Are you ready for another acronym? We human beings love to embrace these linguistic short cuts in our efforts to show off our perceived understanding of complex issues. NCDs! Have a quick practice and commit these three letters to memory. Non Communicable Diseases (NCD) is the buzz word term of the day. Does oral disease and systematic health have a bidirectional association? This means that there is a two way relationship between these things. The state of our teeth and gums has a bidirectional connection with the development and existence of NCDs.

Understanding The Relationship Between Oral Health & Our Wellbeing

What is the import of this emerging understanding within the health sciences?

“Oral diseases are highly prevalent worldwide. Recent studies have been supporting a potential bidirectional association of oral diseases with systemic noncommunicable diseases (NCDs). Available evidence supports that people with NCDs have a greater prevalence of oral diseases particularly those with limited ability of oral self-care. Regarding the reverse relationship, the lines of evidence pointing out NCDs as putative risk factors for oral diseases have increased significantly but not with a consistent agreement. “
– Nature.com

First and foremost, medical science experts are paying a lot more attention to the state of a patient’s dental health. Chicken or egg? Which bidirectional association is primary? The jury is still out on this but studies indicate the fact that if you have poor oral health you are far more likely to have a serious NCD.

“Twenty-eight NCDs were strongly associated with oral diseases. Among those NCDs are five types of cancer, diabetes mellitus, cardiovascular diseases, depression, neurodegenerative conditions, rheumatic diseases, inflammatory bowel disease, gastric helicobacter pylori, obesity, and asthma.”
– Botelho, J., Mascarenhas, P., Viana, J. et al. An umbrella review of the evidence linking oral health and systemic noncommunicable diseases. Nat Commun 13, 7614 (2022). https://doi.org/10.1038/s41467-022-35337-8

Recognition & The Return Of The Formerly Exiled Dental Care

In Australia, we have an artificially imposed barrier between the care of our teeth and the rest of our body. This was imposed via the economic model of our universal healthcare insurance scheme, Medicare, excluding dental care. This has had the effect of isolating dentistry from the body of medical science in a number of ways. Oral health became an outlier from the main body of healthcare. Dentistry is to a large degree not subsidised by the state. Dentists stand alone cut off from the socialised medicine teat. Exile from main street means neglect and indifference can occur at academic levels. Oral disease & systematic health: A bidirectional association is having the effect of putting dental health care back on the map. A newly found respect for dentistry is beginning to emerge out of this recognition. 
– Sarah R Barker on X.com

“The World Health Organization (WHO) approved, in 2021, a Resolution on oral health, urging key risk factors of oral diseases shared with other NCDs12. Instead of the traditional curative approach, WHO caveats the importance of prevention encompassing oral health in universal health coverage programs. Over 3.5 billion people are estimated to suffer from oral diseases, and the associated burden is likely to remain or increase…”
– Botelho, J., Mascarenhas, P., Viana, J. et al.

The Science Tells Us You Can’t Separate Oral Care From Systematic Health

Dentists can walk tall once again or, perhaps, for the first time. No more operating in the shadows of the snobbery of ‘real’ doctors. Our dentists have long been considered mere technicians plying their trade on the fringes of the healthcare model. Renewed professional respect can only further the vocational enrichment of dentists beyond their hip pocket concerns – no longer mercenaries wielding electrical drills but valued members of the wider healthcare profession. A brave and sensible federal government would, in many views, correct the mistake made at the inception of Medibank/ Medicare and bring dental care into the fold of our universal healthcare insurance scheme, here in Australia. Let us see the return of our teeth and gums to the greater body of our physical wellbeing being cared for by our Australian government in economic terms.

Australia has one of the best socialised medicine systems in the world. Imagine what the current cost of living crisis would be like if Medicare did not exist and ‘user pays’ rapaciously fed on our already struggling working poor. For too long economics has been a case of the tail wagging the dog. The scientific evidence does not recognise artificial barriers established on financial grounds. This exclusion of oral care has contributed to the prevalence of poor standards of oral health among the greater population of Australians. The growing divide between rich and poor is clearly illustrated on the dental front, where wealthier Aussies have access to world class dental care and poorer citizens do not, especially in regional Australia and among Indigenous Australians.

Oral Health Now Ranks Highly In The Eyes Of The Experts

Oral health is vitally important to the general health and wellbeing of human beings. The evidence from numerous reputable studies confirms this fact. The impetus this provides the realm of dentistry is undeniable. Governments and institutions need to get on board to make the necessary changes required to save lives and improve the wellbeing of all Australians. Oral care should not be a luxury for the growing number of Australians doing it tough in the current economic clime. Generational neglect of Indigenous Australians places the great majority of these folk well down the wealth ladder. ‘User pays’ models of healthcare will not assist these members of our communities to achieve basic standards of oral health – quite simply because they cannot afford it and the dental care services are not available where they live.

ADA Calls For Greater Government Investment In Australian Oral Health

The Australian Dental Association (ADA) wants greater federal government investment in subsidised oral healthcare programs to address the gulf. This the main guild of dentists in Australia has long been calling for this.

“Ratilal Lalloo, from the University of Queensland’s School of Dentistry, says poor oral health is associated with other chronic health conditions.(ABC News: Curtis Rodda) Dr Lalloo says the vast unmet demand for oral health care across Australia highlights the need for “a significant increase and injection of funds” into the public dental sector over the long term and believes treatment should be included in Medicare. The Greens have called for dental treatment to be covered under Medicare and estimate the policy would cost about $77 billion over a decade.”
– ABC.net.au

Governments wishing to reduce the incidence of NCDs among the Australian population would be well advised to listen to the growing calls for greater investment in oral health. Closing The Gap is a campaign to draw attention to the huge divide between the standards of health, wealth, and education of white Australia compared with Indigenous Australians. Making oral health a vanguard approach on the health front may well help close the gap.

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