The new NIH report provides a roadmap to improving the nation’s oral health, drawing on public research and evidence-based practices.

The National Institutes of Health released a new report on oral healthcare in America detailing the changes and challenges in the 20 years since its seminal 2000 Oral Health in America: A Report of the Surgeon General.

The report updates the findings of the 2000 publication and highlights the national importance of oral health and its relationship to overall health. It also focuses on new scientific and technological knowledge and innovations in health care delivery that offer promising new directions for improving oral health care and creating greater equity in oral health across communities. 

According to the NIH, achieving that equity is an ongoing challenge for many who struggle to obtain dental insurance and access to affordable care.

“This is a very significant report,” said Lawrence Tabak, DDS, PhD NIH acting director. “It is the most comprehensive assessment of oral health currently available in the United States, and it shows, unequivocally, that oral health plays a central role in overall health. Yet millions of Americans still do not have access to routine and preventative oral care.”

The report provides a comprehensive snapshot of oral health in America, including an examination of oral health across the lifespan and a look at the impact the issue has on communities and the economy.

The report found that healthy behaviors can improve and maintain an individual’s oral health, but social and economic conditions also shape these behaviors.

Group disparities around oral health, identified 20 years ago, have not been adequately addressed. More efforts are needed to tackle the social and commercial determinants that create these inequities and the systemic biases that perpetuate them.

On oral and medical conditions, it was found that they often share common risk factors. Just as medical conditions and treatments can influence oral health, so can oral conditions, and their treatments affect other health issues.

Substance abuse and mental health conditions also seriously impact oral health. 

“This is an in-depth review of the scientific knowledge surrounding oral health that has accumulated over the last two decades,” said Rena D’Souza DDS, PhD, director of the National Institute of Dental and Craniofacial Research which oversaw and funded the project’s three-year research program. “It provides an important window into how many societal factors intersect to create advantages and disadvantages with respect to oral health, and, critically, overall health.”

The authors make several recommendations to improve oral health in America, including the need for health care professionals to work together to provide integrated oral, medical, and behavioral health care in schools, community health centers, nursing homes, medical care settings, and dental clinics. 

They also identify the need to improve access to care by developing a more diverse oral health care workforce, addressing the rising cost of dental education, expanding insurance coverage, and improving the overall affordability of care.

“Although there are challenges ahead, the report gives us a starting point and some clear goals that offer reasons to be hopeful, despite those challenges,” said D’Souza. “It imagines a future, as I do, in which systemic inequities that affect oral health and access to care are more fully addressed, and one in which dental and medical professionals work together to provide integrated care for all.”

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