Recent decades showed marked improvements in the field of oral
health. However; the gap is still large. Oral health remains underestimated in
many parts of the world. The concept of dealing with oral diseases as one of
the preventable non-communicable ones needs more attention. Some people
consider it as a welfare. Such a thought is supported with the high expenses of
oral health care. Besides, even most of those who realized its importance,
cannot have adequate access either regarding availability or financial support.
In fact, oral health is the mirror of general health. This
theme should be taken into consideration when dealing with this global health
issue. Hold on it is critical!
Oral cancers are lethal especially that they are kept hidden
for long periods of time. Fatal conditions are not only restricted to cancers
but also include other conditions that may seem simple although they are not! Do
you know that you can have an oral infection and die from swelling and suffocation
if not treated? Do you know that simple periodontal pocket which can progress
to periodontal abscess, severe bone loss and disfigurement, may also lead to
death of bacteremia?
From another perspective, oral diseases have a lot of social
implications. For example, dental caries not only causes pain and eating
difficulties, but also it affects speech, esthetics, social communication, in
addition to significant reduction in productivity in adults and academic
performance in schools for children.
Although, I used to raise the theme that primary level of
prevention is the key of success, I intend to talk here from a different
perspective. After I handled the readings of the last two weeks, I realized
that politics and health care systems share a great responsibility! How can we
blame people for their behaviors without providing the MINIMUM essentials to maintain
their oral health?! Although, the problem is over-presented in developing
countries due to extreme lack of resources, it is also well established in
developed ones which ensures the globality of this threat. Here, in US we see
dental insurance being separated from health insurance, as if they are separate
entities! Moreover, dental insurance is so expensive, that cannot be afforded
by many people, and also with limited benefits! As I understand, this is one of
the critical consequences of neoliberalism in health care. Privatization, free
markets and focusing on the capital on the expense of patient benefit is a
disaster. I know one of my colleagues, in the US, who is currently having pulp exposure and
is in bad need of root canal treatment. However, she couldn’t afford the fees!
She is suffering a terrible pain and is on extreme high doses of analgesics,
which is destructive to her general health, to keep her life on till she
arranges her financial situation. How sad the condition is! What makes me even
more frustrated, that I am talking about one of the developed countries. What
about developing ones? How can we manage and face this neoliberal monster that
is attacking and destroying health equity and justice? What can we do, as
public health professionals, for such an issue? How can we save our populations
and improve their health conditions taking into consideration these global political
and commercial considerations?
Salma, you are correct in that oral health is a window into overall health. Before I knew that I was pregnant with my first child my dentist pose the question to me. I laughed because I was thinking you are only a dentist. When I asked him why he thought I was pregnant, he indicated something about my gums and teeth to which I laughed again. Later I found that I was indeed pregnant. I share that story because many times our oral health does affect our overall health and well-being causing increases in health care cost. In developed countries we seem to be more concerned with treating parts of the person instead of the entire person. We are not interested in prevention but cures. Many companies do not offer oral health benefits, because it is not a necessity and when they do it is at exuberant prices and only covers the minimum and basic requirements. i believe that we have to start thinking of health from a holistic point of view than piecemealing everything. Oral health affects mental health, CVD etc., etc., and mental health affects oral health etc., etc. I believe that with globalization we should look at some of the Eastern philosophies and medicines and incorporate that into our practice of healthcare from a holistic, treat the entire man, point of view and then maybe we will see changes.
ReplyDeleteExcellent post and questions Salma. What can we do indeed? Look at the readings more and see if you get more answers. There is a lot we can do and talking about this, analyzing this is another step in that direction.
ReplyDeleteSalma, I love how you bring your personal field of expertise into the discussion! Beyond social implications of oral deformities, I really hadn't considered oral health in a global context. I love Chris's story about her dentist discovering she was pregnant, and it does raise awareness of the interconnectedness of all dimensions of our health. It is interesting to me that medical school covers the rest of the medical profession, and that dentistry school is isolated. Eye doctors and dermatologists go to medical school, so why is oral health cast into its own category? This may lead to some of the lack of understanding of the link between oral and general health.
ReplyDeleteThe post also made me question why oral health issues seem to be so much more severe in other countries. Yes, in the US many of us (or at least of the people I have interacted with in my life) have access to regular dental care, get cavities filled and teeth cleaned at least every few years. But I have never had a cavity for them to treat! So why is that? I had preventive care from my dentist, but I also had proper access to hygienic measures and the tools and time for brushing and flossing, etc. You mentioned oral cancers being a problem as well, and in the US we have much better awareness than a lot of other nations of the dangers of tobacco use. It is amazing how many outside factors with simple fixes are influencing oral health. These low-cost, high-impact measures could be really useful in improving global oral health and therefore general health, mentally and physically.