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No matter how many times we see the statistics, they remain staggering. Nearly half of adults over age 30 suffer from some form of gum disease. Nearly one in four children under age five already has cavities. The number of emergency department visits in the U.S. for dental conditions increased from 1.1 million in 2000 to 2.1 million in 2010. All of these people need treatment, but many won’t get it, at least not as soon as they should. The Affordable Care Act will improve the availability of care for many children from low-income families. But most of their parents, and other adults, even those who qualify for state-assisted medical coverage, will be left behind because there is no mandate for adult dental coverage under the Affordable Care Act. Millions of Americans are living in what amounts to a dental health crisis. The ADA, state and local dental societies and individual dentists have a proud history of finding ways to provide care to people who for whatever reason cannot access it. But clearly, more aggressive action is needed. The ADA this year launched Action for Dental Health: Dentists Making a Difference, an aggressive campaign to deliver care now to people suffering from untreated disease; strengthen and expand the public/private safety net to provide more care to more Americans; and bring dental health education and disease prevention to people in underserved communities. Action for Dental Health now represents all existing and new ADA programs and initiatives aimed at improving oral health in underserved individuals and communities. For this reason, we have renamed this ongoing series of statements from its previous “Breaking Down Barriers to Oral Health for All Americans.” This paper focuses on the third element of Action for Dental Health — preventing disease, a subject sufficiently broad that it will occupy more than one such paper. Disease prevention is the object of increasing focus in all of health care and holds the greatest promise for continued success. But dentistry is unique in both the length of time that it has practiced prevention and the degree of its success. The two most prevalent dental pathologies — tooth decay and gum disease — are almost entirely preventable. Education about the dangers of tobacco and alcohol use can, by leading to behavioral changes, help prevent oral cancer. For patients with oral cancers, early detection yields a much greater survival rate than those whose disease has progressed undetected. Significant facial trauma can be prevented with the use of mouth guards and other protective equipment in recreational sports. Prevention will never be universal. There will always be disease that has progressed to the point that restorative care is needed. But the occurrence of disease can be reduced dramatically. To that end, we offer the following discussion of prevention — what works and why, what more is needed and the rewards that are possible by stopping disease before it starts. Charles H. Norman III, D.D.S. President American Dental Association BOARD OF TRUSTEES Charles H. Norman President Maxine Feinberg President-elect Brian E. Scott First Vice President Jonathan Shenkin Second Vice President Ronald P. Lemmo Treasurer Glen D. Hall Speaker Jeffrey D. Dow First District Steven Gounardes Second District Andrew J. Kwasny Third District Jeffrey M. Cole Fourth District Red Stevens Fifth District Mark R. Zust Sixth District Joseph P. Crowley Seventh District Joseph F. Hagenbruch Eighth District Gary E. Jeffers Ninth District James K. Zenk Tenth District Roger L. Kiesling Eleventh District Gary L. Roberts Twelfth District Carol Gomez Summerhays Thirteenth District Gary S. Yonemoto Fourteenth District Hilton Israelson Fifteenth District Hal Fair Sixteenth District Terry L. Buckenheimer Seventeenth District Kathleen T. O’Loughlin Secretary and Executive Director A Statement from the American Dental Association 3 Action for Dental Health: Bringing Disease Prevention into Communities Action for Dental Health: Bringing Disease Prevention into Communities Disease Patterns Dental caries, the disease process that causes tooth decay, is the most prevalent childhood disease, and, according to the Centers for Disease Control and Prevention (CDC), affects more than 25 percent of U.S. children aged two to five and half of those aged 12 to 15. The problem doesn’t cease in adulthood. Twenty-eight percent of those 35 to 44 years of age have untreated tooth decay, and the rate is 18 percent in adults 65 and older. The occurrence of tooth decay is unacceptably high, and disproportionately affects minorities and low-income populations. For many American Indian and Native American communities, for instance, the occurrence of early childhood caries is approximately three times higher than it is in the U.S. as a whole. Numerous factors other than income and ethnicity