Did Oregon rank No. 25 of 32 states in untreated decay in 2007?

Last week, PolitiFact Oregon heard an earful from fluoride opponents upset with our ruling on their claim that Multnomah County has the 15th lowest cavity rate in the country, as the county hovered at roughly the same percentage as the state of New York.

We ruled the statement False because county data is not comparable to state data. Plus, we found that New York didn’t really rank 15th lowest because the cavity numbers posted on the website of the Centers for Disease Control and Prevention were from varying years and, consequently,  can’t be ranked.

Accurate dental health statistics are critical because Portland residents will vote May 21, 2013, on whether to add fluoride to the city’s drinking water.

For that fact check, we spoke with Shanie Mason, oral health program manager for the state agency that published the "Smile Survey" in 2002 and in 2007. Her office released a draft of the 2012 version last week at the request of The Oregonian. At the time, she cautioned against such comparisons and said, "We have only compared ourselves against neighboring states with a similar methodology."

So imagine our surprise when we read this statement in the 2012 draft report: "In 2007, Oregon scored worse in every major measure of oral health for children compared to 2002. At that time, Oregon ranked 25th – or 7th from the bottom – in percentage of children with untreated decay compared to 32 other states with similar data."

It’s accurate to say that Oregon measured worse in 2007 when compared to itself in 2002. However, the "ranked" numbers looked very much like the numbers erroneously relied on by anti-fluoride campaign Clean Water Portland -- which Mason cautioned against comparing -- when it made its claim about New York and Multnomah County.

The CDC posts the percentage of third-graders with "untreated decay." But a spokeswoman for the CDC says the statistics are not meant to be "ranked" because they cover different time periods, with some as dated as 1999. The states have different response rates and vary in the percentage of children who qualify for free and reduced-price meals, she said.

"There are many caveats in looking at these data across states," wrote Linda S. Orgain in yet another email to PolitiFact Oregon. "These issues make ranking the states on these children's indicators less meaningful and probably not accurate. We would not recommend doing that."  

We returned to the Oregon Health Authority for a response. Bruce Gutelius, who is presenting the 2012 survey, said in a reply email they wanted to provide context for Oregon’s numbers.

He said they had other options -- for example, sticking with 2002 and 2007 Oregon figures, or measuring Oregon against a national figure from 1999-2004 -- but decided that a ranking "was the most meaningful to provide the needed context."

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We do not see how declaring Oregon No. 25 based on a list of percentages from other states and other years provides meaningful or accurate context. The percentage of third-graders in Oregon who showed evidence of untreated decay in 2006-07 was 35.4. Vermont was at 16.2 percent in 2002-03 and Arkansas was at 42.1 percent in 2001-02.

The Smile Survey released last week contains numbers for children ages 6 to 9 -- so we’re talking largely kids in first, second and third grades. This is slightly different from the numbers reflected on the CDC website. In 2011-12, the percentage of children in this group who showed evidence of untreated tooth decay was 20 percent. In 2007 it was 36 percent. That’s a sizable decrease.

This week, the Oregon Health Authority also shared statistics for 43 states, including numbers not yet posted to the CDC website. More than 21 percent of third-graders in Oregon and in Alabama have untreated decay for 2011-13. Oregon is in the middle of the pack if you look just at the percentages for the 43 states -- but again, we don’t know how some of the older numbers have shifted since then.

We want the state to make recommendations on public health, even if controversial. The Oregon Health Authority has no official position on the city water measure, although public health officials there clearly favor fluoridating water.

But we don’t think this was the most responsible way to put perspective on Oregon’s untreated decay percentages. The agency could have run in its 2007 report all the percentages for the 32 states, clearly citing the years and without designating a ranking. In its 2012 report, writers should have deleted the phrase: "Oregon ranked 25th – or 7th from the bottom."

The statement is False.