Although oral health is an important component to general health, many people in the United States go without appropriate oral and dental health services, and millions experience dental problems, periodontal (gum) disease, and oral and pharyngeal (throat) cancers. 

These problems can result in needless pain and suffering, difficulty in speaking, chewing, and swallowing, increased costs of care, loss of self-esteem, decreased economic productivity through lost work and school days, and, in extreme cases, death. Oral infections have also been linked to respiratory disease, endocarditis (infection of the heart valves), and bacteremia (infection elsewhere in the body). In 2007 (the most recent year of data collection), only 44.5% of the population over the age of two had visited a dentist in the past 12 months.  About 14% of adults ages 35-44 have gum disease, and about 25% of adults age 65 or older have gum disease.  About 36,500 cases of oral and pharyngeal cancers are diagnosed every year, and 7,800 people die of these cancers every year.

Risk Factors:

• Poor dental hygiene: Failing to brush and floss teeth regularly can allow plaque, a substance made up of bacteria and saliva, to build up on the teeth.  If plaque is allowed to stay for too long, it hardens and turns into tartar, which has harmful effects on the teeth.
  
  
• Tobacco use: Smoking or chewing tobacco is responsible for about 75% of all oral and pharyngeal cancers, and is a major risk factor for periodontal disease, including gingivitis and periodontitis.
  
  
• Alcohol use: Chronic alcohol use has been linked to cancer; combined with tobacco use, it may result in even higher risk.
  
  
• Age: Oral cancer is more common in people over age 40.
  
  
• Other health issues: Human papillomavirus (HPV) infection can cause some oral and pharyngeal cancers.  Diabetes can be a risk factor for periodontal disease, and AIDS and some cancers can contribute to risk as well.  Obesity is also a risk factor for these cancers.

Further risk factors exist for racial and ethnic minorities and people with less education. Discrepancies are evident in childhood dental care, where Hispanic and African American children typically receive less preventive dental care than white children, as well as into adulthood.

Symptoms

Symptoms of periodontal disease include swollen, sore, and bleeding gums, persistent bad breath, loose teeth, and gums that have pulled away from the teeth.

Symtoms of oral and pharyngeal cancers include white, red, or mixed white and red patches in the mouth, difficulty or pain swallowing, loose teeth, and numbness of the chin and lower lip.

Prevention

• Good dental hygiene: Practicing adequate dental hygiene – brushing and flossing teeth and having regular dental check-ups – is critical in preventing dental and oral health problems.
• Avoiding tobacco use: Tobacco is responsible for a large proportion of dental and oral health concerns.  If you smoke and need help quitting, visit our smoking resource page.

Treatment

A deep cleaning method called scaling and root planing, performed by a dentist or dental hygienist, can often treat periodontal disease.  Medications, either taken in pill form or placed inside periodontal pockets (spaces between the teeth and gums) by a dentist after deep cleaning, may also be used. Two types of surgery can be used to treat periodontal disease: flap surgery involves lifting the gums, removing tartar buildup, and putting the gums back in place so that they are closer to the teeth; bone and tissue grafts are put in place to help regenerate bone or gum lost to periodontal disease.
Oral and pharyngeal cancers may be treated by any combination of radiation, chemotherapy, or surgery to remove the tumor.

Barriers to Care
Barriers to oral healthcare include cost (possibly due to lack of dental insurance, public programs, or providers from underserved racial and ethnic groups) and fear of dental visits. People with limited health literacy may not be able to find or understand information and services available to them.
Additional barriers exist for lesbians and women who partner with women, including systematic bias in health insurance and public entitlements, which routinely fail to cover gay and lesbian partners or to provide reimbursement for procedures of particular relevance to LGBT populations.

References

Centers for Disease Control and Prevention.  “Oral Health: Preventing Cavities, Gum Disease, Tooth Loss, and Oral Cancers.”  Retrieved on August 2, 2024 from http://www.cdc.gov/chronicdisease/resources/publications/AAG/doh.htm.

Department of Health and Human Services.  “Oral Health in America: A Report of the Surgeon General.”  Retrieved on August 2, 2024 from http://www2.nidcr.nih.gov/sgr/sgrohweb/home.htm.

Healthy People. “Oral Health.” Retrieved on August 2, 2024 from http://healthypeople.gov/2020/LHI/oralHealth.aspx.

National Institute of Dental and Craniofacial Research.  “Periodontal (Gum) Disease: Causes, Symptoms, and Treatment.”  Retrieved on August 7, 2024 from http://www.nidcr.nih.gov/OralHealth/Topics/GumDiseases/PeriodontalGumDisease.htm.

National Institute of Dental and Craniofacial Research.  “What You Need to Know About Oral Cancer.”  Retrieved on August 7, 2024 from http://www.cancer.gov/cancertopics/wyntk/oral/page1