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Oral Health Care Is Primary Care

4a35c09ef8d7a4883bcf3d39cbe2ac4f-huge-deMonday is National Dentist's Day. We're recognizing dentists today on the blog with a post from a public health dentist who works on the frontlines of preventive health care. 

By Debra Bradfield Smith, DMD

The first time I saw my current OB-GYN, he performed a quick exam of my mouth. My first thought was to burst out laughing. I am a dentist and I take care of my oral health. Why on earth was he looking in my mouth? My second thought was, wow, you understand the relationship between good oral health and overall health. Great job! We all need to follow his example. 

On a typical day at the public health dental clinic where I practice, I get many calls from school personnel about children’s problems that can ultimately be traced back to poor oral health. Recently a school nurse called about a child with a toothache. We told the nurse to send the child to us as soon as possible. When I walked in the treatment room, the child was sobbing in the chair and had a swollen face. She had two abscessed teeth, was in severe pain, and had just completed a state standardized test. The entire scenario was heartbreaking. How could she eat or sleep? How could she concentrate on a test? How could I have prevented this from happening?

A few weeks later, I received a call from a school counselor. Concerned about a child with numerous school absences, the counselor had visited the family and realized the child had dental problems. All four of his permanent molars were broken down below the gum line. His family had no dental insurance and could not afford dental treatment. His face would swell and the family would go to the emergency room. The boy would receive antibiotics and the swelling would go down. After a short time, the swelling would return and the cycle would begin again. Once again, I asked myself, how could this situation have been prevented?

Stories like these are very common. Dental decay is the most common illness of childhood and can lay the groundwork for a lifetime of health problems. The good news is that dental decay is a preventable disease. Our oral cavity is teeming with bacteria. Cavities, oral infections, inflammation, and gum disease are caused by these bacteria. Sugar and carbohydrates feed the oral bacteria and cause it to multiply and release cavity-causing acids. In simple terms, our daily goal is to reduce the number of bacteria in our mouth. Brush the bacteria away, floss it away, rinse it away, and do not feed it with sugar and carbohydrates!

It is also very important to prevent oral bacteria from traveling to other areas of our bodies. Numerous studies have recorded a link between diabetes and gum disease. Diabetics with gum disease have a more difficult time regulating blood sugar levels. Studies have shown a relationship between pregnant moms with oral infections and low-birth-weight, pre-term babies. Cardiovascular disease has been linked in recent studies to oral infection and gum disease. Pneumonia and rheumatoid arthritis have also been linked to oral infections. The list of health conditions related to poor oral health continues to grow with every new study. Fewer bacteria in the mouth mean less chance of bacteria traveling to other areas.

We also must keep the bacteria in our mouths from traveling to other more vulnerable bodies. Dental decay is now considered an infectious disease because cavity-causing bacteria can be transferred to an infant’s mouth from parents and caregivers. Infants themselves are born without cavity-causing bacteria in their mouths. It is critical for parents to work daily to reduce the number of bacteria in their mouths so no bacteria are transferred to babies. The American Academy of Pediatrics recommends the first dental visit by the age of one year, but dental prevention must begin before the baby is born. OB-GYNs should discuss the importance of good oral health with their patients. Parents, caregivers, and grandparents should receive the newest information about infant dental care when they visit the dentist every six months.

It is imperative that good preventive primary health care include prevention of dental disease. One cannot have good health without good oral health. Everything we eat, everything we drink, the tobacco that some of us unfortunately smoke or chew, the air we breathe - it all enters the body through our mouth. The health of our oral cavity is vital to the health of our body. I would encourage all clinicians on the front lines of primary care to discuss this relationship with their patients.

My stories have a happy ending. The two children both received the dental treatment they needed. But one must wonder how different their situations would have been - how many fewer days of school they might have missed, how much better they might have done on their tests - if they had received primary health care that included preventive dental care, dental health education, and nutrition counseling.

Debra Bradfield Smith, DMD, is the district dental health director for the South Central Public Health District in Dublin, Georgia. She is a graduate of Medical College of Georgia School of Dentistry.
Posted by Sonya Collins on Mar 2, 2017 2:16 PM America/New_York
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