A smile can speak volumes and is a universal language in not only the human race but can be seen in some animals as well – chimpanzees, cats, and dogs amongst a few. When words fail, a simple smile can create and exemplify feelings of joy, happiness, confidence, care, and safety. A smile also has the simple power to connect people in unspoken deeper ways. So, what happens when someone cannot smile? Or what if someone has so much insurmountable pain in their mouth, it affects their daily life? Or what if someone does not have the funds to afford quality dental care? George Cuvier, a 19th-century naturalist once said: “Show me your teeth, and I will tell you who you are”.
Just as the power of a healthy mouth and smile can radiate positive qualities, the opposite is true of frowning and poor dental care. Poor dental hygiene in America today is not spoken about or corrected as it should be. Everything starts with the mouth – the three most important factors being communication, quality of life, and diet and nutrition. It is imperative that we began to stop compartmentalizing the mouth from the rest of the body. By changing the way, we look at dental care and hygiene, educating our youth, and making changes in accessibility, we then can be able to change the course of people’s overall health and well-being.
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Bad Teeth
Unlike other medical conditions, people are held personally accountable for their poor dentition. Poor dental hygiene and the state of one’s teeth often become somewhat of an indication of the adversities of their life. We are living in a continuous and ongoing ‘silent epidemic’ of oral disease stated in a report by David Satcher, the U.S. Surgeon General. “Just as we now understand that nature and nurture are inextricably linked, and mind and body are both expressions of our human biology, so, too, we must recognize that oral health and general health are inseparable”. As America’s deplorable dental care continues, we must continue to research, correct, and educate for the very essence of human connection and life.
Teeth can be considered a history book for developmental high points and environmental changes. The whole history of the human being is behind the smile and inside the oral cavity. With intertwined dental history per person, it quickly can infiltrate the rest of the human body connection. Bad teeth are also to be considered a window into overall health and well-being. How so? According to a publication by the World Health Organization, “Severe caries detracts from children’s quality of life: they experience pain, discomfort, disfigurement, acute and chronic infections, and eating and sleep disruption as well as a higher risk of hospitalization, high treatment costs and loss of school days with the consequently diminished ability to learn. Caries affects nutrition, growth, and weight gain. Children of three years of age with nursing caries weighed about 1 kg less than control children because toothache and infection alter eating and sleeping habits, dietary intake, and metabolic processes. Disturbed sleep affects glucosteroid production. In addition, there is suppression of hemoglobin from depressed erythrocyte production” (Sheiham, 2011). With this study, we can see that our youth are a prime target for the development of healthy dentition. Unfortunately, educating our youth about the effects of poor dental hygiene is not a prime subject in our schools.
In our adult population in America, you will see a parallel universe of chronic diseases in both the body and the mouth. Chronic diseases such as obesity, diabetes, and caries are increasing in numbers, especially in our areas where inequalities are seen most. A medical complication that is clinically linked is a condition known as Ludwig’s angina. Ludwig’s angina is an acute bacterial infection of the mouth and throat with progression deep within the neck. This is usually caused by a tooth abscess or infection. In a journal article from the AJN, Donna Cohill stated: “50 years ago patients with Ludwig’s angina had a high morbidity and high mortality rate. But the incidence of the disease has decreased significantly because of antibiotic therapy, improved oral hygiene, and preventative dentistry” (Cohill, 2002). The most common medical factors of Ludwig’s angina are poor oral hygiene. With this study, we see that oral hygiene can prevent deadly, painful diseases. Unfortunately, we still live in a nation where a lot of people do not have access to antibiotic therapy, proper dental hygiene education, and preventative dentistry.
Inequality
Just as access to affordable healthcare is divided among classes and races, so is dental care. There are numerous barriers and roadblocks for these populations in obtaining affordable, quality health care, and dental care. Lack of dental coverage and the rising cost of care continue to add to the inconsistencies in obtaining proper oral health. People who lack medical insurance surely will be lacking dental insurance.
Societal income is considered to be a primary factor in establishing differences between social groups. Income has a lot to do with obtaining proper dental hygiene. Because poor dental hygiene plays a large part in psychological stability, those with poor oral health are likely to be affected by self-esteem issues, relationships, and emotional permanence. In a study by the ADA, “respondents from counties with higher levels of income inequality reported experiencing social and functional problems related to their mouth and teeth more often than did those from counties with less income inequality” (Moeller, Jamie et al., 2017).
Changing Oral Health in America
Educating our youth on the importance of dental hygiene at a young age in schools across America would be the first proactive approach to change the future of dental hygiene. While this is not the only factor in poor oral hygiene, it is a great road to embark upon for better societal oral health. A way to make this possible is by administering a simple solution like fluoride varnish in our schools. Fluoride varnish can be administered by a school nurse. Fluoride varnish is a highly concentrated form of fluoride that is applied to the tooth’s surface by a dentist, auxiliary, or other health professionals. It is not permanent but is applied to the enamel or dentin to prevent caries (decay), remineralize the tooth surface, and treat hypersensitivity (Robinson, 2017).
A journal article from Public Health Nursing states: “Fifty‐five percent of children have dental caries by age 8. The majority of these children are nonwhite and poor. Caries could be decreased by 40% if fluoride varnish application started with tooth eruption” (Gnaedinger, 2018). With this information, we can gather that if school nurses were allowed to apply fluoride varnish, 40% of caries can be prevented in children if they are unable to access proper dental care at home.
Conclusion
Because losing teeth and having poor dental health is considered to be an impairment or disability by definition, we must cross the historical bridge where the oral cavity is no longer dissociative to the rest of the body. Oral disorders contribute to emotional and psychosocial barriers. We need to improve dental conditions in our youth and areas of inequality, and if not, we continue to bridge the gap between people through smiles.
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