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Toothless In Hawaii? Not Likely
by Dr. Dean Edell

April 13, 1999

How many of us are going to wind up without any natural teeth after age 65? The answer may depend on where you live, your educational level, your income, and whether you smoke, according to a survey from the Centers for Disease Control (CDC).

Edentulism, or the loss of all natural permanent teeth, ranges from a low of 14 percent of people over 65 in Hawaii to a high of 48 percent in West Virginia - or almost half that state's older population.

Less than 20 percent of people over 65 have lost all their teeth in five states - California, Arizona, Hawaii, Oregon and Wisconsin. In addition to West Virginia, Kentucky and Louisiana have an edentulism rate of over 40 percent.

The CDC report, published in the Journal of the American Medical Association (JAMA), analyzed data from 46 states that took part in the oral health section of the 1995-1997 Behavior Risk Factor Surveillance system. Here are some other facts on total tooth loss in the over-65 population:

  • The edentulism rate in people with less than a high school education was about 42 percent, compared to 10-25 percent in those with more schooling.
  • People without dental insurance are more likely to lose their teeth (27 percent), than those with insurance (18 percent).
  • Current, everyday cigarette smokers are at higher risk of losing all their teeth (41 percent), than occasional smokers (39 percent), or former smokers (29 percent). For people who never smoked, the rate is 20 percent.
  • Non-Hispanic blacks have high edentulism (32 percent), compared to non-Hispanic whites (24 percent) and Hispanics (18 percent).
  • Total tooth loss is more common in those older than 75 (27 percent) than among those ages 65-74 (23 percent).

The CDC says the survey shows that total tooth loss doesn't have to be an inevitable part of aging. It notes that proper dental hygiene, fluoridation of water, and new advances in dentistry techniques are all helping to ensure tooth retention.

The study also shows what I've noticed in other population surveys, and that is how social demographics are related to health issues.

To help even things out, the CDC and public health officials are recommending the promotion of oral health education for all age groups, expansion of dental insurance coverage, improved access to dental clinical services and optimal fluoridation of community water supplies.

And, don't forget to brush and floss.

 

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