One-Third of Americans Haven’t Visited Dentist in Past Year

WASHINGTON, D.C. — About one in three U.S. adults say they did not visit the dentist at some point in the past 12 months. The 64.7% in 2013 who said they did visit the dentist at least once in the previous year is essentially unchanged from the rate found in 2008. Women are more likely than men to report visiting the dentist annually.

Percentage of U.S. Adults Who Have Visited the Dentist Over the Previous 12 Months, 2008 vs. 2013

These findings are based on interviews with 178,072 American adults conducted during 2013 and with 354,645 adults conducted during 2008 as part of the Gallup-Healthways Well-Being Index. Respondents were asked whether they had visited the dentist in the previous 12 months. Results for all years between 2008 and 2013 are similar.

The American Dental Association recommends that adults develop a plan for dental visits with their dentist, but say even those at low risk of oral disease benefit from at least annual cleanings. Thus, one in three American adults do not meet this minimum level of dental care.

Blacks, Hispanics, and Young Adults Least Likely to Visit Dentist

Among racial and ethnic groups, 55% of both blacks and Hispanics report visiting the dentist in the past year. Whites and Asians, in contrast, each are at about 70%, demonstrating that there is a notable racial and ethnic divide. Dental visit rates across most groups are similar to levels found in 2008, although there has been a small decline among blacks since that time.

In contrast, there are much smaller differences across age groups in reported dental behaviors. Young adults aged 18 to 29 are the least likely to have visited the dentist, but only marginally less so than those who are middle aged or older. An improved rate among seniors since 2008 is offset by a similarly sized decline among those 30 to 44.

Percentage of U.S. Adults Who Have Visited the Dentist Over the Previous 12 Months, by Age and Race/Ethnicity, 2008 vs. 2013

Dental Habits Improve With Income

The most pronounced differences in dental habits are those across income groups. Those who earn $120,000 or more annually in household income are about twice as likely as those who earn less than $12,000 to say they visited the dentist in the past 12 months, 82.3% vs. 42.7%, respectively. Dental visit rates have held steady since 2008 for top earners, while they have declined for all other groups, particularly for low- and middle-income households with incomes between $24,000 and $60,000 per year.

Percentage of U.S. Adults Who Have Visited the Dentist Over the Previous 12 Months, by Annual Household Income, 2008 vs. 2013

Annual Dental Visits Least Common in the South

Dental visit rates are essentially unchanged in all regions compared with 2008. As was the case in 2008, 2013 rates are lowest in the South (60.0%) and highest in the East (68.9%).

Percentage of U.S. Adults Who Have Visited the Dentist Over the Previous 12 Months, by Region, 2008 vs. 2013

Married Adults Much More Likely Than Nonmarried to Visit Dentist

Marital status also influences dental decisions, with those who are married much more likely to report visiting the dentist annually than those who are not married. Those who are separated are the least likely to report visiting the dentist, and rates have dropped the most among this group — nearly six percentage points — since 2008.

Percentage of U.S. Adults Who Have Visited the Dentist Over the Previous 12 Months, by Marital Status, 2008 vs. 2013

Implications

Poor oral care can lead to many potential negative health

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Why Are Americans So Fascinated With Extreme Fitness?

A blond woman in a hot pink spandex tank hoists a sledgehammer over her shoulders, then slams it down with a dull thud onto the big tire in front of her. Beside her, another woman swings her sledgehammer even higher, grimacing and groaning with the effort. Their faces are bright red and dripping with sweat. It’s 9:45 a.m. and 85 degrees, and the sun is glinting off the asphalt of the strip-mall parking lot where the women are laboring.”Swing it higher, above your shoulder!” a woman bellows at them, even as they gasp each time they raise their hammers, each time they let them fall.

As one woman pauses to wipe the sweat from her eyes, she spots me studying her. I’ve been trying not to stare, but it’s a strange spectacle, this John Henry workout of theirs, hammering away in front of a women’s fitness center, just a few doors down from a smoke shop and a hair salon. It looks exhausting, and more than a little dangerous. (What if a sledgehammer slips and flies from one woman’s hands, braining her companion?) It also looks fruitless. Why not join a roofing crew for a few hours instead? Surely, there’s a tunnel somewhere that needs digging, or at least some hot tar that needs pouring.

