Editor’s Letter

Diana Swift
Editor-in-Chief
editor@canadian-health.ca

If the eyes are the mirror of the soul, then the mouth is the gateway to the body. Today, oral health is moving to centre stage, full spotlight, as a critical factor in overall health. The teeth and gums are being recognized as vital organs, not just disposable utensils for eating. To ignore their care is to court physical and social disaster. Two cases in point. This year, a young man made the front page of a Toronto newspaper. He was living a life severely limited by a lack of dental care. Over the years, Jason Jones lost almost all his teeth because his working-poor family could not afford regular visits to the dentist. Emergency extractions for agonizing decayed teeth were Jason’s only affordable option.

Photo : Susan Ashukian

By the age of 25, Jason had the sunken cheeks of an edulentous old man and lacked self-esteem and social confidence. He rarely smiled and felt constant pain from the blackened stumps of his four remaining teeth.

In a second case, Moses Han, a 45-year-old father of three, lost his sight and his livelihood to an abscess in a dying molar. The hard-working store operator could not afford the root canal needed to treat it. Despite antibiotics and eventual hospitalization, the infection  spread rampantly to his neck, head and eyes.

These stories, and others like it, underline the pressing need for access to dentistry for those who have neither private nor workplace insurance and do not qualify for the government-funded treatment usually available for citizens with disabilities or on social assistance.

The plights of these two men unleashed public support for giving the uninsured working poor better access to dental care and raised questions as to why oral health is not covered by Medicare. Poor oral health is a magnet for dangerous inflammation and infection. Like open wounds, sick gums are portals through which bacteria enter the bloodstream, promoting the release of harmful inflammatory compounds and increasing the risk of systemic diseases.

Mounting evidence suggests that periodontitis, the chronic inflammation/infection of gum tissue, bone and other tooth-supporting structures, can predispose people to insulin resistance and diabetes, respiratory diseases, rheumatoid arthritis, obesity and osteoporosis. It can play a role in bad pregnancy outcomes such as premature birth and low birth weight and has been linked to hypertension, congestive heart failure, coronary artery disease and heart attack.

According to Dr. Peter Cooney, the country’s chief dental officer, as many as 20% of Canadians struggle to afford dental care. Cooney has a mandate to assess the state of our oral health as part of the Canada Health Measures Survey, scheduled to be completed in 2009. A dental module has been added to evaluate the link between oral disease and major health concerns such as diabetes and cardiovascular and respiratory diseases. The survey also hopes to determine relationships between poor oral health and environmental risk factors ranging from poor nutrition and low income to low education levels. Perhaps the survey results will be an impetus for improving access to affordable dental care.

Jason’s tale has a happy ending. Thanks to the generosity of Dr. Raj Singh — a dentist in Markham, Ont. — he was fitted free of charge with dentures and dental implants. He has a new job and a new outlook on life. But for Moses, his inability to pursue timely dental care has left him facing a lifetime of medical care and social assistance. As the oral-health/overall health link becomes clearer, let’s hope stories like these will
become a rarity.