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Oral Health

County-level data and information about the Assessed Health Issue and Social Determinants of Health indicators can be found in the report appendices.

Key findings

Recent Dental Visit

One of the most useful ways to assess oral health-related challenges is to determine how frequently citizens are utilizing oral health services. In the OHC Region, just over half of adult residents’ report visiting a dentist within the past year (56.4%); therefore, around half have not been to the dentist in the past year. This is lower than both the state (61.4%) and national (64.4%) averages. Alarmingly, less than half of those living in the Mountain View Community report visiting a dentist in the last twelve months.

Number of Childhood Caries

The dental needs of adults and children are different. One way to measure the overall pediatric oral health in an area is to look at the dental caries rate for children living in a community. Caries, or cavities, occur when tooth enamel is broken down as a result of bacteria(6). While this information is not available for every child living in the OHC Region, the Missouri Department of Health and Senior Services, Office of Oral Health does collect data for children participating in the Preventive Services Program (PSP), which is dedicated to promoting and improving healthy smiles for all Missouri children through education and preventive services(7). More than one in every four children under the age of five (participating in the PSP program) that live in the Bolivar and Branson Communities had at least one cavity referred for follow up. This high rate of dental caries (decay) correlates with the lack of an essential public health service- drinking water fluoridation. 

Public Water Service Fluoridation

The most effective way to prevent tooth decay is by providing fluoride in a resident’s drinking water. This safe and effective public health measure is also cost effective- in most cases, every $1 invested in water fluoridation saves $38 in dental treatment costs. Fluoride is naturally occurring in groundwater and oceans- adjusting the amount of fluoride in drinking water can be compared to fortifying salt with iodine or orange juice with calcium(8). The Missouri Department of Health and Senior Services, Office of Rural Health monitors the number of Public Water Systems (PWSD) that provide fluoride to consumers. Some areas of the Region have high percentages of residents receiving fluoride- more than 80% in the Springfield Community. Concerningly, no residents utilizing public water systems in the Bolivar or Mountain View Communities are provided this dental-health and cost-saving service. There is an inverse relationship between the communities with low levels of fluoridation services and high childhood dental caries rates. 

Lack of available data related to oral health and factors impacting oral health conditions is an unfortunate limitation for analysis. Based on qualitative and anecdotal evidence, however, the Ozarks Health Commission Region appears to show widespread need for greater resources to improve oral health. There is a growing body of evidence suggesting that substandard oral health can be linked to chronic disease, including heart disease, diabetes, and stroke. 


(6)Centers for Disease Control and Prevention. (2016, September 22). Water, Sanitation & Environmentally-relatedHygiene. Retrieved from Hygiene- related Diseases: tal_caries.html#:~:text=Dental%20caries%20or%20cavities%2C%20more,and%20results%20in%20tooth%20 decay 

(7)Missouri Department of Health and Senior Services, Office of Dental Health. (2021, March 18). Information aboutPSP. Retrieved from PSP Annual Report, 2019-2020: oads/sites/13/2021/03/PSP-Annual-Report-2019-2020-3.18.21.pdf 

(8)American Dental Association. (2021). 5 Reasons Why Fluoride in Water is Good for Communities. Retrieved from Fluoride in Water: tion/5-reasons-why-fluoride-in-water-is-good-for-communities 

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