prevent cavities (the optimal amount of 0.7 milligrams per Liter), ask your dentist, pediatrician, family doctor, or nurse if your child needs oral fluoride supplements, such as drops, tablets, or lozenges.

Good Dental Health Is Important for Pregnant Women

When you’re pregnant, you may be more prone to gum disease and cavities, which can affect your baby’s health. Follow these 3 steps to protect your teeth:

• See a dentist (it's safe!) before you deliver
• Brush twice a day
• Floss Daily

What Are the Risk Factors for Cavities?

Your child’s chance of getting cavities can be higher if:

• Family members (older brothers, sisters, or parents) have cavities.
• They eat and drink a lot of sugary foods and drinks, like soda, especially between meals.
• They have special health care needs.
• They wear braces or orthodontics or oral appliances.

If any of these apply to your child, be sure to talk with your dentist, pediatrician, or family doctor to make sure you are taking extra steps to protect your child’s teeth.

Adult Oral Health

Facts About Adult Oral Health
The baby boomer generation is the first where the majority of people will keep their natural teeth over their entire lifetime. This is largely because of the benefits of water fluoridation and fluoride toothpaste. However, threats to oral health, including tooth loss, continue throughout life.

The major risks for tooth loss are tooth decay and gum disease that may increase with age because of problems with saliva production; receding gums that expose “softer” root surfaces to decay-causing bacteria; or difficulties flossing and brushing because of poor vision, cognitive problems, chronic disease, and physical limitations.
Although more adults are keeping their teeth, many continue to need treatment for dental problems. This need is even greater for members of some racial and ethnic groups—about 3 in 4 Hispanics and non-Hispanic black adults have an unmet need for dental treatment, as do people who are poor. These individuals are also more likely to report having poor oral health.
In addition, some adults may have difficulty accessing dental treatment. For every adult aged 19 years or older without medical insurance, there are three who don’t have dental insurance.
Oral health problems in adults include the following:

(i) Untreated tooth decay: More than 1 in 4 (26%) adults in the United States have untreated tooth decay.

(ii) Gum disease: Nearly half (46%) of all adults aged 30 years or older show signs of gum disease; severe gum disease affects about 9% of adults.4

(iii) Tooth loss: Complete tooth loss among adults aged 65-74 years has steadily declined over time, but disparities exist among some population groups.5 If left untreated, cavities (tooth decay) and periodontal (gum) disease lead to tooth loss.

(iv) Oral cancer: Oral cancers are most common in older adults, particularly in people older than 55 years who smoke and are heavy drinkers.6

• People treated for cancer who have chemotherapy may suffer from oral problems such as painful mouth ulcers, impaired taste, and dry mouth.

(v) Chronic diseases: Having a chronic disease, such as arthritis, heart disease or stroke, diabetes, emphysema, hepatitis C, a liver condition, or being obese may increase an individual’s risk of having missing teeth and poor oral health.

• Patients with weakened immune systems, such as those infected with HIV and other medical conditions (organ transplants) and who use some medications (e.g., steroids) are at higher risk for some oral problems.
• Chronic disabling diseases such as jaw joint diseases (TMD), autoimmune conditions such as Sjögren’s Syndrome, and osteoporosis affect millions of Americans and compromise oral health and functioning, more often among women.

Older Adult Oral Health

Facts About Older Adult Oral Health

By 2060, according to the US Census, the number of US adults aged 65 years or older is expected to reach 98 million, 24% of the overall population.1 Older Americans with the poorest oral health tend to be those who are economically disadvantaged, lack insurance, and are members of racial and ethnic minorities. Being disabled, homebound, or institutionalized (e.g., seniors who live in nursing homes) also increases the risk of poor oral health. Adults 50 years and older who smoke are also less likely to get dental care than people who do not smoke.6 Many older Americans do not have dental insurance because they lost their benefits upon retirement and the federal Medicare program does not cover routine dental care.

Oral health problems in older adults include the following:

• Untreated tooth decay: Nearly all adults (96%) aged 65 years or older have had a cavity; 1 in 5 have untreated tooth decay.
• Gum disease: A high percentage of older adults have gum disease. About 2 in 3 (68%) adults aged 65 years or older have gum disease.
• Tooth loss: Nearly 1 in 5 of adults aged 65 or older have lost all of their teeth. Complete tooth loss is twice as prevalent among adults aged 75 and older (26%) compared with adults aged 65-74 (13%).3  Having missing teeth or wearing dentures can affect nutrition, because people without teeth or with dentures often prefer soft, easily chewed foods instead of foods such as fresh fruits and vegetables.
• Oral cancer: Cancers of the mouth (oral and pharyngeal cancers) are primarily diagnosed in older adults; median age at diagnosis is 62 years.
• Chronic disease: People with chronic diseases such as arthritis, diabetes, heart diseases, and chronic obstructive pulmonary disease (COPD) may be more likely to develop gum (periodontal) disease, but they are less likely to get dental care than adults without these chronic conditions.6 Also, most older Americans take both prescription and over-the-counter drugs; many of these medications can cause dry mouth. Reduced saliva flow increases the risk of cavities.

