Oral Health Pandemic: Why It’s Vital to Protect Against Oral Diseases

The World Health Organization (WHO) recently published a 120-page report detailing the oral health crisis going on in the world today. According to the Global Oral Health Status Report published in November 2022, there are 3.5 billion people currently affected by one or more oral diseases. More than 1 billion new cases of oral disease have been recorded over the past 30 years. Let’s dive in to find out what this means and how you can protect your oral health.

The mouth is the portal to your body. The health of the mouth is directly related to the overall health of a person. When oral diseases are present, it can affect other parts of the body as well. The WHO defines oral health as the state of the mouth, teeth, and orofacial structures that enable a person to perform essential functions, such as eating, breathing, and speaking. Oral health affects not only how a person lives day to day, but also how a person interacts with the world around them. Our oral health is one aspect that can change over time.

Common oral diseases

Today, more than half the world’s population is affected by some form of oral disease. Many oral diseases are completely preventable through home care and education. In 2019, oral diseases were the most widespread conditions affecting humanity. In fact, oral diseases have been the largest condition affecting the world since oral disease data was first collected in 1990.

The most common of these oral diseases are untreated dental caries (cavities), periodontal disease, edentulism (total tooth loss), and oral cancers. Untreated oral diseases have a huge impact on the overall health systems. Let’s dive more in-depth into these 4 oral conditions.

Untreated dental caries

Dental caries, also known as cavities or tooth decay, have become a huge issue in both primary teeth (baby teeth) and permanent teeth (adult teeth). It is estimated in many areas of the world, close to half the population has dental decay that is untreated. Tooth decay is directly linked to specific types of bacteria in the mouth. These bacteria produce byproducts that weaken the tooth. Once this happens, the bacteria can then form a cavity, or hole, in the tooth.

Many factors can affect the prevalence of cavities in a person. Things like socioeconomic status, access to dental care, high sugar consumption, and oral hygiene home care increases the risk of developing dental decay. Untreated dental caries can negatively impact a person throughout their life. It is common for untreated caries to cause the following:

• Dental pain;
• Difficulty chewing;
• Poor sleep;
• Missing work;
• Missing school;
• Tooth loss.

Untreated cavities in adult teeth are the most prevalent of all oral diseases. It is estimated there are around 2 billion cases of untreated dental caries. Untreated cavities in primary (or baby) teeth account for about 510 million cases. Brushing your teeth 2 times a day greatly reduces the risk of developing cavities in both primary and permanent teeth. Also, using toothpaste with fluoride and regular dental check-ups can help improve oral health as well.

Periodontal disease

Periodontal disease is chronic inflammation of the hard and soft tissues that support and anchor the teeth. Periodontal disease develops in stages.

The first is generalized inflammation or gingivitis. Gingivitis is superficial inflammation, bleeding and swelling of the gum tissue. This stage is completely reversible with proper oral care.

The second stage is periodontitis and involves loss of gingival attachment. If this stage is left untreated, it can lead to severe periodontal disease. This also results in irreversible bone loss and eventual tooth loss. Severe periodontal diseases make up approximately 1 billion of the reported oral diseases in the world.

Common risk factors for developing severe periodontal disease are:

• Poor oral hygiene;
• Tobacco use;
• Poor diet;
• Low socioeconomic status;
• No access to dental care.

Severe periodontal disease has also been associated with other health concerns, such as unmanaged type 2 diabetes. Good oral home care and regular dental cleanings can help reduce the risk of developing periodontal issues. Once periodontal problems arise, the dental team can help manage this disease and stop its progression. Therefore, dental care is a must.

Edentulism

Edentulism occurs when all natural teeth are lost. Complete tooth loss is estimated at around 350 million cases or about 7% of the world’s population. Many people see tooth loss as a natural progression of aging. This is not necessarily the truth. Tooth loss is usually the last resort after a long battle with other dental diseases, such as caries, tooth fractures, and periodontal diseases. Poor dental care also increases the risk of tooth loss.

According to the WHO report, when a person has reduced dentition (fewer than 9 natural teeth), it can be psychologically traumatic, socially damaging, and functionally limiting for the person. Replacing missing teeth can be painful and expensive. Missing teeth can be replaced with partial dentures, dental implants, or full dentures. However, maintaining a person’s natural teeth should be the primary goal.

