The Epidemic

The Surgeon General’s report in 2000 describes oral health in the United States as a “silent epidemic of dental and oral diseases.” Tooth decay is now the most common disease affecting children in the United States. It has become more common than asthma and hay fever combined. This can lead to many serious health problems and pain.

  • More than 51 million school hours are lost each year to dental-related illness.
  • An estimated 5 percent of children under 18 have untreated dental problems, but that percentage rises to 39 percent for African American children and 60 percent for Mexican American children.
  • Children in poor families have five times more untreated cavities than children in families with higher incomes. These poor children will miss three times as many days of school because of oral health issues than their more affluent peers.
  • Approximately 25 percent of children living in poverty enter kindergarten without ever having seen a dentist.
  • Dental caries affects over 50 percent of youths ages 5-17.

As stated by the United States surgeon general, C. Everett Koop, “You’re not healthy without good oral health.”

  • An individual with poor oral health may experience difficulty chewing and digesting food properly and therefore will have poor nutrition and overall poor health.
  • Poor dental health can correspond with poor mental health and a lesser quality of life.
  • Loss of teeth may also affect a person’t ability to talk and communicate properly.
  • Tooth loss and visible cavities may have psychological effects and can lead to lower levels of self-esteem.
  • Poor oral health has also been observed to result in difficulty obtaining and maintaining employment due to prejudices associated with the physical appearance of an individual with tooth loss as well as time lost from work for oral health related issues.

Children are often unable to verbalize their oral pain. Teachers may notice a child whose is having difficulty attending to tasks or who is demonstrating the effects of pain: anxiety, fatigue, irritability, depression, and withdrawal from normal activities; however, teachers may not understand the cause of such behavior if they are unaware that a child has an oral health problem.


  • Department of Health and Human Services, Public Health Service, Office of the Surgeon General. Oral Health in America: A Report of the Surgeon General. 2000: Rockville, MD. [report]
  • Association of State and Territorial Dental Directors. Best practice approach: Prevention and control of early childhood tooth decay. 2013 [report]
  • Gift HC, REisine ST, Larach DC. The social impact of dental problems and visits. American Journal of Public Health, 1992. 82 (12): p. 1663-1668.
  • Quine S, Morrel S. Hoplessness, depression and oral health concerns reported by community dwelling old Australians. Community of Dental Health, 2009. 26(3) p. 177-182.
  • Locker D. Concepts of oral health, disease and the quality of life, in Measuring Oral Health and Quality of Life, G.D. Slade, Editor. 1997 Chapel Hill: University of North Carolina. p11-23
  • Ramage @. 2000. The impact of dental disease on school performance; The view of the school nurse, Journal of the Southeastern Society of Pediatric Dentistrys 6 (2) :26.