Oral disease contributes to illness burden and disparities

Abstract

Oral health cannot be isolated from physical or mental health and should form part of comprehensive care. Dental disease affects 3.9 billion people worldwide, with untreated caries being the most prevalent condition in the Global Burden of Disease Study 2010.1 In spite of this, disparities in oral ill health receive less attention than those in other chronic illnesses, even though dental disease is significantly more prevalent and severe in socially disadvantaged and marginalised groups. These include people on lower incomes, those born outside Australia, Indigenous Australians and people with severe mental illness.2‐4 For instance, in comparison with the overall Australian population, Indigenous Australians have 2.77 times the prevalence of untreated dental caries,3 while people with severe mental illness have nearly three times the odds of total tooth loss, the end result of untreated caries and gum disease.4

Explanations for these disparities are common across all socially disadvantaged or marginalised groups and include smoking, poverty and reduced access to dental care.2‐4 As with other aspects of physical ill health, high rates of alcohol and substance misuse, smoking and the consumption of carbonated drinks all contribute to poor oral health.2‐4 Dry mouth (xerostomia) is a side effect of many medications, including most antipsychotics, all classes of antidepressants, and mood stabilisers.4 In turn, xerostomia increases plaque formation and leads to caries, gingivitis and periodontitis.