Disparities in Oral Health

The nation’s oral health has greatly improved since the 1960s, but not all Americans have equal access to these improvements.1 Some racial/ethnic and socioeconomic groups have worse oral health2 as a result of the social determinants of health—conditions in the places where people are born, live, learn, work, and play.3, 4 For example, some groups of people:

• Can’t afford to pay out of pocket for dental care, do not have private or public dental insurance, or can’t get time off from work to get to dental care.
• Live in communities where they don’t have access to fluoridated water and school sealant programs, healthy foods, and public transportation to get to dental appointments.

Regular preventive dental care is essential for good oral health so one can find problems earlier when they are easier to treat, but many don’t get the care they need. More people are unable to afford dental care than other types of health care.5 In 2015, the percentage of people in the United States with no dental insurance was 29% overall and 62% for older adults.6 Traditional Medicare does not cover routine dental care, therefore many lose their benefits upon retirement.
In addition, many low-income adults do not have public dental insurance. Medicaid programs are not required to provide dental benefits to adult enrollees, so dental coverage varies widely from state to state. Currently, 15 states provide no coverage or only emergency coverage.
Among working-age US adults, over 40% of low-income and non-Hispanic Black adults have untreated tooth decay.8 Untreated oral disease has a large impact on quality of life and productivity:

• Over 34 million school hours were lost in the United States in 2008 because of unplanned urgent dental care.
• Over $45 billion is lost in productivity in the United States each year because of untreated oral disease.
• Nearly 18% of all working-age adults, and 29% of those with lower incomes, report that the appearance of their mouth and teeth affects their ability to interview for a job.

For more information on the high cost of oral disease and the cost-effectiveness of oral disease interventions, see CDC’s Power of Prevention fact sheet.

(i) Oral Health Disparities in Children Aged 2 to 19

• Cavities and racial or ethnic groups: Based on data from 2011–2016, for children aged 2 to 5 years, about 33% of Mexican American and 28% of non-Hispanic Black children have had cavities in their primary teeth, compared with 18% of non-Hispanic White children. For children aged 12 to 19, nearly 70% of Mexican American children have had cavities in their permanent teeth, compared with 54% of non-Hispanic White children.12
• Untreated cavities and family income: For children aged 2 to 5 years, 17% of children from low-income households have untreated cavities in their primary teeth, 3 times the percentage of children from higher-income households. By ages 12 to 19, 23% of children from low-income families have untreated cavities in their permanent teeth, twice that of children from higher-income households.12
• Sealants and family income: Children aged 6 to 19 years from low-income households are about 15% less likely to get sealants and twice as likely to have untreated cavities compared with children from higher-income households.12

(ii) Oral Health Disparities in Adults Aged 20 to 64

• Untreated cavities and racial or ethnic groups: Nearly twice as many non-Hispanic Black or Mexican American adults have untreated cavities as non-Hispanic White adults.12
• Untreated cavities and education: Adults with less than a high school education are almost 3 times as likely to have untreated cavities as adults with at least some college education.12
• Untreated cavities and smoking status: Among adults who smoke cigarettes, over 40% have untreated cavities.12
• Untreated cavities and income: About 40% of adults with low-income or no private health insurance have untreated cavities. Low-income or uninsured adults are twice as likely to have one to three untreated cavities and 3 times as likely to have four or more untreated cavities as adults with higher incomes or private insurance.

(iii) Oral Health Disparities in Adults Aged 65 or Older

• Untreated cavities and racial or ethnic groups: More than 9 in 10 older adults have had cavities, and 1 in 6 have untreated cavities. Older non-Hispanic Black or Mexican American adults have 2 to 3 times the rate of untreated cavities as older non-Hispanic White adults.12
• Untreated cavities and education: Older adults with less than a high school education have untreated cavities at nearly 3 times the rate of adults with at least some college education.
• Edentulism (complete tooth loss): Seventeen percent of older adults have lost all their teeth. Low-income older adults, those with less than a high school education, or those who are current smokers are more than 3 times as likely to have lost all of their teeth as adults with higher incomes, more than a high school education, or who have never smoked.

