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untreated oral diseases can lead to not only pain, infection, and tooth loss, but also contribute to an increased risk for serious medical conditions such as diabetes, heart disease, and poor birth outcomes.10 Since 2000, when the U.S. Surgeon General called dental disease a “silent epidemic,”11 there has been increasing attention paid to oral health issues. “Healthy People 2020,” a report issued every decade by the Department of Health and Human Services released in December 2010, includes oral health as a leading health indicator for the first time, and the Institute of Medicine published two reports in 2011 which illustrated that the lack of access to needed care and oral health disparities continue to be huge problems for millions of people. However, not nearly enough has been done to adequately address the true oral health crisis that exists in America today. KEY FINDINGS tMore than 47 million people live in places where it is difficult to access dental care.1 tAbout 17 million low-income children received no dental care in 2009.2 tOne fourth of adults in the U.S. ages 65 and older have lost all of their teeth.3 tLow-income adults are almost twice as likely as higher-income adults to have gone without a dental check up in the previous year.4 tBad dental health impacts overall health and increases the risk for diabetes, heart disease, and poor birth outcomes.5 tThere were over 830,000 visits to emergency rooms across the country for preventable dental conditions in 2009 - a 16% increase since 2006.6 tAlmost 60% of kids ages 5 to 17 have cavities - making tooth decay five times more common than asthma among children of this age.7 tNearly 9,500 new dental providers are needed to meet the country’s current oral health needs.8 tHowever, there are more dentists retiring each year than there are dental school graduates to replace them.9 2 THE PROBLEM: MANY AMERICANS CANNOT GET THE ORAL HEALTH CARE THEY NEED Those Who Need Care the Most are the Least Likely to Get It Oral health problems affect people of all ages and backgrounds. For many, oral health problems start when they are young and get worse over time. One quarter of children ages 2-5 and one half of those 12-15 have tooth decay. In fact, dental caries (cavities) are the most common chronic disease of childhood affecting almost 60% of children ages 5 to 17. As people grow older they continue to be plagued by oral health problems. One in four adults ages 65 and older in the U.S. have lost all of their teeth.12 While there are high rates of oral disease in all age groups, low-income Americans of any age are more likely than higher-income Americans to have oral health problems. Lack of access to a dental provider and the high costs of dental services are a major cause of these dental problems. About 17 million low-income children go each year without basic care that could prevent the need for higher cost treatment later on.13 Children living below the poverty line are twice as likely as their more affluent peers to suffer from toothaches, and the likelihood of experiencing this pain is even greater for kids with special needs.14 In Vermont in 2009, 62,000 adults ages 18 to 64 and 10,000 seniors went without dental care because they could not afford it.15 Some racial and ethnic minority groups have even higher rates of oral health conditions. American Indian and Alaska Natives have the highest rates of dental disease, and rates of untreated decay are also significantly higher among Mexican Americans and African Americans than among those who are White.16 People from minority groups are underrepresented in the dental profession although they are in greater need of care. In addition to the high costs of care, low-income and minority families may experience other barriers to care including language and cultural barriers, transportation challenges, and difficulty finding work and childcare arrangements. Seeing a dentist is expensive, so many people seek care only when the disease is advanced and the pain is