Text Size
Increase text size
Increase text size

Oral Health

 Oral Health in Colorado

Oral disease, although nearly 100 percent preventable, affects children, adults and families across the state of Colorado every day.  While oral diseases are significant themselves, their relationship to overall general health is often overlooked.  The Oral Health Program is working to show connections every day to general health, diabetes, cardiovascular disease, cancer, tobacco, school health, seniors, and pregnancy outcomes.

The Oral Health Unit is part of the Prevention Services Division at the Colorado Department of Public Health and Environment.  Staff members are working on programs to improve the oral health of Coloradans.  The most cost-effective preventive programs for reducing dental decay are community-wide efforts such as community water fluoridation and tobacco cessation programs, which reach the greatest numer of people.  Direct service such as the placement of dental sealants and screenings for common oral and throat cancers are effective for many individuals.  Everyday activities including daily oral hygience, brushing and flossing, and other lifestyle behaviors, including eating well and getting plenty of exercise also help prevent disease and improve health.


Chew On This pdf file , Colorado's 2012 Oral Health Burden Document contains information about the prevalence statewide of oral disease, unmet dental needs and oral health disparities. Please contact the Oral Health Unit with any questions: (303) 692-2470 or email to cdphe.psdrequests@state.co.us.




The  surgeon general supports community water fluoridation.  CWF Surgeon General Letter pdf file .


Community Water Fluoridation Program


In 1908, a Colorado Springs dentist, Dr. Frederick McKay, first discovered fluoridation in the state of Colorado, and its role in preventing tooth decay.  He noticed slight brown staining of the teeth in his young patients who grew up in the vicinity of Colorado Springs.  Through 20 years of research, Dr. McKay found that the optimal amount of fluoride helps protect the teeth from decay, without causing objectionable cosmetic staining.  In 1945, the first national trials began to adjust the water fluoride level to the optimal level in community water supplies of 1 part per million.  Most fluoride ion efficacy studies performed included the use of silica forms of the ion to include the use of the acid form, appearing for the first time in 1949.  For the last 55 years, water fluoridation has been a proven public health measure shown to be safe, economical, and effective in protecting the teeth of the population from dental decay.  Currently, about 70 percent of Colorado residents on public water systems drink water that is optimal in fluoride.


Community Water Fluoridation within the state of Colorado is not regulated.  However, all US Environmental Protection Agency rules and regulations apply to the Community Water Fluoridation Program just as they normally would if not adjusting, or managing the natural fluoride levels found in all water sources.  Communities can volunteer into the program by Mayoral delegation, Council or Board Decision, or even by public vote.  Once a community volunteers to provide the great public health benefit that comes from having optimal levels of fluoride in their public water, the community agrees to participate fully in the Colorado Department of Public Health and Environment program.


In Colorado, the Department of Public Health and Environment administers the fluoridation program to help prevent tooth decay.  It has the responsibility for informing the public of the fluoride levels in community water systems throughout Colorado.  It also promotes and monitors new fluoridation systems. The fluoridation specialist works to promote, maintain, monitor, and ensure safe, effective operations of existing public water fluoridation systems.


Fluoride is present naturally in small, yet varying amounts in almost all soil, water supplies, plants, and animals and thus is a normal constituent of all diets.  Many water systems in Colorado have enough natural fluoride for the prevention of tooth decay.  However, many water systems are deficient in fluoride to provide this public health benefit.  Many of these communities opt to adjust the fluoride levels so they may receive this oral health benefit.  These communities participate in the Community Water Fluoridation Program.  Water fluoridation is the deliberate addition of the natural trace element fluorine (in the ionic form known as fluoride) into drinking water in accordance with the latest scientific, dental and health guidelines.  The Colorado Community Water Fluoridation Program is a non regulatory program, one in which any community can choose to participate.


A community, for the oral health benefit of its public, should consider adjusting upward the fluoride levels if the natural (post filtration or treatment) fluoride level is equal to or under 0.6 milligrams per Liter.  At or below this level, little benefit is gained (if optimal levels are not maintained a reduction in benefit as large as up to 40 percent may result.)  Once a community volunteers to participate in the program, the community falls under the regulations and recommendations of the Colorado Department of Public Health and Environment, essentially agreeing to participate fully in the program with safety procedures, sampling, reporting requirements, etc.  For more information regarding this, please visit the Colorado Primary Drinking Water Regulations.


When the operator adjusts the water fluoride content up to optimal levels recommended by the Centers for Disease Control and Prevention (CDC), they can reach and benefit more people through this cost effective program in reducing cavities than can all the dentists in that Colorado community.  However, it is important that the community population understand that individuals should visit a dentist on a regular basis, even when the community has decided to participate in this program.


Safe and effective disease prevention measures exist that everyone can adopt to improve oral health and prevent disease.  These measures include daily oral hygiene procedures and other lifestyle behaviors, community programs such as community water fluoridation and tobacco cessation programs, and provider-based interventions such as the placement of dental sealants and examinations for common oral and pharyngeal cancers.


There are profound and consequential oral health disparities within the population.  Disparities for various oral conditions may relate to income, age, gender, race, ethnicity, or medial status.





Old Age Pension Dental Program


(Dental Assistance Program for Seniors) 


The program was established by legislation in 1977 to provide dental care (dentures and related services) to senior citizens who receive Old Age Pension public assistance.  This legislation was instituted to improve the oral health of the low-income elderly of Colorado (CRS 25-21-104).  The OAP Dental Program assists qualified low-income seniors in obtaining dental services including preventive and restorative services, dentures and partials, denture and partial repair, and tooth extractions.  Good oral health is vital to maintaining overall health, expecially in our vulnerable senior populations.  The OAP Program emphasizes the importance of preventive care due to the positive impact that has been demonstrated when care is received routinely.


