Dental Health

Canada may have one of the best oral health care systems in the world and the oral health of Canadians as a whole has improved considerable over the past 30 years, but Dr. Robert MacGregor, president of the Canadian Dental Association (CDA), says that’s no reason for complacency.

“We need to not only maintain our current high standard of oral health care, but also work hard to help ensure that all communities across Canada have access to oral health care,” says Dr. MacGregor.

This is important because the CDA believes that oral health is an integral part of general health and that all Canadians have a right to good oral health. While dental decay is a preventable chronic disease, a collaborative approach is needed among oral, medical and other health care providers, provincial and federal health departments and educators to combat it.

“Research has shown that there is a link between oral disease and other health problems such as diabetes, heart disease and stroke, as well as pre-term and low-birth-weight babies,” says Dr. MacGregor. “Although researchers are just beginning to understand the link, evidence shows that oral disease can aggravate other health problems and that keeping a healthy mouth is an important part of leading a healthy life.”

The CDA recommends a five-step process to help ensure a healthy lifestyle and reduce the risk of oral disease:

  1. See your dentist regularly – regular dental exams and professional cleanings are the best way to prevent problems or to stop small problems from getting worse.
  2. Keep your mouth clean – brush you teeth and tongue at lease twice a day, and floss once a day.
  3. Eat, drink and be wary – healthy food is good for your general health and your oral health. The nutrients that come from healthy foods help fight cavities and gum disease.
  4. Check your mouth regularly – look for warning signs of gum disease and oral cancer.
  5. Avoid tobacco products – smoking and chewing tobacco can cause oral cancer as well as many other types of cancer and disease.

“Dentists are trained to look for signs of oral disease, which often goes unnoticed and may leads to or be a sign of serious health problems in other parts of the body,” says Dr. MacGregor.

However, while regular dental examinations by a dentist are essential to maintain oral health, Dr. MacGregor says people should also examine their own mouths often to pick up early signs or potential problems.

“For example, sore or sensitive gums, bleeding when you brush or floss, or bad breath that won’t go away could be signs of gum disease, which is one of the main reasons why adults lose their teeth.”

“People should also look for warnings signs of oral cancer, which usually occurs on the sides and bottom of the tongue and the floor of the mouth.  These can include symptoms such as bleeding that can’t be explained, open sores that don’t heal within seven to ten days, white or red patches, numbness or tingling, or small lumps and thickening on the sides or bottom of the tongue, the floor or roof of the mouth, the inside of the cheeks or on the gums,” says Dr. MacGregor.

The CDA says maintaining a healthy diet is good for general health as well as dental health.  Sugar is one of the main causes of dental problems, so the consumption of foods that contain sugar should be limited.

Dr. MacGregor says teaching children good oral health habits from an early age is the best way to help ensure that they will continue to care for their teeth and mouths throughout their lives.

“While dental decay is not reversible, it is preventable in most cases. If people look after their teeth, brush them twice a day, visit their dentist for regular exams and eat sensibly, there’s no reason why they should not keep their teeth throughout their lives,” says Dr. MacGregor.


Experts Agree: Water Fluoridation Saves Teeth

The Canadian Dental Association (CDA) has no doubt that adding fluoride to public drinking water is one of the single most important measures to help reduce the incidence of dental decay.

CDA manager for Dental Programs, Dr. Euan Swan, says there is clear evidence that fluoride helps natural tooth enamel re-mineralize, and it is important that Canadians understand the facts and the benefits of fluoride.

“The appropriate use of fluorides in dentistry is one of the most successful preventive health measures in the history of health care. Over 50 years of extensive research throughout the world has consistently demonstrated the safety and effectiveness of fluorides in the prevention of dental decay,” says Dr. Swan.

The CDA has supported the fluoridation of community water since it was introduced in 1953. The association believes fluoride in drinking water is a safe and effective preventative measure, particularly for communities at high risk of tooth decay.

Dr. Arthur Conn, assistant chief dental officer, Health Canada, says drinking water that is optimally fluoridated is safe and will help protect children’s teeth.

Dr. Swan says research has shown that fluoride can reduce dental decay by between 20 percent and 40 percent in children by protecting and strengthening their tooth enamel. Provincial and territorial governments regulate the quality of drinking water in their jurisdiction. Decisions on fluoridation are made by each municipality in collaboration with the appropriate provincial or territorial authority.  The current level in Canada is set at 0.7 mg per liter of water.

