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Oral Health America (OHA) recently published the fourth volume in a series of reports titled A State of Decay, surveying the state of oral health for older Americans.  The first volume in the series focused on the cost of services and financial reimbursement rates as the primary barrier to accessing oral healthcare.  Since then, the series has expanded to highlight both public health and healthcare delivery factors contributing to older adults’ oral health. 

The reports combine data gathered in surveys of state dental directors with publicly available data about the oral health status of adults aged 65+ in each of the 50 states.  Each state is ranked based on its scoring on six variables.  Variables assessed in the 2018 report are: the percentage of older adults with severe tooth loss (6 or more teeth) because of disease or decay; the percentage of older adults who visited a dentist within the past year; whether the state’s Medicaid program covers 13 dental services commonly used by older adults; the existence of community water fluoridation; a State Oral Health Plan (SOHP); and the development and completion of Basic Screening Surveys (BSSs) that include older adults.

The purpose of A State of Decay is to shine a light on the success and adversities of oral health outcomes for seniors at the state and national level.  It is designed for use by both professionals and consumers.  The reports are available online and for download at:  The website includes resources (e.g., toolkit, infographic, fact sheet) for advocates who are trying to improve the conditions and outcomes of oral health for seniors in the United States. 

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