Comparing Caries in Two Similar Populations Seventy Years Apart

Objective: According to the recent report of the US Surgeon General, "there are profound and consequential disparities in the oral health of our citizens...Those who suffer the worst oral health are among the poor of all ages... Members of racial and ethnic minority groups also experience a disproportionate level of oral health problems." The purpose of this study was to determine differences in oral health between two poor populations 70 years apart. Method: A population of unclaimed bodies from the 1930s (Hamann-Todd Collection of the Cleveland Natural History Museum) were compared to a random sample of patients examined at the Free Medical Clinic of Greater Cleveland. Both populations represent the poorest segment of subjects separated by 70 years in time. For both populations, we recorded decayed and filled surfaces and missing teeth. Results: Of the 186 subjects from the Hamann-Todd Collection, 102 were African-American. From those subjects examined at the Free Clinic, 186 out of 227 were African American. Overall and among African-American subjects, there was a significant difference between the unclaimed bodies of the 1930s and the patients examined at the Free Clinic with respect to DMF. While patients at the Free Clinic had significantly greater numbers of filled surfaces than those from the Hamann-Todd Collection (p<.05), the population of unclaimed bodies from the 1930s had significantly more missing teeth and carious tooth surfaces than those examined at the Free Clinic (p<.05). Conclusion: From these analyses, it has been shown that today's poorest patients receive significantly more dental treatment and have significantly less missing teeth and carious tooth surfaces than a similar population 70 years earlier. The study was funded by Case Western Reserve University School of Dentistry, Cleveland, OH.