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.3, 4
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.
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.
- Antibiotic Safety: Do’s and Don’ts at the Dentist pdf icon[PDF – 543K]
- ADA MouthHealthy: Decayexternal icon
- National Diabetes Education Program: Healthy Teeth Matter pdf icon[PDF-200K]
- A Guide for Pharmacy, Podiatry, Optometry, and Dentistry: Oral Health and Diabetes pdf icon[PDF-240K]
- Working Together to Manage Diabetes: A Toolkit for Pharmacy, Podiatry, Optometry, and Dentistry (PPOD)
- National Institutes of Health, National Institute of Dental and Craniofacial Research: Oral Cancerexternal icon
- National Cancer Institute: Head and Neck Cancerexternal icon
- CDC Wonder: Cancer Statistics
- CDC: United States Cancer Statistics by state and region
- Tips From Former Smokers
- Smokefree.govexternal icon
- U.S. Department of Health and Human Services, (2000). Oral Health in America: A Report of the Surgeon General. National Institute of Dental and Craniofacial Research, National Institutes of Health. Rockville, MD.
- Centers for Disease Control and Prevention. Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States, 1999–2004 to 2011–2016. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2019.
- Community Preventive Services Task Force. The Guide to Community Preventive Services. Preventing dental caries: community water fluoridation (abbreviated). Available at: https://www.thecommunityguide.org/findings/dental-caries-cavities-community-water-fluoridationexternal icon.
- Community Preventive Services Task Force. The Guide to Community Preventive Services. Preventing dental caries: school-based dental sealant delivery programs: Task Force findings and rationale statement (abbreviated). Available at: https://www.thecommunityguide.org/findings/dental-caries-cavities-school-based-dental-sealant-delivery-programsexternal icon.
- Eke PI, Thornton-Evans GO, Wei L, Borgnakke WS, Dye BA, Genco RJ. Periodontitis in US Adults: National Health and Nutrition Examination Survey 2009-2014. J Am Dent Assoc. 2018;149(7):576-588.
- Centers for Disease Control and Prevention. United States Cancer Statistics: Data Visualizations. Available at: https://gis.cdc.gov/Cancer/USCS/DataViz.html.
- Centers for Disease Control and Prevention. HPV and Oropharyngeal Cancer. Available at: https://www.cdc.gov/cancer/hpv/basic_info/hpv_oropharyngeal.htm.