OBJECTIVES: National and Kentucky (KY) state-specific oral health indicators were compared to Healthy People (HP) 2010 oral health objectives to assess the progress of the state. METHODS: Oral health surveillance system--derived estimates from national and KY surveys for various oral health indicators (1999-2004) were examined and compared with national estimates and the HP 2010 objectives. The null hypothesis that differences between national and KY indicators did not differ significantly was statistically evaluated using a "z" statistic-based test. RESULTS: About 99.7% of KY had water fluoridation, ranking 2nd highest in the US. KY ranked 24th in the US for adult dental visits (69.8% people with a dental visit compared to national average of 69%). Some 38% of the elderly population was edentulous (national, 20.5%). Compared to other states, KY ranked high for teeth cleaning and dental sealants, but had greater caries experience and untreated caries among children. These patterns remained even in socio-demographic factor subgroup analysis. Most of these indicators improved from 1998 to 2004. CONCLUSIONS: KY oral health indicators as documented by state/regional oral health surveys are not encouraging, and the progress towards the HP 2010 objectives is quite limited. Despite major national emphasis on oral health improvement and better than national average annual dental visit for some segments of the population, KY has a very high prevalence of edentulism compared to the rest of the country. Educated policy making and additional resources for program planning and implementation are required to improve the oral health status of KY residents.