Changes in the oral health of US children and adolescents and dental public health infrastructure since the release of the Healthy People 2010 Objectives.

We examined progress in US children's oral health and dental public health infrastructure since the Healthy People 2010 Oral Health Objectives were issued. We summarize trends in the prevalence of dental caries and dental sealants on the basis of national and state-specific data. Trends in state oral health program activities, funding, and staffing were derived from annual surveys. The prevalence of dental caries in primary teeth of children aged 2-4 years increased from 18% in 1988-1994 to 24% in 1999-2004. Racial disparities persisted in that age group, with caries significantly more prevalent among non-Hispanic black and Mexican American children than among non-Hispanic white children. Caries prevalence in primary teeth of non-Hispanic white children aged 6-8 years remained unchanged, but increased among non-Hispanic black and Mexican American children. State-specific prevalence of caries among third-graders ranged from 40.6% to 72.2%. Caries in permanent teeth declined among children and adolescents, while the prevalence of dental sealants increased significantly. State oral health programs' funding and staffing remained modest, although the proportion of states with sealant programs increased 75% in 2000 to 85% in 2007 and the proportion with fluoride varnish programs increased from 13% to 53%. Progress toward improving the oral health of America during the past decade has been mixed. Greater attention to the oral health of young children is clearly needed, and child health professionals can be valuable partners in the effort. With continued high prevalence of a largely preventable disease, ongoing problems with access to basic oral health services, and increased national attention to health care reform, there is a clear need and opportunity for governments to make serious and sustained investments in dental public health.

Total body weight and waist circumference associated with chronic periodontitis among adolescents in the United States.

OBJECTIVE: To investigate whether measures of obesity are associated with periodontitis. DESIGN: A case-control study. SETTING: A nationally representative sample using data from the Third National Health and Nutrition Examination Survey. PARTICIPANTS: The sample included 2452 nonsmokers, aged 13 to 21 years, who received a periodontal examination and had complete information for age, sex, and smoking habits. MAIN EXPOSURES: Skinfold thickness, weight, and waist circumference were examined as independent variables in logistic regression models. Final models were adjusted for sex, race/ethnicity, poverty index ratio, last dental visit, and self-reported calcium intake. MAIN OUTCOME MEASURES: Cases were subjects with the presence of 1 or more periodontal sites with both a loss of tissue attachment of 3 mm and a probing depth of 3 mm (n = 111). Subjects who did not meet these criteria were classified as controls (n = 2341). RESULTS: Total body weight and waist circumference were associated with periodontitis, but the association varied by age. Adolescents aged 13 to 16 years were not at increased risk of chronic periodontitis, while adolescents aged 17 to 21 years had an increased risk per 1-kg increase in body weight (adjusted odds ratio, 1.06 [95% confidence interval, 1.01-1.09]). Similarly, adolescents aged 13 to 16 years were not at increased risk for periodontal disease, while adolescents aged 17 to 21 years were at an increased risk of periodontal disease per 1-cm increase in waist circumference (adjusted odds ratio, 1.05 [95% confidence interval, 1.01-1.08]). CONCLUSION: Periodontitis may follow patterns similar to other chronic conditions that originate early in life and are related to central adiposity.