Prevention

5.2.2 Oral health

Our oral health, together with its complex and diverse microbiome, plays ah increasingly recognised role in maintaining health and preventing disease. Oral health extends beyond aesthetics, impacting digestion, nutritional status and systemic inflammation. Disruptions to the oral microbial balance can lead to conditions such as periodontal disease and dental caries, which have been linked to systemic health issues, including CVD and obesity (Petersen et al., 2020; Nazir, 2017).

Link Between Oral Health and Health Outcomes

Periodontal disease has been established as an independent risk factor for CVD (Leng et al., 2023). Elevated inflammatory markers resulting from poor oral health can contribute to systemic conditions, including obesity (Nijakowski et al., 2020). Oral microbiota have been found to influence inflammatory pathways related to obesity, further complicating the interaction between oral health and overall bodily health (Zeigler et al., 2012).

A bidirectional relationship exists between oral health and some chronic diseases. Obesity can exacerbate oral health issues while inflammation from oral diseases can contribute to obesity (Nazir, 2017).

Poor oral health can also contribute to mental health conditions of depression and anxiety. Quality of life assessments consistently demonstrate that individuals with poor oral health report lower health-related quality of life scores, impacting their physical health and psychological well-being as well (Merdad & El‐Housseiny., 2017).

The elderly population can experience greater cognitive decline when oral health is neglected due to the exacerbation of inflammation and compromised cerebral blood flow (Chung & Chan, 2023).

A Strategy for Oral Health

A strategy to improve oral health should factor in the link between dental and medical professions, which often work in silos, and consider influences and interventions for different demographics including age group

Considerations by Age Groups

Prenatal

Pregnant women face unique challenges, including increased susceptibility to periodontal disease due to hormonal changes, which can affect foetal development (Nazir, 2017). Interventions at home focused on nutrition and managing sugary beverage consumption can mitigate risks. For example, education regarding oral health as part of prenatal care can help expecting mothers maintain better oral hygiene, thus promoting healthier pregnancy outcomes.

Ages 0-4 Years

Children aged 0-4 years are particularly susceptible to early childhood caries, often exacerbated by sugary drinks and improper dental hygiene practices. Parents play a critical role in mitigating these risks through dietary choices at home, which ideally should focus on minimizing sugar intake (Nazir, 2017).

Ages 5-14 Years

Children 5-14 years often face compounded oral health challenges as they transition from primary to permanent teeth. Schools can introduce oral health education programs highlighting proper brushing techniques and the importance of routine dental visits. This age group can greatly benefit from preventive care that includes fluoride varnish applications and regular check-ups to stave off dental decay

Parents can reinforce these lessons at home by limiting sugary snacks and encouraging regular brushing.

Community health initiatives aimed at increasing access to dental care in schools can further support oral health in this age group, preventing the onset of dental issues that could carry into adulthood.

Ages 15-22 Years

Altered dietary habits and increased consumption of sweetened beverages impacts this age group in particular. Encouraging good oral hygiene practices and routine dental visits should be incorporated into educational campaigns targeting this demographic..

Age 23-54 Years

Adults face the dual burden of maintaining oral health and managing systemic conditions, necessitating integrated care approaches.

Age 55-70 Years and 70+

The emphasis shifts towards maintaining dental function and managing chronic illnesses, which can significantly impact their quality of life (Petersen et al., 2020)

Policy

Incorporating oral health into general health policies can facilitate a holistic approach to disease prevention and health promotion.

Global health organizations have recognized the necessity for effective oral health policies. The World Health Organization has emphasized the importance of integrating oral health into primary health care and promoting oral health education across communities (Petersen et al., 2020).

Strategies such as water fluoridation, school-based oral health education programs, and funding for dental health services are critical in reducing the prevalence of oral diseases. For example, fluoridation has been shown to significantly reduce dental caries in populations (Ngan et al., 2021).

Legislative and fiscal policies towards sugar consumption, although primarily targeted at the prevention of obesity and chronic disease, may indirectly contribute to improved oral health at population level.

Private Sector

The private sector plays a crucial role in enhancing oral health through innovative products and interventions targeting the oral microbiome.

One significant advancement comes from the development of oral microbiome testing kits, which allow consumers to assess their oral microbial health, directly empower them to make informed dietary and hygiene choices tailored to their microbiome profile (TSLABS).

Probiotics have demonstrated potential in managing conditions such as dental caries and periodontal disease by restoring balance to the oral microbiome. Dental probiotic lozenges or chewing gums containing strains such as Lactobacillus have been shown to inhibit the growth of harmful bacteria while fostering the growth of beneficial bacteria (Porksen et al., 2023).

Smart dental devices, such as Oral-B’s AI toothbrush, which analyzes brushing patterns and provides real-time feedback, ensuring users can maintain optimal oral hygiene practices, particularly among adolescents who may neglect manual brushing techniques (Karimy et al., 2020).

Private dental practices play a significant role in incorporating preventative measures into their services. Education initiatives from private sector entities also contribute to oral health awareness.

Food and beverage companies are increasingly recognizing their role in promoting oral health through product reformulations. Policies that encourage sugar intake reduction are being adopted by some private sectors, aligning corporate practices with public health goals and demonstrating a commitment to community health.