If you are like me, growing up in the 80s and 90s in Zimbabwe, the only time I ever got to see a dentist was when I had a toothache. I was at the dentist’s office and the troublesome tooth was promptly removed. I don’t remember much education about the importance of good dental hygiene beyond brushing. The TV commercials were mostly about Colgate and Close Up and how these toothpastes would make my teeth white if I used them, nothing about flossing or about the importance of dental visits. My parents did ensure I brushed my teeth twice a day, made sure I had my supply Colgate or Closeup and toothbrushes when I needed them.
Fast forward to 1993 when I left Zimbabwe, a few back teeth missing due to cavities. I end up in London and I got my first dental exam abroad almost 8 years later. The only reason I went to the dentist was because the NHS offered free dental care for expectant mothers, I took the opportunity to have the free check up. Well I cannot remember most of what happened at that visit, but I did come out of there with a couple of black horrible mercury fillings in my back teeth. I never went back again. Partly because I didn’t have dirty teeth that anybody could see, my teeth where pearly white when I smiled, and I got compliments on how beautiful they were.
10 years later I move the USA, I chipped a tooth chewing on a piece of bread. That chipped tooth caused me so much agony because it rubbed against my tongue giving me some really bad mouth sores. I had dental insurance which I had never bothered to use, but I found a reputable dentist and made an appointment, again I couldn’t stand the discomfort. That dental visit was different for me, for despite my pearly looking white teeth, it turned out I had some problems with gum disease and a lot of plaque build up that had not been cleaned for some years, if ever. That dentist fixed my tooth, did a deep cleaning scrapping away the plaque and there was no need to extract any teeth. As a matter of fact, he was surprised how many of my teeth back there were missing.
You see, most good dentist will not remove teeth if they can help it, but they would rather save them. I came out of that dentist visit with a $25 000 dental plan on what I needed to be fixed in my mouth. I also came out with a variety of educational materials on gum disease. A dental hygienist taught me about the need and importance of flossing and the best toothpaste and mouth washes to use. My dental plan included the need to remove my other decayed teeth, which included all of my wisdom teeth. In the process learning that I don’t need my wisdom teeth and due to the location of these teeth it is difficult to get a good cleaning of them by regular brushing and they tend to harbor bacteria due to their location. I also needed root canal for that other tooth that had been painful and hypersensitive for sometime, but I had ignored and simply chewed with the other side of my mouth. I studied a little more about dental hygiene to discover the scary truth of the different health conditions that could affect my overall health if I didn’t start taking particular attention to my teeth and gums, and it was not limited to bad breath alone, medically known as halitosis, bad breath was to become the least of my worries. There were some serious if not some life threatening conditions that could come about just because of poor oral hygiene.
Is It About the Money when it comes to oral health?
Socio economic Status and ill oral health is well documented. There is a body of evidence showing that poor oral health is associated with low socio economic status (www.dentalhealth.ie) Why is this important to understand? Well because when most of us leave home for the diaspora, our minds are set on making money by working constantly, going to school, ensuring family we leave at home are taken care of financially and during this process some people tend to neglect the oral health and sometimes overall health. Most people will not spend money on a dentist, unless of course its is because one cannot sleep during a bad sore tooth episode. And some will have a friend remove that tooth for them, sometimes using homemade tools. We all know that one uncle who will gladly and proudly use his skills. This is not an area of importance to spend our hard earned money. It may not be because one does not have the financial means, it could simply be because it may not seem that important. But would it make a difference if people knew otherwise?
Well oral health does hold important clues to overall health and wellbeing. Studies have shown that oral health can provide warning signs for other diseases or conditions.
A Relationship and Link to Heart Disease
Cardiologists (doctors that treat heart disease) and Periodontists (the dentist that treats gum disease) have debated this very link. A review of published studies finds that gum disease is by itself a risk factor for coronary heart disease. (www.m.webmd.com) (Gum disease and Heart Disease). This study shows that people with moderate or advanced gum known as periodontal disease are more likely to have heart disease than those with healthy gums. The warning signs of for gums disease include: Red tender or swollen gums or other pain in your mouth. Most people will notice bleeding gums while brushing or flossing or eating hard food. Gums that seem to pull away from your teeth or receding causing the teeth to look longer than before. Chronic or persistent bad breath, a bad taste in your mouth. Teeth that are loose or separating from each other. Sores in your mouth. (https://www.perio.org)
I personally ignored some of these symptoms for a while. Note also gum disease is often silent, meaning symptoms may not appear until advanced stages of the disease. Being a cardiac nurse for almost 20 years, I have witnessed many patients who need open heart surgery who require teeth extractions due to poor dentine of their teeth, this will often happen prior to the surgery. The Cardiothoracic surgeon knows the ultimate high risk of infection after surgery associated with decayed teeth, untreated dental abscesses, and gum disease. Particularly endocarditis, (an inflammation of the inner layer of the heart).
