HJAR Jan/Feb 2020

HEALTHCARE JOURNAL OF ARKANSAS I  JAN / FEB 2020 55 Niki Carter, D.M.D. Dental Director Delta Dental of Arkansas IF YOU WERE ASKED what the most prevalent chronic disease worldwide is in both children and adults, would you have the right answer? A surprise to many, it’s dental caries, better known as tooth decay. Yes, tooth decay equates as a disease, and remains the most common disease for adults and children around the globe, yet it is preventable 1 . Dental caries has greatly decreased in the U.S. over the past four decades, but oral disease disparities remain among some population groups 2 . According to the World Dental Federation, approximately 3.5 billion people globally suffer from oral diseases. In Arkansas, 62 percent of adults feel life in general is less satisfying due to the condition of their teeth and mouth. Thirty- five percent of Arkansans avoid smiling due to the condition of their teeth, 28 percent of adults feel embarrassed about the appearance of their teeth, and 27 percent report the appearance of their teeth affects their ability to interview for a job 3 . Comparing household incomes, 44 percent of low-income adults reduce their participation in social activities due to the condition of their teeth, compared to 14 percent in high-income adults. Twenty-four percent of low-income adults experience pain very often, as compared to 4 percent in middle-income adults, and 3 percent in high-income adults 4 . As unfortunate as these statistics are, there is another aspect of oral health that deserves the attention of healthcare providers in all disciplines. Oral health status affects overall health a great deal. The biggest factor? Bacteria. These microorganisms are the epidemiological agent. The destruction of teeth by the cariogenic process is curable if the teeth are treated early enough, before loss of tooth structure. Periodontitis, or gum disease, is the real culprit since it is the most common chronic inflammatory disease in adults worldwide 5 . Gum disease is often silent until signs and symptoms such as swollen and bleeding gums, mobile teeth, and spaces between teeth become noticeable. Periodontal disease is a chronic inflam- matory process caused by persistent patho- logic microbes, which feed on plaque and excrete acid. When bacteria are allowed to accumulate, this pathological process trig- gers the body’s immune response, which leads to damage of the supporting struc- tures of the teeth. Connective tissue is lost and bone in the oral cavity is destroyed. This periodontal condition is the leading cause of tooth loss around the world 6 . InArkansas, 22.9 percent of adults who are 65 and over have had all of their natural teeth extracted 7 . Oral health plays a major role in the over- all health in our bodies. The mouth is the entry portal for our digestive system and respiratory tract, and it affects all that enters. This includes not only food and drink, but also bacteria, saliva, and infection. If teeth are missing in the mastication process, di- gestion and absorption of nutrients will be profoundly compromised. When this pro- cess is compromised, bodily functions are also compromised due to lack of nutrients received, thereby reducing the amount of energy received. Oral mucosa, the oral cavity’s layer of skin, is amazingly absorptive. This is how many nutrients and medications enter the bloodstream so quickly when placed sub- lingually. Conversely, this is also how toxins are quickly absorbed into the bloodstream 8 . The natural defenses of the body and good oral hygiene help to decrease bacteria. When bacteria are allowed to thrive, as in the case of periodontitis, this increased bacterial level can lead to infections and compromise other co-existing diseases, such as diabetes or cardiovascular disease 9 . Research has well documented the con- nection of several chronic illnesses and disease states to poor oral health. Besides diabetes and cardiovascular disease, other diseases associated with poor oral health include endocarditis, stroke, pneumonia, HIV/AIDS, osteoporosis, Alzheimer’s disease, birth complications, Parkinson’s disease, ar- thritis, kidney disease, and liver disease.

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