The Importance of Oral Health in Comprehensive Health Care

People often underestimate the importance of their oral health.

According to a recent Gallup poll, about one-third of Americans reported not seeing a dentist in the last year. These statistics have remained fairly consistent since 2008.

The danger of not maintaining proper dental care, though, is that it can impact a person’s overall health and well-being. Bad oral health can lead to consequences that go far beyond bad breath, including the development of disease, the worsening of existing diseases and increased medical expenses.

A 2014 study published in the American Journal of Preventive Medicine determined that treating periodontal disease can reduce medical costs and hospital admissions in pregnancy and some chronic systemic conditions, such as Type 2 diabetes and heart disease.

Periodontal disease is a chronic bacterial infection of the gums or oral tissues that hold teeth in place. It is also called gum disease.

The Washington Post reported in 2014 that dental-related problems can lead to increased school absences for children and 164 million lost work hours each year for adults, citing estimates by the Centers for Disease Control and Prevention.

Dental-related visits to emergency departments, likewise, contribute to an increase in U.S. health care costs, according to the report.

The short of it is, taking care of your teeth can save you money, time and potentially your life.

There are many reasons why people avoid the dentist or do not make dental care a top priority.

In 2012, Frontline reported that more than 100 million Americans opted out of going to the dentist because of its accompanying price tag.

Other commonly reported reasons for skipping regular dentist appointments include no time, lack of motivation or no visible or apparent dental problems to warrant scheduling an appointment, fear of the dentist or prior bad experiences, and fear of hearing that there’s a problem.

Hygiene is the practice of certain behaviors to improve cleanliness and preserve one’s health.

The Centers for Disease Control and Prevention says that appropriate personal hygiene can prevent or control diseases and other adverse health conditions.

Dental care is a part of hygiene. Dental hygiene is the practice of keeping the mouth, teeth and gums clean.

Proper dental care can prevent hygiene-related illness and undesirable oral health conditions, such as cavities, gingivitis, bad breath, tooth decay or periodontal disease.

The mouth is full of mostly harmless bacteria. These bacteria can normally be controlled with proper dental care and the body’s own defenses, such as saliva.

But when oral health is neglected, bacteria can flourish and cause infections or other diseases.

Plaque, a sticky combination of bacteria and food, can build up over time, leading to inflammation. Studies suggest that the oral bacteria and inflammation lead to certain diseases.

Cavities are one of the most common chronic diseases of childhood in the United States, according to the CDC.

Cavities are also known as tooth decay. According to the CDC, 20 percent of children between the ages of 5 and 11 have untreated tooth decay. About 90 percent of tooth decay in permanent teeth occurs in the chewing surfaces of the back teeth, or molars.

When left untreated, tooth decay can cause pain and infections. Children living in poverty are more than twice as likely as the general population to have untreated tooth decay.

Poor oral health in children can lead to problems with eating, speaking, playing and learning.

Oral Health and Academic Performance

A 2011 study published in the American Journal of Public Health found that children with poor oral health were almost three times more likely than their peers to miss school due to dental-related pain.

These absences were further associated with poorer school performance.

On the other hand, missing school to go to the dentist was not found to similarly adversely affect a child’s studies.

What Can Parents Do?

There are some steps that parents can take to protect their child’s oral health.

Seniors are likely to suffer from oral health problems that occur with the natural aging process. Also, some seniors with disabilities, dementia or other health conditions might be unable to practice adequate hygiene, including proper dental care.

Seniors are prone to tooth loss, tooth sensitivity, gum disease, inflammation of gum tissue, tooth decay and discoloration, dry mouth, oral thrush, and oral cancer.

The CDC determined that oral health problems are also common among Americans who grew up without access to fluoridated water or other fluoride products.

Recent estimates show that about 25 percent of adults currently aged 60 years and older no longer have their natural teeth.

Missing teeth can also affect a person’s diet and nutrition leading to other health problems for seniors.

Gum Disease

Gum disease and tooth decay are the most common causes of tooth loss.

Seniors experience new tooth decay at higher rates than children. This decay can occur on the crowns of the teeth as well as the roots, as a result of gum recession, or root exposure.

The severity of gum disease also increases with age. Nearly 11 percent of seniors aged 65 and older have moderate to severe gum disease, according to the National Institute of Dental and Craniofacial Research. Men are more likely than women to have more severe gum disease.

Research has also shown that current smokers, patients who are black or Hispanic, and those with lower income or less education have more severe gum disease.

