Oral Health is Crucial to Overall Health, says JAMA

The July 24/31 issue of the American Medical Association's publication JAMA includes an article titled "The Importance of Oral Health in Comprehensive Health Care".This article is an excellent summary of the connection between oral and systemic health, as well as the value of the oral cavity in diagnostic and preventive medicine.

Dental caries is a widespread condition. If untreated, dental caries can lead to severe and costly oral and systemic manifestations. The CDC’s National Health and Nutrition Examination Survey, 2011-2012, identified the presence of dental caries in 91% of the adult US population. In the pediatric population, dental caries is the single most common chronic disease of childhood. In addition, overall health care costs continued to increase between 1996 and 2013 for both children and adults. This, coupled with reductions in dental coverage and limited access to routine and preventive dental services, has increased emergency department visits for basic dental services and has disproportionately affected lower socioeconomic and minority groups.

The financial burden of lost days from work due to dental and oral diseases and the expense of care outweigh the costs for prevention. This imbalance is readily seen in osteoradionecrosis of the jaw (ORN), a preventable disease with severe consequences, including poor bone and oral healing, bone necrosis, and fracture after dental trauma such as extraction of nonsalvageable teeth. ORN most often occurs following radiation therapy for oral cancer. Financial costs can be a barrier for access to treatment for ORN, yet appropriate treatment of dental disease prior to radiation therapy can reduce the complications associated with ORN. Oral conditions such as ORN may result in difficulty chewing and poor nutrition, acute or chronic pain, increased risk for opioid dependence, and a decrease in quality of life.

To meet the challenge of widespread dental diseases, oral health examinations should be implemented in multiple venues beyond dental practices and clinics. Physicians have an important role by providing a thorough oral evaluation and referral when warranted... Federally qualified health centers and accountable care organizations are service delivery models that, with increased attention to coordinated interprofessional care, should help address the challenges of access to care. Other models are being evaluated, such as the community health worker and increased use of newer technologies like teledentistry. Such practices, which show promise for improving access to care, could be closely coordinated with primary care models to provide the most comprehensive health care possible.

This article provides further evidence for our approach to building a stronger foundation and support for our students and graduates as leaders in helping everyone in our communities lead healthier lives through our expertise and understanding of oral health and the value we bring to comprehensive health.