(iv) Disparities in Oral Cancer and Gum Disease

• Adults and oral cancer: Head and neck cancers are more than twice as common among men as women.11 The 5-year survival rate for oral pharyngeal (throat) cancers is lower among Black men (41%) than White men (62%).
• Adults and gum (periodontal) disease: Forty-two percent of adults have some form of gum disease. Among adults aged 65 and older, the rate of gum disease increases to 60%.
• Severe gum disease is most common among adults aged 65 or older, Mexican American and non-Hispanic Black adults, and people who smoke.

(v) CDC’s Work to Reduce Oral Health Disparities

CDC works to reduce disparities in the rate of cavities and integrate oral health programs into chronic disease prevention and medical care. The agency and its partners promote two interventions that are strongly recommended by the Community Preventive Services Task Force because they prevent cavities and save money.

• School sealant programs typically provide dental sealants at no charge to children who are less likely to receive private dental care. Providing sealants to the 5 million children from low-income families could prevent 3.4 million cavities over 4 years.
• Community water fluoridation is an equal and effective way to deliver fluoride to all community members regardless of age, education, or income. It also saves money for families and the US health care system.

Oral Health Conditions

• Oral health refers to the health of the teeth, gums, and the entire oral-facial system that allows us to smile, speak, and chew. Some of the most common diseases that impact our oral health include cavities (tooth decay), gum (periodontal) disease, and oral cancer.
• More than 40% of adults report having felt pain in their mouth within the last year, and more than 80% of people will have had at least one cavity by age 34. The nation spends more than $124 billion on costs related to dental care each year.  On average, over 34 million school hours and more than $45 billion in productivity are lost each year as a result of dental emergencies requiring unplanned care.
• Oral conditions are frequently considered separate from other chronic conditions, but these are actually inter-related. Poor oral health is associated with other chronic diseases such as diabetes and heart disease. Oral disease also is associated with risk behaviors such as using tobacco and consuming sugary foods and beverages.
• Public health strategies such as community water fluoridation and school sealant programs are safe and effective interventions proven to prevent cavities and save money.

Cavities (Tooth Decay)

• Cavities are caused by a breakdown of the tooth enamel by acids produced by bacteria located in plaque that collects on teeth, especially along the gumline and in the crevices on the chewing surfaces of the teeth. Eating and drinking foods high in carbohydrates cause this bacteria to produce the acids that can cause the outer coating of the tooth (enamel) or root surface to break down (demineralize).
• Although cavities are largely preventable, they are one of the most common chronic diseases throughout the lifespan.1 About one-fourth of young children, half of adolescents and more than 90% of adults experienced tooth decay. Untreated tooth decay affected 10% of young children to 26% of adults aged 20–64.2 Untreated tooth decay can lead to abscess (a severe infection) under the gums which can spread to other parts of the body and have serious, and in rare cases fatal, results.
• Community water fluoridation and school-based dental sealants programs are both cost-saving, proven strategies to prevent tooth decay.

Gum (Periodontal) Disease

About 4 in 10 adults aged 30 years or older had gum (periodontal) diseases in 2009–2014.5 Gum disease is mainly the result of infections and inflammation of the gums and bone that surround and support the teeth. Certain chronic conditions increase one’s risk for periodontal disease including diabetes, a weakened immune system, poor oral hygiene, and heredity. Tobacco use is also an important risk factor for gum disease. If early forms of periodontal diseases are not treated, the bone that supports the teeth can be lost, and the gums can become infected. Teeth with little bone support can become loose and may eventually have to be extracted.

Oral Cancer

In 2016, there were nearly 45,000 new cases of cancer of the oral cavity and pharynx diagnosed in the United States and more than 10,000 deaths. The 5-year survival rate for these cancers is about 61 percent. The mortality rate from oral cancer is nearly three times as high in males as it is in females (4 vs 1.4 for every 100,000 people) and nearly twice as high in white and black populations as it is in Hispanic population (2.6 vs. 1.5 for every 100,000 people).6 Preventing high risk behaviors, that include cigarette, cigar or pipe smoking, use of smokeless tobacco, and excessive use of alcohol are critical in preventing oral cancers. Early detection is key to increasing the survival rate for these cancers. Oral Human Papilloma Virus (HPV), the most common sexually transmitted disease, can cause cancers in the back of the throat, called “oropharyngeal cancers.” More research is needed to determine whether HPV itself causes oropharyngeal cancers, or if other factors (such as smoking or chewing tobacco) interact with HPV to cause these cancers.