Trends in Oral Health by Poverty Status as Measured by Healthy People 2010 Objectives

Objective. Poverty is a significant social determinant for oral health, yet Healthy People 2010 (HP 2010) does not monitor changes in oral health status by poverty. We assessed recent trends for six HP 2010 oral health objectives by poverty status. Methods. We used data from the 1988-1994 and 1999-2004 National Health and Nutrition Examination Surveys to analyze trends for HP 2010 age-specific objectives relating to caries experience, untreated tooth decay, dental sealants, periodontal disease, tooth retention, and complete tooth loss by poverty status. Results. Dental caries significantly increased from 19% to 24% for children aged 2-4 years, but when stratified by poverty, caries only increased significantly for non-poor 2- to 4-year-old children (10% to 15%) (Objective 21-1a). The largest percentage point increase in dental caries was for non-poor boys (9% to 18%). The use of dental sealants continues to grow in the U.S. The largest percentage point increase in sealant use (Objective 21-8) between the two survey periods was for all poor children aged 8 years (3% to 21%). Among adults aged 35-44 years, periodontal disease significantly declined in the U.S. from 22% to 16% (Objective 21-5b) and more adults retained all of their natural teeth (30% to 38%) (Objective 21-3). However, the increase in tooth retention was significant only for non-poor adults, particularly non-poor men (34% to 48%). Conclusions. Overall, the oral health status of Americans as measured by HP 2010 objectives mostly showed improvement or remained unchanged between 1998-1994 and 1999-2004. However, some changes in oral health status for some traditionally low-risk groups, such as non-poor children, may be reversing improvements in oral health that have consistently been observed in previous decades. These results suggest that poverty status is an important factor for planning and monitoring future national oral health goals.