Cancer and Oral Hygiene… this may shock some of you… but…
People with poor oral hygiene/dental care may have an increased risk of oral cavity cancer. Poor dental hygiene, especially in people who use alcohol and tobacco products, may contribute to an increased risk of oral and oropharyngeal cancer. Poor oral hygiene makes these individuals more susceptible to oral viruses that can cause these mouth and throat cancers. (www.cancer.net). The results of a study by researchers of men who had mild to severe periodontitis in some cases suffered from prostate cancer. These patients with the most severe form of prostatitis also showed signs of periodontitis. (deltadentalazblog.com). There is a link between poor dental care and breast cancer. You maybe 11 times more likely to develop breast cancer if you have poor oral health or gum disease. (Journal of Cancer Research or Treatment). The World Health Organization (WHO) reported a study that concluded that gum disease increases the risk of breast cancer. (www.totalhealthmagazine.com)
Other conditions have also been linked to gum disease, including pneumonia, this happens when the bacteria of the oral cavity causes respiratory diseases. Diabetic patients are more likely to develop gum disease, which in turn can increase the risk of infection. Inflammation that starts in the mouth seems to weaken the body’s ability to control blood sugars. Gum disease further complicates the diabetes because the inflammation impairs the body’s ability to utilize insulin. High blood sugars provide an ideal condition for infection to grow. (www.m.webmd.com). (Oral Health: The Mouth – Body Connection). Pregnant women who have gum disease are more likely to have babies that are born too early and too small.(www.totalhealthmagazine.com). While many other factors can contribute to low birth weight deliveries, researchers are looking at the possible role of gum disease. Some other mouth body connections under investigations include Rheumatoid Arthritis, Lung diseases ie chronic obstructive pulmonary disease, obesity and even infertility. (www.m.webmd.com).
Lets Tie This all together…
Periodontitis or gum disease begins with bacterial growth in your mouth and may end if not properly treated with tooth loss due to destructions of the tissue that surround your teeth. Gingivitis or gum inflammation usually precedes periodontitis. All gingivitis progresses to periodontitis. Usually plaque builds up, causing the gums to become inflamed and easily bleed during teeth brushing as discussed earlier. If the condition is left untreated it progresses the inner layer of the gum and bone pull away from the teeth and form pockets. This space then collects debris and can become infected with bacteria. The disease can progress and the pockets deepen and more gum tissue and bone are destroyed. When this happens teeth are no longer anchored in place, they become loose and tooth loss occurs. Do not ignore red bleeding, tender gums. ( American Academy of Periodontology). Make that appointment to see a dentist. Let it not be a one time visit, schedule regular dental check ups that include cleanings and examinations of your mouth. While regular dental exams and cleanings are necessary to remove this bacteria and plaque and tarter build up and detect gum disease, these dental check ups also could save your life. Learn how to floss if you do not know how. This is an essential part of taking care of your teeth and gums. Floss twice a day to remove the debris in between your teeth and food particles where your toothbrush cannot reach. My dentist recommends brushing teeth at least twice a day including the tongue, the last time before bedtime. I look at this way, if I do not brush and floss my teeth before bedtime, I imagine food rotting in my mouth overnight,,, morning breath anyone?
Fast forward some many years later, I am glad to report that I have not had anymore gum or teeth problems, my $25000 dental and periodontal bill is $0 after many dental visits. My ugly black mercury fillings have replaced by a composite resin that matches the colour as the rest of my teeth. I have had a couple of root canals, a few deep cleanings in the beginning. But that’s all in the past. I now maintain a regular dental cleaning every 6 months and once a year I get xrays of my teeth done, overall excellent dental/oral hygiene. If you have dental issues, start now to a healthy overall you.
About the author Ingrid Muhambi
Ingrid Muhambi RN/BSc, is a Registered Nurse who has been practicing in her profession since 1997. She graduated from the University of the West of Scotland with a Diploma in Higher Education Nursing and also has a Bachelor Of Science in Health Studies from the same institution. She started her career at the Royal Alexandra Hospital in Paisley Scotland and worked in the Coronary Care Unit (CCU) for almost 10yrs. She has remained and specializes in Cardiac Care and Cardiac Nursing for almost 20yrs. Having started her career in the United Kingdom, she now resides in North Carolina in the USA working for UNC/Rex Healthcare as an RN\Team Leader for a cardiac telemetry unit. She has a passion for health, with hopes of educating and getting the message about healthcare related issues to fellow Zimbabweans both at home in Zimbabwe and abroad in the Diaspora.
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I am Dr Brighton Chireka; a GP based in Kent in the United Kingdom. I am passionate about health education and committed to raise health awareness to the general members of the public – www.docbeecee.co.uk. Nothing About Me without Me comes from the realisation that everyone should be involved in anything that will affect their lives. So get involved today!