By David A. Albert, D.D.S., M.P.H.
Columbia University College of Dental Medicine

A recent government research report shows that oral health is getting better for most Americans. The report came from a survey by the U.S. Centers for Disease Control and Prevention.

The good news is that tooth decay and periodontal disease have declined for most age groups. They have declined among all races and income groups. Fewer people are losing their teeth early. In addition, more children are getting a vital preventive treatment, dental sealants, applied to their teeth.

These improvements were found in permanent teeth. They are notable and indicate that dentistry is moving in the right direction and helping to improve U.S. oral health.

But let's hold the applause for now. Unfortunately, the health of baby teeth (primary teeth) appears to be getting worse.

Children ages 2 through 5 were more likely to have tooth decay (dental caries) in baby teeth than in earlier surveys. Decay in baby teeth was even more common among children who live in poverty. In fact, the overall tooth decay rate actually increased for low-income children.

Children ages 6 through 11 did not fare much better than preschoolers. For all children in this age group, the decline in tooth decay was minimal. Lower rates of decay were reported only for children over age 12 and for adults.

The decline in oral health status of children, particularly very young children, requires immediate attention. We need more resources to help reduce tooth decay in this group.

We don't have enough dentists and dental hygienists who specialize in caring for young children. Pediatric dental programs need to expand to train more people. We especially need more people who are comfortable treating preschool children.

The American Academy of Pediatrics and the the American Academy of Pediatric Dentistry say that children should have their first dental visit by age 1. This visit would help to establish a "dental home" for the child. Some children are at high risk for cavities. Their parents would receive counseling to prevent the disease process from starting or getting worse.

We need public campaigns to promote the age 1 visit. The improvements reported for so many Americans need to be brought to our most vulnerable citizens — young children.

David A. Albert, D.D.S., M.P.H., is an associate professor and associate director of community health at the Columbia University College of Dental Medicine. He also holds an appointment in the Joseph Mailman School of Public Health at Columbia University. He maintains a practice within the ambulatory care network of the Columbia DentCare program in the community of Washington Heights/Inwood in Northern Manhattan.