Oral and Pharyngeal Cancers

Oral and pharyngeal cancers are most commonly diagnosed in seniors. Pharyngeal cancer refers to a type of cancer that affects the pharynx, the part of the throat behind the mouth and nasal cavity and above the esophagus.

In 2022, about 54,000 Americans were diagnosed with these cancers, and about 11,230 people in the U.S. died from them, the National Cancer Institute estimated. A person diagnosed with either type of cancer has a poor prognosis because these cancers are often found in the later stages.

Protecting Senior Oral Health

Seniors can take steps to maintain their oral health. Caregivers should reinforce proper daily oral hygiene routines for seniors unable to carry out the tasks themselves.

Cancer treatments to the head or neck can damage oral tissues and cause oral irritation, mouth ulcers, loss of saliva, tooth decay and bone destruction. Make sure to see your dentist before having chemotherapy or radiation.

If it is necessary to take medications that cause dry mouth, drink lots of water and chew sugarless gum.

Poor dental care during pregnancy is linked to premature delivery, growth restriction in the uterus, gestational diabetes and preeclampsia, a serious condition involving high blood pressure in pregnant women, according to the American Dental Association.

Also, pregnancy can make existing dental hygiene conditions worse or create new ones.

Pregnancy Gingivitis

The American Dental Association estimates that as many as half of all women develop a mild form of gum disease called pregnancy gingivitis. This phenomenon typically occurs between the second and eighth months of pregnancy and usually goes away after childbirth.

Pregnancy Tumors

Some pregnant women may develop overgrowths of tissue called pregnancy tumors on the gums. These unsightly swellings typically surface in the second trimester. They are not cancerous, but they are often associated with excess plaque and bleed easily. They are also likely to disappear after childbirth.

Increased Risk of Tooth Decay

Cavities can crop up more easily during pregnancy due to changes in diet and morning sickness. Acid in the mouth from excessive vomiting can deteriorate tooth enamel, the outer covering of a tooth. Slacking off on dental care while pregnant because of exhaustion or morning sickness, especially if brushing makes you gag, can also increase a woman’s risk for oral health complications as well as pregnancy-related problems.

Bleeding Gums

Gums may be more sensitive during pregnancy due to hormones. Plaque can irritate them more easily causing them to be tender and bleed. During pregnancy, the hormones progesterone and estrogen can also relax the ligaments and bones holding the teeth in place, causing them to feel loose. These can also be signs of gum disease, though, so it’s best to speak with your dentist about any dental-related changes that occur during pregnancy.

Is Dental Care Safe During Pregnancy?

The American Dental Association, the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics all recommend that women continue to see their dentist throughout pregnancy.

Women should tell their dentist if they are pregnant or even if they think they might be pregnant.

Some treatments may need to be postponed as a precaution when a pregnancy is high-risk. Otherwise, basic procedures, such as cavity fillings, crowns and root canals, are perfectly safe during pregnancy.

Dental X-rays and local anesthetics are also not a cause for concern, according to a 2015 study in the Journal of the American Dental Association.

Sitting in the chair at the dentist’s office may be uncomfortable later in the pregnancy. For this reason, it may be a good idea to schedule all dental care while pregnant for the end of the second trimester.

Eating for Baby’s Teeth Development

Fetuses usually develop teeth between the third and sixth months of pregnancy. Eating foods rich in vitamins A, C and D, protein, calcium and phosphorous can help their teeth — and other body parts — to develop properly.

Researchers have found that people with periodontal disease are almost twice as likely as the general population to have heart disease, according to a 2017 publication in Dentistry IQ.

One theory on how oral disease might contribute to heart disease is that bacteria from gum disease might enter the bloodstream and attach to fatty deposits in the heart’s blood vessels. This can lead to blood clots and possible heart attacks.

Scientists believe it might also be due to inflammation. A buildup of inflammatory substances in the blood is linked to the worsening of heart disease, diabetes and other chronic illness. Treating inflammation associated with gum disease might lessen its effects throughout the body.

While a definitive cause-and-effect relationship has not yet been proven, several studies confirm that there is a clear association between gum disease and heart disease. Other studies have also pointed to a connection between gum disease and stroke.

Dental Care and Existing Heart Problems

Gum disease can also worsen existing heart disease. People with preexisting heart conditions may be at risk for developing bacterial endocarditis.

Bacterial endocarditis is an infection of the heart’s inner lining or the heart’s valves. You should let your dentist know if you have a heart condition before any dental work is performed.

What to Watch Out For

Maintaining good oral health is an important factor when maintaining one’s overall health, according to the research.

Patients should be aware of the signs and symptoms of gum disease, so they can ward off its effects before it leads to major health problems, such as heart disease.