Am Fam Physician. 2024;109(3):online
Related Putting Prevention Into Practice: Screening and Preventive Interventions for Oral Health in Children, Adolescents, and Adults
As published by the USPSTF.
| What does the USPSTF recommend? | For asymptomatic adults 18 years or older: The evidence is insufficient to assess the balance of benefits and harms of routine screening performed by primary care clinicians for oral health conditions, including dental caries or periodontal-related disease. Grade: I statement The evidence is insufficient to assess the balance of benefits and harms of preventive interventions performed by primary care clinicians for oral health conditions, including dental caries or periodontal-related disease. Grade: I statement |
| To whom does the recommendation apply? | This recommendation applies to asymptomatic adults 18 years or older. |
| What's new? | This is a new USPSTF recommendation. |
| How to implement this recommendation? | The USPSTF found insufficient evidence to recommend for or against routine screening or preventive interventions for oral health conditions in the primary care setting for adults. The USPSTF is calling for more research on addressing oral health in nondental primary care settings, particularly in persons who are more likely to experience oral health conditions and on social factors that contribute to disparities in oral health. In the absence of evidence, primary care clinicians should use their clinical expertise to decide whether to perform these services. |
| What additional information should clinicians know about this recommendation? | The USPSTF has a separate existing recommendation for children younger than 5 years that recommends prescribing oral fluoride supplements starting at age 6 months for children younger than 5 years whose water supply is deficient in fluoride and applying varnish to the primary teeth of all children younger than 5 years starting at the age of primary tooth eruption. Dental caries refers to a multifactorial disease process resulting in demineralization of the teeth. Periodontal disease refers to inflammation of the gingival tissue, or gingivitis, which affects the hard and soft tissue that support the teeth and can progress to periodontitis involving bone loss. The evidence review focused on dental caries and periodontitis as the most common oral health conditions and the most potentially amenable to primary care interventions. |
| Why are this recommendation and topic important? | Dental caries is the most common condition in adults worldwide; more than 90% of U.S. adults are affected by dental caries, and an estimated 26% have untreated dental caries. Untreated dental caries can lead to serious infections and tooth loss. Untreated periodontitis can contribute to destruction of tissues that support the teeth and is the leading cause of tooth loss in older adults. In the U.S., oral health disparities are shaped by unequally affordable and accessible dental care and other disadvantages related to social determinants of health (e.g., living in a rural area). Dental caries and periodontitis disproportionately affect persons living in poverty; Asian, Black, Hispanic/Latino, Native American/Alaska Native, and Native Hawaiian/Pacific Islander adults; pregnant persons; adults with disabilities; older adults; adults living in rural and urban underserved areas; adults without insurance or with public insurance; and adults experiencing homelessness. |
| What are other relevant USPSTF recommendations? | The USPSTF has issued recommendations on routine screening and interventions to prevent dental caries in children younger than 5 years. The USPSTF has issued recommendations on routine screening and preventive interventions for oral health in children and adolescents aged 5 to 17 years. |
| What are additional tools and resources? | The Health Resources and Services Administration's oral health factsheet and report on Integration of Oral Health and Primary Care Practice emphasize optimal collaborations between primary care clinicians and oral health professionals. The U.S. Department of Health and Human Services' Report of the Surgeon General and the National Institutes of Health's report Oral Health in America: Advances and Challenges comprehensively describe the importance of oral health to overall health and highlight advances and challenges toward improving oral health in the U.S. The Community Preventive Services Task Force recommends fluoridation of community water sources to reduce dental caries. |
| Where to read the full recommendation statement? | Visit the USPSTF website or the JAMA Network website (https://jamanetwork.com/collections/44068/united-states-preventive-services-task-force) to read the full recommendation statement. This includes more details on the rationale of the recommendation, including benefits and harms; supporting evidence; and recommendations of others. |
The full recommendation statement is available at https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/oral-health-adults-screening-preventive-interventions.
The USPSTF recommendations are independent of the U.S. government. They do not represent the views of the Agency for Healthcare Research and Quality, the U.S. Department of Health and Human Services, or the U.S. Public Health Service.
