Facts of the Matter – Dental health

Five of many Virgin Atlantic travel toothbrushes, Shirley Parker Levine, New York City

S ince ancient times, the mouth has been viewed as an indicator of overall health. Symptoms of conditions including osteoporosis, eating disorders, substance abuse, sexually transmitted diseases, autoimmune disorders, and some cancers often first appear orally.

• In 5000 BC, Sumerians attributed dental decay to tooth worms, and used modified tree branches to clean teeth. Around AD 700, the Chinese began using a silver paste to treat tooth decay. Monks in Europe practiced dentistry from AD 500 to 1130, when barbers assumed the practice.
• In 1840, the world’s first college of dentistry was established in Baltimore. Today, the profession is ranked as one of the top-paying careers in the United States, yet more than 49 million people reside in 4,230 “dental shortage” areas, where 9,642 more practitioners are needed.
• In 2009, the cost of teeth cleaning in the United States ranged from $50 to $150. In 2008, 42 percent of surveyed U.S. adults ages 18 and older had contacted a dentist in the previous six months. In many countries, many adults have never seen a dentist. A recent survey revealed that in India, nearly 67 percent of adults have never had dental care.
• Worldwide, 60 to 90 percent of schoolchildren have dental decay. Untreated, it can result in painful and dangerous abscesses and a loss of permanent teeth. In the United States, an estimated 27 percent of adults ages 20 to 64 and 20 percent of children ages two to five have untreated dental caries or cavities.
• In developing countries, dental care is often nonexistent, leaving tooth extractions as the only remedy for all but the wealthiest. Pain and infections are among the most common complaints that visiting medical teams encounter, especially in rural areas. Tobacco use, heavy alcohol consumption, HIV/AIDS, malnutrition, and endemic infections result in a disproportionate share of dental caries, gum disease, and oral cancers, especially among disadvantaged populations.
• In 1938, the first mass-marketed nylon toothbrush was sold in the United States. In the 1950s, community water fluoridation and fluoride toothpaste sales began. At that time, more than half of adults over 65 were toothless. Today, the majority of Americans retain their natural teeth throughout their lifetime. Disparities in access to dental care and oral health persist, however, particularly affecting African Americans, Hispanics, American Indians, and Alaska Natives. In the United States, 5 percent of adults ages 40 to 59 have lost all their teeth.
• In high-income countries, oral and dental health accounts for 5 to 10 percent of public medical spending. In the United States, conditions related to these areas result in more than 164 million hours of lost work each year. The most commonly reported complaint is toothache. The World Health Organization calculates that compromised dental health, accidents, and infectious diseases are significant parts of the global burden of disease.