Three Chronic Diseases Relevant to Dental Practices

Three chronic diseases that are relevant to dental practices include: dental caries, periodontitis, and oral cancer.

Dental caries are the most non-communicable disease in dental practices. It occurs due to the development of specific types of bacteria in the mouth that metabolize sugars to produce acid that demineralizes the hard tissues of the teeth.

Periodontitis is an advanced stage of gum disease that involves infection of the gingiva, which can destroy the soft tissue and bone that supports the teeth. It is usually the result of poor oral hygiene, and the inability to remove harmful bacteria from the mouth.

Oral cancer is relevant to dental practices as it can occur on the lips, gums, tongue, inner lining of the cheeks, roof and floor of the mouth. Oral cancer is caused by many risk factors, some of which are: etiological, lifestyle (smoking, heavy alcohol use, excessive sun exposure to lips, HPV, and/or a weakened immune system.

What are the rates of these chronic diseases in Alberta and the rest of Canada?

	Dental caries	Periodontitis	Oral cancer
Canada	6-11 years old: 57% 12-19 years old: 59% Adults: 96% (Government of Canada, 2010)	Adults: 21% (Government of Canada, 2010)	In 2019, an estimated 5300 Canadians were diagnosed with oral cancer. (Badri et al., 2021)
Alberta	Unable to Find. Due to dental caries treatment being largely dealt with through the private sector, unable to find data or reports on the prevalence of dental caries in Alberta.	Unable to Find. Due to periodontitis treatment being largely dealt with through the private sector, unable to find data or reports on the prevalence of periodontitis in Alberta.	Alberta Cancer Registry (2005-2017), 1763 people were diagnosed with oral cavity cancer. (Badri et al., 2021) Alberta has the 4th highest oral cancer incidence after Ontario, Quebec, and British Columbia

The primary determinants for dental caries and periodonititis involve high and frequent sugar consumption in conjunction with poor oral hygiene practices. Low socioeconomic state, low household income, low education, ethnic minorities, refugee and/or immigrant status, as well as poor access to oral health services are factors that contribute to the incidence of certain groups and populations having a higher risk factor for chronic diseases.

For oral cancer, etiological factors, lifestyle, access to care and quality of management of disparities in staging diagnoses are determinants and factors that lead people to become high risk for developing oral cancer disease.

How do dental practices handle these types of chronic diseases?

For the management and prevention of dental caries:

• Scaling and root planning procedures that involve the physical and mechanical removal of cariogenic bacteria from the mouth (the frequency of this procedure can be modified to every 3, 4, or 6 months based on severity).

• Fluoride applications can involve high concentrated rinses, gel, or varnishes. The fluoride prevents dental caries by making the enamel more resistant to the action of the acids.

• Tooth restorative procedures remove the existing dental caries from the tooth and replace it with an amalgam or composite filling.

For the management and prevention of periodontitis:

• Similar to removing bacteria from the mouth scaling and root planning procedures (and frequency) can be done.

• Oral hygiene prescription rinses such as Peridex (chlorhexidine) is a disinfectant and antiseptic that reduces bacteria in the mouth associated to periodontitis.

For the management and prevention of oral cancer:

• Oral cancer screenings are examinations that look for signs of cancer or precancerous conditions in the mouth. Lesions red or white in colour, mouth sores, or lumps or other abnormalities can be physical signs of oral cancer.

• Referrals and access to clinical specialists with suspicious lesions can be made at a dental practice in order to initiate treatment of care for potential oral cancer.

References

Badri, P., Ganatra, S., Baracos, V., Lai, H., & Amin, M. S. (2021). Oral Cavity and Oropharyngeal Cancer Surveillance and Control in Alberta: A Scoping Review. Journal of Canadian Dental Association, 87(l4), 1488-2159.

Health Canada. (2010). Canadian health measures survey (CHMS). Retrieved July 5, 2022, from https://www.canada.ca/en/health-canada/services/healthy-living/reports-publications/oral-health/canadian-health-measures-survey.html