Brushing your teeth is essential to maintaining optimal oral health, but like most aspects of health, the whole story is more complicated.
As directors of the Appalachia Oral Health Research Center, part of the University of Pittsburgh School of Dentistry, we know firsthand that disparities exist when it comes to oral health, including in children. Some people or groups have significantly more oral health problems than others due to a combination of factors beyond personal dental hygiene.
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For example, the Appalachians—which stretch from northern Mississippi, Alabama, and Georgia up through southern New York and include all of West Virginia—have one of the highest burdens of human oral health problems in the United States.
This is a chronic but often preventable problem.
While the terms dental hygiene and dental health largely focus on the teeth and gums, oral health is more comprehensive. According to the FDI World Dental Federation, oral health encompasses the proper functioning of the mouth, including “a person’s ability to speak, smile, smell, taste, touch, chew, swallow and communicate a range of emotions through facial expression” without pain or discomfort . Oral health affects not only a person’s teeth, but also the overall well-being and quality of life.
Tooth decay affects children in the United States, but too little attention is paid to how preventable and treatable it is. Tooth decay or tooth decay is the most common chronic disease in children – five times more common than asthma and seven times more common than environmental allergies, although they can be prevented. More than 40% of children have cavities when they start kindergarten.
However, people who have less formal education or lower incomes, marginalized ethnic and racial groups, and those living in more rural areas such as Appalachia tend to have more oral health problems than others and at a younger age. age. The higher prevalence of childhood caries among certain populations is not only an inequity but also a serious public health problem. Oral health problems early in life continue into adulthood and can last a lifetime.
A common misconception is that consumption of sugary foods and drinks is the only cause of tooth decay. While this is undoubtedly a problem, there is much more to good oral health. Includes sequential brushing and flossing; eating healthy foods such as fresh fruits and vegetables; avoiding tobacco products; and wearing mouth guards while playing certain sports. Regular dental visits are also crucial as they provide an opportunity for cleaning and preventative care.
Children’s oral health is a reflection of their overall health and that of their families; however, in addition to behavioral and social influences, genetic and other biological factors also play a role. For example, genes affecting taste preferences – such as those for sweet foods – are associated with certain tooth cavities and tooth surfaces. It is possible that our taste genes predispose some of us to prefer sweet foods and drinks, which is a risk factor for developing tooth decay.
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Bacteria and other microorganisms in the mouth, known as the oral microbiome, also play a role. Some parts of the oral microbiome are beneficial and even necessary for good oral health. Other bacteria are invaders that can lead to oral disease.
Equally important are environmental factors, including air quality, access to healthy foods, the cost of dental care, access to transportation to and from the dentist, and school programs that promote good oral hygiene among children. Access to fluoridated water or fluoride treatment is also important because fluoride helps prevent tooth decay. Water quality in communities is another factor. If the only water available is toxic or unappealing, people may turn to soda and other sugar-sweetened beverages.
In addition, mothers’ perceived social support and parents’ social networks may influence their children’s oral health. Among mothers with a high number of cavities, having someone to talk to about the problems was shown to be associated with fewer cavities in their children.
Parents and caregivers’ own oral health significantly affects that of their children. Children and their parents usually drink the same water and many of the same beverages and eat many of the same foods. Children also often follow their parents’ dental hygiene habits. Children also tend to pick up on their parents’ and caregivers’ feelings about dental visits—whether it’s comfort, stress, anxiety, or fear.
Parents’ thoughts about dental care influence their decisions about preventive care. Dental fear and anxiety can cause them and their children to delay or avoid dental appointments. “Oral health values”—the importance placed on maintaining natural and good-looking teeth—influence decisions about dental hygiene and professional dental care. Depression in parents can even affect their own dental hygiene and the oral health of their children.
Dental problems in children can lead to missed school, pain and embarrassment from visible cavities and missing or crooked teeth. Teeth and gums are critical for speech, nutrition, development and appearance. They affect social functioning and enjoyment of food. Children’s dental problems also affect their parents, as they can cause parents to unexpectedly miss work to take their child to the dentist.
Dental problems in children are largely preventable. Some preventive steps are influenced by economic, educational and health factors. One of the best things parents or carers can do is to put their child in touch with a dentist, practice, office or clinic to encourage prevention but also to provide emergency care if necessary. In the world of oral health, this connection is called the “home of the teeth.” The American Academy of Pediatric Dentistry and other professional health organizations recommend that children see an oral health care provider before their first birthday or when the first tooth erupts. Access to dental care, especially preventive care, has been shown to improve oral health in families and their communities.
System-level changes are certainly needed as well. Because cost affects whether parents can provide their children with routine dental care, greater access to dental insurance is an important step toward ensuring equal access and reducing oral health disparities. Integrating oral health practices into schools and educational programs is another system-level change that would benefit all children, regardless of their family’s socioeconomic status.
Oral health is a critical factor in a person’s overall health. Teaching children this early can help them develop a healthy smile and care for their pearly whites throughout their lives.
Daniel W. McNeil is the Eberly Professor Emeritus Clinical Professor Emeritus of Dental Public Health and Professional Practice at West Virginia University. Mary L. Marazita is director of the Center for Craniofacial and Dental Genetics; Professor of Oral Biology and Human Genetics, University of Pittsburgh Health Sciences.
This article was republished by The conversation.