Download Periodontal disease

Oral Health and Health Care
Oral health
Conception to
Introduction
Birth
Early Childhood
Caries
Despite great strides in improving oral health, disparities still exist across all population
groups. According to Healthy People 2010’s Oral Health Chapter and the US Surgeon
General’s Report, “Oral Health In America”, those suffering the worst oral health are:
Treatment
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The poor, particularly young children and older Americans
Action Steps
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Racial and ethnic minorities
Medically and developmentally compromised individuals.
The two most prevalent oral diseases are Tooth Decay (Dental Caries) and Periodontal
Disease.
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Both are infectious, chronic, progressive, and highly prevalent.
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Both - if left untreated – result in pain, infection, dysfunction, and missed work or school.
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Both are overwhelmingly preventable through self-care.
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Both can be approached through disease management strategies in early stages yet
require surgical interventions if allowed to progress.
Caries is primarily a disease of childhood – typically established during infant and toddler
years and continuing throughout life. Periodontal disease is primarily a disease of adulthood
– typically established during the adolescent years and also continuing throughout life.
Tooth decay
Although preventable – dental caries remains the single most common, chronic disease of
childhood; 5 times more prevalent than asthma (1).
Prevalence : According to Healthy People 2010, one quarter (23%) of all US children have
cavities by age 4. By second grade, one-half (50%) of all US children have experienced
caries. This tremendous but unrecognized prevalence explains why the U.S. Surgeon
General called pediatric caries “the nation’s silent epidemic.”
Distribution : This disease is highly concentrated in low-income and minority children as
80% of the disease is localized in only 25% of children.
NHANES III, US Centers for Disease Control and Prevention
Unmet need : Among children reported by their parents to have one or more unmet
healthcare needs, three times more children have unmet needs for dental care than medical.
Fully one-quarter of parents whose children have special healthcare needs report unmet
needs for dental care.
Newacheck et al Pediatrics 2000 from NHIS
Consequence : Untreated dental disease results in pain, infection, dysfunction, distraction
from learning, and may inhibit general growth and development because of associated
nutritional liabilities.
Periodontal disease
Periodontitis is a chronic infectious and inflammatory disease of the gums and toothsupporting bone. It is the single most common cause of adult oral dysfunction and tooth
loss. It is typically painless until well advanced and produces few signs other than bleeding
gums.
Prevalence : Periodontal disease affects half (48%) of US adults and is particularly
destructive in one-fifth (22%) of US adults.
Distribution : Like childhood caries, periodontal disease disproportionately impacts people
with low income, minority status, and low educational attainment.
Consequence : Periodontal disease is a recognized risk factors for heart disease, inadequate
glycemic control in diabetics and putatively for poor pregnancy and birth outcomes. The US
Surgeon General alerted the public to the link between periodontal disease and poor birth
outcome in 2001.
“ The evidence associating moderate to severe periodontal disease in
pregnant women with low-weight preterm births warrants attention
to the importance of maintaining optimal oral health in pregnancy.
The oral care clinician can contribute to birth defect prevention not
only by treating oral disease, but also by providing educational
messages to patients to promote the birth of healthy, full-term
babies. ”.
The public policy issue: Although the science is as yet uncertain and clinical intervention
trials are now underway at NIH, a number of leading public and private agencies have begun
to alert women of childbearing age about the mouth-pregnancy relationship.
Learning Objectives of Opening the Mouth
The following learning objectives can be met by reviewing the entire Opening the Mouth
program.
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Describe the connection between oral health and overall health
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Characterize dental caries as an infectious, transmissible, communicable disease
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State the prevalence, acuity and consequence of dental disease
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Differentiate the dental care finance, delivery and workforce issues from analogous
medical care issues
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List general action steps that can be taken to decrease oral health disparities
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Describe action steps specific to Title V Maternal and Child Health Federal Block Grant
programs that can be taken to decrease oral health disparities
To learn about these maternal-child oral health issues—from conception through toddler years—you can
follow the experience of Mrs. Perez and her daughter Maria by clicking on the navigation links below or
at left or on the pictures below.
You can follow Mrs. Santos and her baby from pregnancy through the child's second year by
clicking on the photos below
Continue to... Conception to Birth