Poor Dental Health Increases Mortality Risk

People with poor oral health are more at risk of heart attacks and developing different kinds of cancer, a new study in Iran has found.

The study titled “Oral Health and Mortality in the Golestan Cohort Study” published on April 24 in the International Journal of Epidemiology, analyzed oral health of more than 50,000 Iranian participants aged 40 to 75 years over a nine-year period (2004-2014). Among them, 42.4% were men and 57.6% were women, Iran Science Watch website (www.isw.ir) reported.

Fourteen researchers from the Tehran University of Medical Sciences (TUMS) through questionnaires determined each respondent’s frequency of brushing teeth, using of dentures or implants, and decayed, missing, and filled teeth (DMFT). The responses were analyzed by trained physicians and the data used to trace links between oral health and mortality.

There were no previous Iranian studies on the possible association of poor dental and increased mortality.

A total of 3,820 people died during the course of the study, of whom, 1,981 lost their lives to cardiovascular diseases, 839 to cancers, and 217 died in accidents and injuries.

After data analysis, researchers warned that people with poor oral health face the risk of shortened life as it was associated with an increased mortality risk. The results showed that poor oral health can increase risk of mortality by 40%.

According to the study, brushing teeth twice a day or more can significantly decrease the risk of deaths (due to cardiovascular, cancer, diabetes, and chronic obstructive pulmonary diseases).

“Previous studies have found associations between oral health and mortality, but the majority of the studies were conducted in high-income countries,” the study noted.

So far, 15 similar studies have been conducted across the globe, of which 12 have found a strong relationship between poor oral health and increased risk of mortality. Iran is the only developing country which has conducted a study in this regard.

  Dental Awareness Necessary

“People should be made aware of the importance of oral health. Oral health has an impact on physical health, and is associated with chronic conditions including diabetes, heart disease, stroke and cancer,” said Dr Reza Malekzadeh, deputy minister of research at the Health Ministry and the study’s lead author.

Bacteria in the bloodstream (due to an oral infection) can travel to the heart and lead to a heart attack.

The bacteria also may find its way to the inner linings of the heart and valves which in turn create growth pockets of bacteria which cause inflammation and infection of the inner heart linings. Bad oral hygiene can also result in increase of bacteria in the lungs. Oral health also affects psychological development and health. Missing teeth can lead to diminished self-esteem. An individual’s ability to perform basic activities may also be affected by oral health, studies say.

 Statistics in Iran

Tooth decay remains one of the most common chronic diseases in Iran. On average, every Iranian has more than two decayed, missing and filled teeth (DMF) while the global average is 1.8.

One of the reasons for unfavorable dental health conditions is the lack of nationwide promotion of oral hygiene. Furthermore, access to oral healthcare is limited, largely due to inadequate insurance cover and insufficient dental care providers.

“However, over the past two years people’s access to oral healthcare services has improved, albeit marginally,” said Ali Akbar Sayyari, deputy minister of health.

Since the implementation of oral health programs, 7 million primary students in 60,000 schools have received free ‘fissure sealants’ (plastic coatings that are painted on the grooves of the back teeth to prevent food and bacteria from getting stuck in them.) Additionally, 1.6 million received free dental restoration services.

There are 7.4 million primary students in the country studying in more than 61,300 primary schools.

However, so far the focus of oral healthcare has been on improving services in schools and among young students.

 “Further efforts will be made to cover all age groups,” the official said, adding that the ministry has plans to increase access to dental healthcare services in deprived areas.