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Oral health goes beyond teeth and supporting anatomical structures. It is also a determining factor in overall health and well-being and a variety of life functions: the ability to eat and drink, diet and nutrition, self-confidence, social function, as well as employability, promotability, and earning potential. Both children and adults who disproportionately experience oral health inequities carry the disadvantages in these life functions as they grow older.
There is a significant body of scientific evidence that untreated tooth decay in children can have a long-term impact on their overall development, school attendance, school performance and self-esteem.
Since the primary way out of poverty for children is education leading to better employment opportunities, the imperative to improve the oral health of children becomes paramount:
In adults, recent publications demonstrate associations between poor oral health, primarily periodontal disease, and multiple chronic and systemic health issues. Most notable are diabetes, cardiovascular disease, and low-birth-weight, preterm births. These connections indicate a need to consider oral health in primary medical care. They point to major deficiencies in today’s health system, where oral health is often ignored. They also point to the need to improve access to dental care for those populations which have difficulty in accessing affordable dental care.
Several recent studies highlight the impact of poor oral health on overall health in adults:
Using data from the New York State Medicaid program, rates of emergency department use and inpatient admissions, as well as associated costs, were studied to determine the association of preventive dental care to health care outcomes. The authors concluded that there was a strong association between Preventive Dental Care (PDC) and improved health care outcomes. However, for those patients who had extractions and root canal therapy without preventive dental care, there was an opposite association. Importantly, overall health costs were also lower for patients with preventive dental care.
Compelling evidence of the link between periodontal disease and diabetes is seen in the recent Cochrane review entitled “Treatment of periodontitis for glycemic control in people with diabetes mellitus”. The major conclusion was that at 3 months after treatment the reduction in HbA1c was 0.43%, 0.30% at 6 months and 0.50% at 12 months. Critically, the results necessitated “a change in our [Cochrane’s] conclusions about the primary outcome of glycaemic control in our level of certainty in this conclusion. We now have evidence that periodontal treatment using subgingival instrumentation improves glycaemic control in people with both periodontitis and diabetes by a clinically significant amount when compared to no treatment or usual care”. Notably this changed from the previous Cochrane review, which concluded that there was not sufficient evidence to state that periodontal therapy had this beneficial effect. Further, the review stated that additional studies are “not likely to change the outcome”.