As a primary care physician, I am constantly reminded of the connection between good oral health and a good life.
Oral disease can lead to serious health conditions, including heart disease, blood clots, brain infections and diabetes. But just as importantly, missing teeth and toothaches can make it hard for adults to maintain good nutrition, and can be an impediment to securing and retaining employment. Seniors who have lost all their teeth due to a lack of dental care over their lifetime have self-reported lower quality of life and higher rates of depression. Children with untreated cavities often perform poorly in school.
We need to learn more about oral health’s role in chronic disease. Initial studies are promising. For example, one study showed that periodontal treatment for diabetes patients led to a 40 percent reduction in inpatient admissions and a corresponding reduction in annual health care costs. Other studies have found that periodontal disease increases the ten-year mortality rate for people with chronic kidney disease by nine percent and that oral hygiene problems are linked to incidence of aspiration pneumonia in older patients. Further studies are needed to confirm these findings and investigate additional connections between oral health and overall health.
But even as we work on the science linking oral health to overall health, there is no excuse for leaving people across our country without access to care from dental professionals. Every day, I see suffering caused by a lack of preventive and restorative dental care, especially for people living in rural communities, people of lower socio-economic status, and members of ethnic groups including African Americans, American Indians and Alaska Natives. Due to a combination of lack of insurance and a provider shortage, care remains inaccessible to people of many backgrounds. One out of every 50 emergency department visits are generated by acute dental pain – and that number is increasing.
The good news is that there exists a part of the solution to this oral health crisis that should give everyone a reason to smile – it stands to make people healthier, dentists better off financially and teeth cleaner and more sound. A new category of highly-trained professionals, dental therapists, can and should join dental teams to perform routine and preventive services in a role similar to that of physicians’ assistants in medicine. Our health care system is increasingly moving toward a team-based approach to provide the best care to patients and it would be a mistake for dental practices not to follow the same approach. There’s little doubt: the time for a national surge of dental therapists has arrived.
Matthew Tobey, MD, MPH, Instructor of Medicine, Harvard Medical School,
Associate Director, Massachusetts General Hospital Fellowship Program in Rural Health Leadership
This post is part of a Community Catalyst blog series describing different perspectives on dental therapists at work. Dental therapists are highly trained oral health practitioners who work within dental teams similar to the way in which physicians’ assistants work within medical teams. Along with providing education and preventive services, they are able to