“Science clearly indicates that exposure to fluoride in drinking water as levels below the maximum acceptable concentration of 1.5 mg per liter provide protection against cavities and does not resulting any adverse health effects. Scientific reviews conducted by Health Canada and by a number of international agencies also supports these findings,” he says.

Dr. Swan says that parents who have questions about fluoride for their children should talk to their dentist or to public health officials who specialize in dental health care.

“The CDA’s position is that the weight of scientific evidence indicates that there are no health risks associated with fluoridation at the appropriate levels and that the benefits are very significant,” says Dr. Sawn.

In a letter on the Health Canada website, Canada’s chief dental officer, Dr. Peter Cooney, says the safety and efficacy of water fluoridation has been frequently studied and continues to be supported by current science.

“Canadian and international studies agree that water that has fluoridated at optimum levels does not cause adverse health effects. Canada has one of the best systems in the world to ensure water quality.  Health Canada supports water fluoridation as a public health measure to prevent dental decay.  Dental disease is the number one chronic disease among children and adolescents in Northern America; fluoridation can therefore be an important public health measure,” wrote Dr. Cooney.


Regular Exams Catch More Than Cavities

Anyone who has suffered through the agony of a toothache because they didn’t catch a small problem before it became a big problem will have learned a valuable lesson the hard way – don’t neglect your regular dental examination.
It’s an issue that dentists can’t stress strongly enough: regular dental examinations not only catch tooth decay at an early stage but also help identify many other potential oral health problems before they become serious.
Dr. Bruce Ward, president of the British Columbia Dental Association, says dentistry is all about prevention and early detection.
“Dentistry is focused on keeping patients healthy through preventive care.  Unlike many other diseases or illnesses, dental disease is not reversible.  By the time a patient recognizes that an issue exists, it may be more serious and require more extensive treatment than if identified and diagnosed earlier through a dental exam,” says Dr. Ward.
Aging baby boomers in particular need to pay careful attention to their oral health because of the physiological changes that occur as they get older.
“Gums recede as we age and roots are exposed, which makes them more susceptible to decay.  Many people don’t realize that their gums are receding because it happens slowly.  Regular exams are the best way to identify that the process has started, and what can be done to slow it down,” says Dr. Ward.
In addition, older adults may be exposed to other oral risks that they don’t face when they are younger, such as sore spots from dentures and the effects of diabetes, which can include bleeding gums.
“In general, baby boomers need more maintenance to help prevent periodontal disease, and that means regular examinations,” says Dr. Ward.
Obviously, dental exams are not exactly the same for everyone.  Factors such as age, dental health status, level of general health, medication use and lifestyle choices influence what the dentist will include in the dental exam.
During the exam, the dentist also looks beyond the teeth and the gums.  They will examine all the soft tissues of the mouth including the lips, tongue, cheeks, upper and lower surfaces of the mouth, and the area of the throat at the back of the mouth looking for anything unusual that could suggest oral disease or signs of other health conditions.
For Dr. Lynn Tomkins, president of the Ontario Dental Association, the importance of regular dental exams became very personal when a routine dental exam from her father, Lawrence Preston Tomkins, identified a small swollen area on his lip.  She referred the 85-year-old veteran to an oral surgeon.  A biopsy revealed dysphasia, a precursor to oral cancer.
“I see my father often and never noticed the swelling until I had him in the right environment – the dental chair,” says Dr. Tomkins. “The early signs of oral cancer are very easy to miss, and it concerns me when people aren’t seeing their dentist regularly.”
Dr. Tomkins says dentists, as oral health experts, are in a unique position to help in the early diagnosis of many medical conditions, including oral cancer.
It’s critical that oral cancer be diagnosed as early as possible to increase a patient’s chances of a full recovery.  But signs of oral cancer can be easy to miss unless you know what you are looking for, says Dr. Tomkins.
“Most people see their dentist regularly, so he or she is often the first health care professional to have an opportunity to detect the early signs of oral cancer,” she says.


This article was taken and edited for content from the April 25, 2011 edition of the Globe & Mail 

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