 The Oral Health Program manages the dental component of the Old Age Pension Program (OAP) providing grants to eligible grantees for the provision of dental services to seniors eligible for OAP.


The governor-appointed Dental Advisory Committee helps determine rules for the Old Age Pension Program which requires approval by the Board of Health.


Approved procedures and maximum allowable fees are set in the Code of Colorado Regulations  (6 CCR 1015-8).  Clients may be asked to pay a co-payment not to exceed the amont allowed on the current Provider Reimbursement Schedule.

Only procedures approved on the OAP Dental reimbursement schedule will be provided under this program.  There is no maximum per patient, but there may be associated co-payments for specific services.


To qualify for the Old Age Pension Dental Program, an individual must be 60 years or older, live in Colorado, and receive Old Age Pension or Medicaid public assistance from the state of Colorado.  Interested seniors should contact their individual county department of social services for eligibility information. 


The following contacts are for the Old Age Dental Assistance Program. Individuals must be 60 years or older and be eligible for Medicaid or Medicare Savings Programs QMB, SLIMB or QI-1 but not eligible for long-term care services
the individual must be 60 years or older and be eligible for Old Age Pension.
Please contact one of the following agencies to check your eligibility to receive dental services under the Old Age Pension Dental Assistance Program. You are not required to seek treatment in the county in which you reside; you may contact any of these agencies. 


Grantee Reference Documents


 Dental Advisory Committee 


Old Age Pension Dental Program Annual Reports


The following webinar is presented by the Department of Public Health and Environment and sponsored by the Health Resources and Services Administration.  It is an educational opportunity for dentists who provide care to the elderly and is based upon currently accepted clinical best practices for patients over the age of 60.  Thi webinar should not be construed as directing care for any individual who may receive an oral health benefit from the state of Colorado.


What are dental sealants?

Dental sealants are thin plastic coatings that are put onto the chewing surfaces of the back teeth (molars) for the prevention of tooth decay. Sealants are painted on the tops of the back teeth and harden to form a protective shield over the tooth.

 Why are sealants a good idea?

As the back teeth grow, mountains and valleys form on the tops of the teeth. Food and germs get caught in the valleys and cause the teeth to get cavities. Using a toothbrush doesn’t remove all the cavity causing germs from the pits and grooves because the toothbrush bristles are too big. Sealants fill the grooves and help the teeth stay clean.

 The thin plastic glues to the tooth enamel, acting as a barrier protecting the chewing surface from germs and acids, which can cause tooth decay. As long as the sealants remain on the tooth, it will be protected from getting cavities. Sealants normally last several years.

 When should sealants be placed?

When the first molars start coming in at about the age of 6-7 and again when the second molars come in around the age of 11.

 Who is providing the sealants?


The Oral Health Unit is accepting applications for the Be Smart and Seal Them! program.  CDPHE supports evidence-based primary prevention interventions, including school dental sealant programs.  


   Sealant RFA Questions and Answers  

Sealant Facts


Colorado Oral Health Surveillance System 


The Colorado Oral Health Surveillance System (COHSS) monitors the burden of oral disease among Coloradans.  The COHSS is the result of a collaborative agreement between the Centers for Disease Control and Prevention (CDC), and the Colorado Department of Public Helath and Environment (CDPHE).  The CDPHE represents one of thirteen states responding to the 2002 federal initiative to test the feasibility of developing state oral health surveillance systems.


The system collects, analyzes, and disseminates data to inform and support oral health decision-makers in Colorado.  Data collection uses probability-sampling methods guided by the CDC so that representative samples of the state population are obtained.  With these data, oral disease patterns can be monitored across Colorado's demographic groups.  When high-risk groups or behaviors are identified, oral health programs and resources are targeted appropirately.  Monitoring oral disease patterns in the population will also identify when disease levels change, and emerging trends occur in the state.  The data presented below provide a descriptinve picture of the oral health of Coloradans.  Contact the Oral Health Program at 303-692-2470 regarding requests for specific oral health statistical analysis needs.




Snapshot of Oral Health in Colorado


The "snapshot" has been collected and provided to you through the Oral Health Program at the Colorado Department of Public Health and Environment.  The Oral Health program, through a cooperative agreement with the Centers for Disease Control, is developing a state Oral Health Surveillance System, collecting and analyzing data on the oral health of Coloradans.


By collecting oral health status and access data it will be possible to monitor trends over time and document improvement in oral health among the residents of Colorado.  Much of the data will be represented in the National Oral Health Surveillance System (NOHSS).  The Oral Health Program will also use the information as a starting point for a state oral health plan.




Snapshot Access Data pdf file .  In Colorado an estimated 7.8 million hours of school are lost annually due to oral pain.


Dental caries pdf file (tooth decay) is the single most common chronic childhood disease -- 5 times more common than asthma.


Adult Oral Health:  Pregnant women pdf file are not recieving appropriate informtion ont he importance of oral health.  Chronic Diseases pdf file are often worse in persons who have oral diseases.


Snapshot Oral Cancer pdf file five-year survival rates are less than breast, cervical, and prostate cancers.


Snapshot Community Water Fluoridation pdf file .  Over a quarter of Colorado's population live in communities that have decided not to fluoridate their drinking water despite fluoridation being the most cost-effective preventive measure for reducing dental decay.  Community water fluoridation reduces decay by over 25% throughout the lifespan.


Chew On This Executive Summary pdf file of 2012 Report on the Oral Disease Burden in Colorado - Chew On This



Related Oral Health Links and Information 


Nation's Oral Health Status



General Dental Information and Links: