What is oral health? Why is it so important? Oral health includes having healthy teeth, but it’s also much more. It involves healthy gums and being free from pain, diseases or defects. It means being able to eat, speak and show emotion. Problems in other parts of the body can often be discovered in and can be associated with the mouth. Poor nutrition, infections, diseases and some cancers can be detected in saliva and in other oral examinations. And while oral health has gotten a lot more attention in the past few decades, it’s an area where there are significant health disparities.
One of the most basic ways to protect our oral and overall health is to prevent tooth decay. Mouths are full of bacteria. When the food or drink we consume comes into contact with some of those bacteria, it creates an acid. The acid starts breaking down our teeth and can cause decay. Decay can lead to cavities—permanent damage to the tooth that must be fixed by a dentist. If cavities aren’t fixed, they can cause tooth loss and lead to problems chewing or problems in our gums and bones in the mouth.
Protecting our teeth and our overall health begins in childhood. According to the Centers for Disease Control and Prevention (CDC), tooth decay affects 25 percent of children ages 2-5 in the U.S. In fact, the U.S. Department of Health and Human Services cites tooth decay as the single most common chronic childhood disease—five times more common than asthma. Problems with teeth and gums can cause children to not want to eat properly, to feel embarrassed about their appearance, to miss days of school or even to be hospitalized. If tooth decay or cavities go untreated in childhood, they can lead to gum disease in adulthood. Gum disease begins when bacteria get under the gums and begin to destroy the gums and bone. The CDC states that “gum disease also may be connected to damage elsewhere in the body; recent studies link oral infections with diabetes, heart disease, stroke and premature, low-weight births.”
“Bacteria may spread to the tooth’s nerve or through the gums surrounding the teeth. Then they travel through the body by tissue spaces or the bloodstream. This may create an infection that can cause major problems throughout the body,” says Rick Rubin, DDS, MPH, assistant professor of dental public health at the University of Pittsburgh School of Dental Medicine. “Most people only generally worry about the possibilities of getting Unfortunately, oral health problems don’t affect everyone in the same ways. The CDC reports that the greatest disparity in children 2-4 years and 6-8 years is seen in African Americans and Mexican Americans. African American adults have untreated tooth decay nearly twice as often as Whites. The five-year survival rate for throat cancer is 36 percent for African American men and 61 percent for White men. These disparities reflect overall health disparities in these populations. But why do they exist? Barriers to oral health care include a general lack of access to health care and specifically to dental care services. They include less access to dental health insurance, fear about dental procedures and their cost and ability to take time off of work to go to appointments.
As common as they are, oral health problems are preventable. The first step is to prevent tooth decay. Decay can be avoided by good self-care, which includes regular brushing with fluoride toothpaste (fluoride is a mineral that can prevent tooth decay from progressing), daily flossing and visits to the dentist when possible. Getting regular dental exams will also help detect any other problems associated with oral or overall health. Adults should supervise children’s brushing and flossing habits until the ages of 7 or 8. Tobacco and alcohol use and a diet filled with too many sugary or starchy foods and drinks can also lead to poor oral health.
Public health interventions can also help. Community water fluoridation—adjusting the fluoride in the public water supply to a level that will help prevent decay—is important, but not every community does this (people can call their local water utilities to see if their water contains fluoride). Dental sealants can also prevent tooth decay. Sealants are thin, plastic coatings painted on the chewing surfaces of the back teeth.
For more information about dental services for children, contact the Allegheny County Health Department’s pediatric dental program at 412-432-1620 or visit on the Internet: http://www.achd.net/dental/index.html.