Better access to dental care may have potential benefits beyond Canadians’ mouths

Oral diseases, particularly tooth decay and periodontal (gum) disease, are largely preventable but are some of the most common non-communicable diseases in the world. The pain caused by untreated tooth decay can affect eating and sleeping quality, as well as other basic functions. In fact, the painful nature of toothache earned it the nickname “hell of all diseases” more than 200 years ago.

But pain is only the most obvious of the many ways oral health is related to overall health.

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The federal government recently launched the long-awaited Canada Dental Care Plan (CDCP) to improve access to dental care for the nearly 9 million Canadians who lack dental insurance.

The program comes in light of growing barriers to dental care, with new Statistics Canada data showing one in four Canadians avoid seeing a dental professional due to cost. While this burden primarily affects low-income households, the elderly, and people with disabilities, it also takes a huge toll on the entire population.

In addition to missing time from school or work due to dental problems, many people without access to dental care end up seeking care in hospital emergency departments, needlessly costing the health care system billions of dollars.

The CDCP is an important milestone that will finally allow many Canadians to receive the dental care they need and deserve. At the same time, investments in oral health serve as a reminder of the importance of a healthy mouth, which is critical to overall health, especially as the potential impact of improving access to dental care for those who need it most can extend beyond the mouth.

Oral health is an integral part of overall health

Three men in dark suits stand in front of a sign that reads
NDP MP for Vancouver Kingsway Don Davies and Health Minister Mark Holland listen to questions answered by Public Services and Procurement Minister Jean-Yves Duclos following the dental care announcement on December 11, 2023 in Ottawa.
Canadian Press/Adrian Wyld

The World Health Organization (WHO) defines oral health as “the state of the mouth, teeth and orofacial structures that enables an individual to perform basic functions such as eating, breathing and speaking, and encompasses psychosocial dimensions such as self-confidence and well-being”, as well as in the absence of The ability to socialize and work despite pain, discomfort, and embarrassment.

A healthy, disease-free mouth is key to quality of life and happiness. As the foundation for a variety of basic functions, lack of oral health links it to many chronic diseases in multiple ways.

Read more: Filling the gap: Why Canada still needs a public dental health plan despite decades of Medicare

The latest WHO report shows that nearly 25% of Canadian adults suffer from tooth decay and gum disease, a figure higher than that found in the United States. Importantly, both conditions are the most common cause of tooth loss in adults worldwide, affecting the ability to eat, nutritional quality, and contributing to frailty and cognitive decline in older adults.

Prime Minister Justin Trudeau announced his application for federal dental benefits in December 2022 at a dental clinic at Western University.

Severe gum disease is an inflammatory disease that is linked to several other chronic diseases by exacerbating inflammation in other organs and body systems, and may lead to certain heart and kidney diseases.

Importantly, there is a bidirectional relationship between gum disease and diabetes, with severe inflammation of the gums and supporting bone exacerbating the risks and complications of diabetes, and vice versa.

The consequences of poor oral health can also affect an individual's social interactions. For example, people who have unsightly teeth that are crooked, broken, or stained are more likely to be stigmatized and blamed for the appearance of their teeth. In severe cases, their employment opportunities may be reduced.

Observations such as these are reminiscent of the 19th-century French naturalist Georges Cuvier, the father of paleontology, who famously said: “Show me your teeth and I will tell you who you are.”

Cuvier's statement at the time was intended to describe how the teeth of different populations varied based on diet and environmental influences. Nonetheless, it is not difficult to see its relevance to the appearance and health of the mouth and teeth, and the impact they have on how a person is viewed in today's society.

Children's Health and Dental Care

A boy is being examined.Off-camera by a dental nurse
Canadian kindergarten children who needed dental treatment scored lower on physical, cognitive, social and emotional development than children without dental problems, the study found.

Of course, oral disease affects all ages, and children are no exception. Recent reports show that nearly 39% of Canadian children under the age of 9 have tooth decay. Just like in adults, the effects of tooth decay in children can extend to malnutrition and affect sleep and development.

For example, Canadian kindergarten children who needed dental treatment were found to have lower scores on physical, cognitive, social and emotional development than children without dental problems. Beyond this, researchers found that treatment of severe tooth decay is by far the most common reason for surgery under general anesthesia in children aged 1 to 5 years.

Dental care and chronic disease

The link between oral health and overall health is evident in many ways, creating a need to improve oral health and access to dental care in Canada. It also raises the question of whether dental care can help alleviate chronic conditions outside of the mouth.

The scientific evidence for this varies and depends largely on the chronic disease in question. For example, people with diabetes are one of the groups that could benefit most from better access to dental care. Treating gum disease can help the body regulate blood sugar levels, thereby reducing inflammation in the body and reducing the risks and complications of diabetes.

Notably, Canada ranks fourth among 29 countries in the Americas for lip and oral cancer rates. Many dentists are trained to recognize the signs of oral cancer, which can help catch oral cancer early, which can save lives.

As we learn more about the impact of dental treatments on chronic disease management, we know that promoting access to dental care can produce promising results on multiple fronts. In addition to cost savings for individuals and our healthcare system, it can enhance people's oral health and may help manage some chronic diseases, such as diabetes.

Importantly, it can reduce the widespread and unfair burden of oral disease.

In fact, investing in better access to dental care may bring each of us Canadians closer to a healthy smile and beyond.

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