Task Force on Community Preventive Services

Releases Oral Health Recommendations

An oral health report issued in July by the Task Force on Community Preventive Services strongly recommends school-based dental sealant programs and community water fluoridation to prevent tooth decay, particularly among low-income families, families without private dental care, and families who are at highest risk for oral health problems. 

The task force is a 15-member non-federal group of health experts convened by the Department of Health and Human Services (HHS) and supported by the Centers for Disease Control and Prevention (CDC). Its role is to address a variety of topics important to communities, public health agencies and health care systems.

In a supplement to the American Journal of Preventive Medicine (AJPM) (Volume 23, No. 1S), the task force outlined its recommendations for preventing dental caries (tooth decay) oral and pharyngeal cancers, and sports-related craniofacial injuries.

"Two community-based interventions, applying dental sealants in a school setting and fluoridating drinking water, are both beneficial as well as equitable in preventing tooth decay among our most vulnerable populations," said CDC Director Dr. Julie Gerberding. "If more communities would implement these programs, we could save many children from needless pain and suffering and save the nation millions of dollars in dental care costs," Gerberding said. According to CDC, costs to treat severe cases of tooth decay for some children can be as high as $2,000 per child.

In examining the effectiveness of school-based dental sealant programs, the task force found that there was typically a 60 percent decrease in tooth decay on the chewing surfaces of posterior teeth (molars) after sealant application.  Currently, only 23 percent of 8-year-old children in the United States have dental sealants—a plastic coating applied to protect the chewing surface of teeth.  The prevalence is far lower for children who may have a higher decay risk; only 3 percent of low-income children and only 11 percent of African-American children have received a dental sealant.

Another key finding of the Task Force was the overall benefit of community water fluoridation in preventing tooth decay. The fluoridation process, which involves the adjustment of the natural fluoride level in a community's water system to the optimal level of about 1 part per million, has been shown to be a safe, effective and inexpensive measure in preventing tooth decay. Tooth decay typically decreased by 30 percent to 50 percent after starting or continuing water fluoridation. These decreases were seen in communities with varying levels of decay and among children of all socioeconomic levels. Although community water fluoridation was introduced more than 50 years ago, about 100 million Americans still do not have fluoride in their drinking water. 

While largely preventable, tooth decay continues to affect the majority of Americans, with many in low-income and certain ethnic and racial groups experiencing higher rates of decay. By age 5, 60 percent of all children have had tooth decay, and more than 80 percent of 18-year-olds have experienced decay. Much of the caries in children remains untreated. Among 6- to 8-year-olds, Hispanic children (43%) African American children (36%), and white children (26 percent), have untreated tooth decay.

"There is considerable opportunity for communities to increase their use of these proven measures to decrease tooth decay for both children and adults," said William Maas, DDS, who directs CDC's oral health program. "At CDC, we recently made cooperative agreement awards to several states to develop additional school sealant programs and to promote adoption of water fluoridation in communities." 

The supplement: "Interventions to Prevent Dental Caries, Oral and Pharyngeal Cancers, and Sports-Related Craniofacial Injuries: Systematic Reviews of Evidence, Recommendations from the Task Force on Community Preventives Services, and Expert Commentary" is available on The Community Guide's Web site: www.thecommunityguide.org/oral/

This is one in a series of AJPM supplements that report on findings of the Task Force. To order a copy of this publication, please send a request to oralhealth@cdc.gov or telephone 770-488-6054.

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