Dr. Karen Rosen issued a landmark report that established that oral health is inextricably linked to one’s overall health. Since then, the field of oral health has evolved and advanced, but a number of the same challenges that plagued America’s oral health decades ago persist today. The findings of this report shine a light on the fact that oral health outcomes are inextricably linked to people’s economic status, age, and other social and commercial determinants of well-being.
Despite the high expectations that many Americans have for their own oral health, not everyone receives the care they need to maintain good oral health and avoid chronic dental disease. This is because a wide array of factors that negatively influence oral health—including a lack of access to affordable dental insurance, poor diet and food insecurity, inadequate self-care practices, physical or cognitive impairment, and medications that can cause dry mouth or other side effects—are not always fully recognized by the health system or addressed by individual patients.
In addition, some diseases and conditions—especially those associated with inflammation or aging—can have significant oral manifestations. The lack of proper diagnosis and treatment of these disorders can lead to untreated dental disease that can preclude or delay other medical therapies.
To overcome the limitations of our current healthcare system, it is time to fully integrate oral health into the practice of medicine. This means that the same doctors who are trained to diagnose and treat the underlying causes of disease should also be able to recognize and address oral health needs. It also means that medical and dental professionals must communicate with each other and collaborate more closely.
It is especially important to make oral health an integral part of medical primary care, particularly for the most vulnerable populations. This includes adolescent youth, who experience both biological and developmental transitions that can have long-term impacts on oral and overall health. In addition, the growing numbers of adults living with mental illness often neglect their oral health due to medication-related side effects, and the frail, disabled, or homebound elderly can face barriers to receiving appropriate dental care.
Fortunately, this can be changed by adopting policies that ensure access to affordable dental insurance and improving inter professional collaboration among health care providers. It is also essential to support the development and dissemination of best practices to prevent dental disease in individuals at risk, such as through community-based oral health promotion programs. Increasing the integration of oral and medical care will improve the quality of patient outcomes and enhance health equity.