DEAR DATA DOG: Are there still toothless people in the United States

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Yes, Virginia, there are still toothless people in the United States -certainly many more than the Centers for Disease Control and Prevention ( would like. In its never-ending war against edentulism (toothlessness), the CDC recently analyzed data amassed from 46 states in its 1995-1997 BRFSS (Behavioral Risk Factor Surveillance System) to determine how close the agency was to its announced goal: reducing, by the year 2000, the number of people who have lost all their natural teeth to no more than 20 percent of United States citizens aged 65 or more. (And you thought landing on the moon was a heroic endeavor.)

The result? Unless the CDC can somehow persuade 41 states to secede from the Union, they've got a lot of work to do in the next six months. While the prevalence of edentulism among those 65 or older has fallen to 13.9 percent in Hawaii (hence the number of smiling people there), only four other states can boast edentate rates of less than 20 percent (California, Oregon, Wisconsin, and Arizona). Thirty-eight of the 46 states fall within the 20-to-40 percent range. In three states (West Virginia, Kentucky, and Louisiana) more than 40 percent of people 65 and older are toothless, raising the specter of an eventual Edentulist gubernatorial candidate somewhere in the region.

The CDC report ( preview/mmwrhtml/00056723.htm), released inMarch, does reveal some important discoveries that can help if you're actually trying to find toothless people, and your town has no hockey franchise. (Speaking of sports: according to the American Dental Association-www. to 39 percent of all dental injuries are sports-related, with a marked increase in girls' injuries over the last four decades. Whereas boys once suffered from three times as many tooth injuries as girls, the ratio is now one-and-a-half to one, boy injuries to girl injuries.) First, start in one of the three edentate-leading states mentioned above. Next, find someone 65 years or over-preferably someone over 75, since they lead those aged 65-to-74 by 26.7 percent to 22.9 percent. Of this group, find someone who (a) never graduated high school, (b) never had dental insurance, and (c) is a regular smoker of cigarettes. (Only 19.9 percent of those 65 or older who have never smoked are edentate, but a whopping 41.3 percent of daily smokers are puffing through their gums or dentures.) Chances are the person you end up with won't have any teeth-or much of a social life, for that matter.

While the CDC is still far short of its announced goal, and should therefore learn to announce goals only after they have been met, it has also happily concluded that edentulism is not an inevitable feature of aging-rather, good dental care can prevent edentulism right up to the time rigor sets in. The single most important factor in preventing tooth loss, says the CDC, is community water fluoridation. (For those of you who believe water fluoridation is a Great Government Conspiracy to kill, brainwash, or bankrupt us all, I recommend a visit to Quackwatch, at, for a breath of minty-fresh air.) Fluoridation, in addition to improved dental restorative techniques and treatment, has gone a long way toward keeping those toothless numbers down. It also helps if people can afford, and have access to, a dentist.

More good news: Since edentulism depends upon sociological and technological factors, toothlessness should continue to decline as baby boomers age-reflecting the improvement in oral health from generation to generation. A 1998 survey sponsored by the American Dental Association and Oral-B Laboratories ( found that 64 percent of American adults believe their oral health to be better than their parents at their age-and that 77 percent think their children's teeth are even in better shape than their own at a comparable age. This should result in people keeping their natural teeth longer, unless cool adolescents turn from body piercing to gum plucking.

The ADA/Oral-B survey also reported that 55 percent of seniors, when asked what single most important dental advice they'd give youngsters, would advise brushing their teeth. That's not surprising. Perhaps this is: 29 percent of senior women said they would recommend flossing, as opposed to only 9 percent of senior men. What could this mean? Since the study also found that people tend to recommend their own health habits, we can assume that a much smaller percentage of senior men floss than women. This may have less to do with dental hygiene than with the last bastion of male chauvinism: the after-dinner toothpick.

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