But paying to simulate backbreaking labor under the watchful eye of a demanding authority figure seems to be a common desire these days. When I type “sledgehammer” into Google later that day, the first suggestion is “sledgehammer workout,” a search term that pours forth half a dozen enthusiastic re-enactments of life on a steel-driving chain gang.

Fitness culture couldn’t have changed more significantly since the late ’60s. Back then, residents of my small Southern hometown would spot my father, an early jogger, and yell out of their car windows, “Keep running, hippie!” These days there aren’t that many joggers in my Los Angeles neighborhood, but every other block there’s another fitness center offering boot-camp classes or Brazilian jiujitsu, with people inside punching, kicking and yelling at one another like drill sergeants. Jim Fixx’s freewheeling running disciples have been replaced by packs of would-be Navy SEALs, sprinting up sandy hillsides with backpacks full of rocks strapped to their shoulders.

Jane Fonda and Richard Simmons once painted exercise as something fun and faintly sexy — a lighthearted trip to a sweaty nightclub in your own living room — but fitness today isn’t supposed to be easy. The “Abdomenizer” and “8-Minute Abs” videos, which practically suggested that exercise could be squeezed in between bites of your hamburger, are now quaint punch lines. By the ’90s, when the soft curves of Ursula Andress had been replaced by the hard bodies of Cindy Crawford and Elle Macpherson, you still worked out to prepare for the beach or the bedroom. These days, though, you aren’t preparing for fun or romance. You’re preparing for an unforeseen natural disaster, or a burning building, or Armageddon.

“We have sought to build a program that

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How Medicine’s Long, Thin Supply Chain Threatens Americans

On the website of the Food and Drug Administration, there’s a page where the agency lists drugs that are in short supply in the United States. Last week, there were 90 entries on the list: antibiotics, drugs for anesthesia, compounds to light up veins and organs for imaging, immunosuppressives to prevent organ rejection, tube-feeding solutions, sedatives. For every type of medical problem, an important drug is off the market or in short supply—and this is routine.

In the fall, after Hurricane Maria tore through Puerto Rico, something new joined the list, not a drug but a category of medical equipment: bags of sterile salt water. When the territory’s electrical grid went down, it took out several plants that make bagged saline for US manufacturer Baxter International. Few noticed at first, until this winter’s flu season got bad. One of the first things you do when someone arrives at a hospital weak and feverish is plug them into a quart bag of saline to rehydrate them. Another might be giving them drugs through a smaller bag hooked to an IV drip. In many hospitals, both were suddenly rationed.

Maryn McKenna (@marynmck) is an Ideas contributor for WIRED. She writes about public and global health and food policy, and she is a senior fellow at the Schuster Institute for Investigative Journalism at Brandeis University. She is the author of Beating Back the Devil, Superbug, and Big Chicken: The Incredible Story of How Antibiotics Created Modern Agriculture and Changed the Way the World Eats. She previously wrote WIRED’s Superbug blog.

Missing IV bags and missing pharmaceuticals seem like unrelated problems, a temporary disruption layered on top of a longstanding problem. But in fact, they are unavailable for the same reason. The United States has allowed the manufacturing of most of its drugs and medical devices to drift offshore, at the end of long, thin supply chains.

If a single hurricane can break one of those chains, undermining the delivery of medical supplies that Americans need every day, imagine the impact of a border-crossing epidemic or a regional military conflict or a natural disaster like the volcanic eruption that shut down most of Europe’s airspace in 2010.

This ought to be a matter of national security. So far, it’s not.

Most people don’t have contact with the ongoing drug and IV shortages, so they can come as a shock. “My wife’s nurse had to stand for 30 mins and administer a drug slowly through a syringe because there are almost no IV bags in the continental US anymore,” Ben Boyer, a former TV executive who lives in San Diego and whose wife is undergoing chemotherapy for brain cancer, tweeted on December 28.

To physicians, though, it’s hellishly normal. “I am on staff at several different hospitals in western Pennsylvania, and there are weekly emails: These are the fluids on shortage, these are the ones in stock,” says Amesh Adalja, an infectious-disease physician and a senior scholar at Johns Hopkins University’s Center

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