In a 1997 episode of the hit TV show, Friends, Phoebe believes that every time she goes to the dentist someone dear to her dies. She makes the, somewhat ridiculous statement,
But I want to argue today that Phoebe was right…….in a way. Research has shown that, every year in the United States, about 277 people die after being hospitalized with a dental problem. Additionally, about 36 people die in our emergency rooms after attending because of a dental problem. This means that every year over 300 people (close to one per day) die in our hospitals after attending due to a dental condition. Did they die because their dental condition was too severe? Did they die because their dental problem was inappropriately managed by the medical profession (research shows only 67% of dental related emergency visits are managed appropriately by the medical profession)? Or did they die because their dental problem exacerbated a medical condition? The exact cause of death is not known, however, one may argue that if we had prevented the hospital visit we may have postponed the death.
This is research we have conducted over the last 5-7 years and it’s important to note some limitations. We have focused on hospital outcomes – other patients may have died at home, in urgent care facilities or other environments that were not documented and our research is, actually, an underestimation of the true problem!
Dental problems are not taken seriously enough in the United States. While the Patient Protection and Affordable Care act mandated that dental insurance should be offered, it did not mandate that patients must take it. Subsequently, many still lack dental insurance. However, this policy fails to acknowledge the seriousness of dental disease and is a disservice to Americans. Moreover, it is in conflict with cost control in our health system – our own research has shown that, when dental disease is controlled, the hospital charges associated with Stem Cell Transplant and Cardiac Valve surgery is tens of thousands of dollars less per surgery. This is still true after adjusting for confounding factors! The importance of oral health has been misunderstood for far too long and the result is high cost and death.
It is critical to note in our study focuses on periodontal disease and dental caries – both are completely preventable. Is it reasonable that, in a developed nation like the United States in 2016, one person per day dies from a preventable dental disease? I don’t think it is reasonable. While we have extraordinary medical advances like artificial limbs, face transplants and robotic assisted surgery we fail to control a basic preventable disease – 92% of American adults have dental caries and 26% still have untreated dental caries. Why? Because the importance of dentistry has been underestimated and the impact of oral health on systemic health has been misunderstood.