Oral cancers

Oral cancers are particularly concerning. This group of cancers has a high mortality rate. According to data from the IARC Global Cancer Observatory (GLOBOCAN), approximately 377, 713 new cases of lip and oral cancers were reported in 2020. Also, more than 177,757 new deaths were reported worldwide. Lip and oral cancers rank 16th among all cancers for men and women combined, while oropharyngeal cancers rank 13th worldwide. Men typically have a 2.5 times higher rate of mortality than women for lip and oral cancer. The most common risk factors for developing lip and oral cancer include:

• Tobacco use (smoking or chewing);
• Nicotine use (e-cigarettes or vaping);
• Alcohol use;
• Betel quid use (includes betel leaf, areca nut, and slaked lime);
• Low socioeconomic status.

There has also been a connection found between certain oral cancers and the human papillomavirus (HPV), specifically, HPV types 16 & 18. These two types are the most common causes of cancers found at the base of the tongue, tonsils, and back of the throat. While these cancers have a slightly higher survival rate, many countries are now pushing for HPV vaccines to help reduce the prevalence of these types of oral cancers.

In general, lip and oral cancers have greatly increased in countries where tobacco use is on the rise. Therefore, special consideration should be taken for individuals who use tobacco. Cessation programs are available in many countries across the world.

Prevalence of oral diseases

The prevalence of oral diseases grew by 50% between 1990 and 2019, while the total world population only grew by 45%. These cases are also spread out over different income-level countries as well. Lower-income countries are more affected. However, high-income countries are not immune. In fact, there was an increase of more than 37% in that 10-year span in high-income countries. Many factors affect how oral diseases occur. Personal home care seems to be one of the leading causes of many oral conditions, which could explain why lower-income countries are more affected. When factors like poverty, hunger, and lack of access to care are present, it is hard to have adequate home care.

Barriers for proper oral care

There are many reasons oral diseases are prevalent. Some of the biggest barriers to proper oral care include education on dental importance, access to quality dental care, and affordability of dental treatment.

Many oral diseases could be prevented with proper dental care at home. It is also important to learn how diet can affect oral conditions.

Access to care is also a big obstacle. Most dental practitioners are in private healthcare settings. This prevents many people from having access to dental care. A few countries do provide public oral care services, which reduces the burden of oral care for many people. But without support, it is nearly impossible for much of the world to prioritize dental care, seek preventative care, and maintain natural teeth.

Once natural teeth are compromised, the cost of dental treatment increases. This is probably the hardest obstacle to overcome for most people. The cost to repair, replace, or treat dental diseases negatively impacts a person’s ability to provide for other needs. Many times, people must choose between dental care, food, housing, or medicine. Therefore, dental needs are often left untreated.

How to protect your oral health

Recognizing the importance of oral health in every person, regardless of age, is a big step in ending this crisis. Many of the leading oral diseases are very preventable. But we must first make sure the information on how these diseases develop and progress is commonly known. Next, addressing access to care. Having affordable dental care available to all persons, regardless of socioeconomic status, is vital. If people have knowledge of oral diseases and the ability for oral care, preventing these diseases will be easier. And prevention is the key!

To prevent oral diseases, first focus on home care. Including the following steps in your daily home care routine is critical.

1. Brush your teeth for 2 minutes, twice daily. Only brushing once a day or skipping days can increase your risk of developing dental diseases.
2. Use only a soft or extra-soft bristle toothbrush. Using a toothbrush with medium or hard bristles can damage your teeth and gums, leading to recession, tooth abrasion, or bone loss.
3. Make sure to use fluoride toothpaste. Fluoride is a mineral that is naturally present in many foods and some water supplies. Fluoride can help to replace minerals in enamel and prevent dental caries.
4. Clean the interproximal (in-between) spaces of your teeth. Brushing alone can only adequately clean 60% of your tooth surfaces. Using floss or a water-flosser daily can help to clean the remaining 40% of tooth surfaces. This reduces the risk of developing cavities between the teeth.
5. Check your mouth for suspicious areas. Suspicious areas can include: dark spots or discolorations on the teeth, white spots on the tooth surface, or sores/abrasions on the tongue, lips, or tonsil areas. If you see any of these areas, contact your dental office for a check-up.

" No other disease group affects humanity across the life cycle and across all countries in the way that oral diseases do."

Our oral health affects more than just our mouth. Luckily, oral health care has greatly advanced over the past 10–20 years. As we continue to progress and with a little prevention, we can make some much-needed changes. By ending the oral health crisis, we not only help ourselves, but we change things for the better for future generations as well. Together we can fight this global crisis, one healthy smile at a time.