More than 100 million people lack private dental insurance and millions more can’t get necessary dental care, says the first-ever Surgeon General’s report on oral health.

The 309 page report “Oral Health in America” – the latest in a series on such topics as smoking and mental health – also says that about 40% of people in the USA lack fluoridated water, an effective safeguard against cavities.

U.S. Surgeon General David Satcher says the report aims to alert people to the importance of preventive dental care, to the bond between oral and general health, and to vast nationwide disparities in access to dental care, particularly in black and Hispanic Americans.

He calls for the creation of a “National Oral Health Plan” as a framework for boosting resources for training, equipment and facilities; for eliminating barriers to oral health care; and for building public-private partnerships to fund education programs and expand access to care. “We have to treat oral health as part of general health care and provide equal access to services,” Satcher says.

Among other findings:

* Tooth decay is the most common chronic childhood disease, five times more common than asthma and seven times more common than hay fever.
* Poor children have twice as many cavities as their better-off peers and their disease is less likely to be treated.
* More than 51 million school hours are lost each year due to dental illness.
* Severe gum disease affects 19% of adults from age 25 to 44.
* Oral Cancers are diagnosed in about 30,000 people each year; 8,000 people die of these diseases annually.

The Consequences of neglect aren’t benign. Research has established firm links between chronic oral infections and stroke, premature births and diseases of the heart and lung.

“Most people have a huge amount of chronic infection ongoing in their mouths,” Fornicola says. “Infections like that anywhere else in your body would alarm everyone.”

Robert Klaus, president of Oral Health America, an advocacy group, says that the report doesn’t focus enough on access to care for people with mental retardation or physical disabilities.

Still, he lauds the effort. “It’s difficult to capture everything in a report, but it’s a good beginning,” Klaus says.

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