HJAR Jan/Feb 2024

HEALTHCARE JOURNAL OF ARKANSAS I  JAN / FEB 2024 45 Niki Carter, DMD, MPH Dental Director Delta Dental of Arkansas fpsyg.2018.00746 5 Bhatnagar, D.M. “Oral Health: A Gateway to Overall Health.” Contemporary Clinical Dentistry 12, issue 3 (July-September 2021): 211-212. doi: 10.4103/ccd.ccd_597_21 6 Kapila, Y.L. “Oral health's inextricable connec- tion to systemic health: Special populations bring to bear multimodal relationships and factors con- necting periodontal disease to systemic diseases and conditions.” Periodontology 2000 87, issue 1 (October 2021): 11-16. doi: 10.1111/prd.12398 7 Păunică. I; Giurgiu, M.; Dumitriu, A.S., et al. “The Bidirectional Relationship between Periodontal Disease and Diabetes Mellitus-A Review.” Diag- nostics (Basel, Switzerland) 13, issue 4 (Feb. 11, 2023): 681. doi: 10.3390/diagnostics13040681 8 Thouvenot, K.; Turpin, T.; Taïlé, J.; et al. “Links be- tween Insulin Resistance and Periodontal Bacte- ria: Insights on Molecular Players and Therapeutic Potential of Polyphenols.” Biomolecules 12, issue 3 (Feb. 28, 2022): 378. https://doi.org/10.3390/ biom12030378 9 Nazir, M.A. “Prevalence of periodontal disease, its association with systemic diseases and pre- vention.” International Journal of Health Sciences (Qassim University) 11, issue 2 (April-June 2017): 72-80. PMID: 28539867 10 Kochar, S.P.; Reche, A.; Paul, P. “The Etiology and Management of Dental Implant Failure: A Re- view.” Cureus 14, issue 10 (Oct. 19, 2022): e30455. doi: 10.7759/cureus.30455 11 Matsuyama, Y.; Jürges, H.; Dewey, M.; Listl, S. “Causal effect of tooth loss on depression: evidence from a population-wide natural experi- ment in the USA.” Epidemiology and Psychiatric Sciences 30, e38 (May 25, 2021): 1–8. doi: 10.1017/ S2045796021000287 12 Paul, O.; Arora, P.; Mayer, M.; Chatterjee, S. “In- flammation in Periodontal Disease: Possible Link to Vascular Disease.” Frontiers in Physi- ology 11 (Jan. 14, 2021): 609614. doi: 10.3389/ fphys.2020.609614 13 Bourgeois, D.; Inquimbert, C.; Ottolenghi, L.; Carrouel, F. “Periodontal Pathogens as Risk Fac- tors of Cardiovascular Diseases, Diabetes, Rheu- matoid Arthritis, Cancer, and Chronic Obstructive Pulmonary Disease-Is There Cause for Consider- ation?” Microorganisms 7, issue 10 (Oct. 9, 2019): 424. doi: 10.3390/microorganisms7100424 14 Cotti, E.; Cairo, F.; Bassareo, P.P.; et al. “Perioper- ative dental screening and treatment in patients undergoing cardiothoracic surgery and interven- tional cardiovascular procedures. A consensus report based on RAND/UCLA methodology.” In- ternational Endodontic Journal 53, issue 2 (Feb- ruary 2020): 186–199. doi: 10.1111/iej.13166 15 American Cancer Society. “Explore Cancer Statistics.” Accessed November 2023. https:// cancerstatisticscenter.cancer.org/#!/cancer -site/ Oral%20cavity%20and%20pharynx 16 Chi, A.C.; Neville, B.W.; Krayer, J.W.; Gonsalves, W.C. “Oral manifestations of systemic disease.” American Family Physician 82, issue 11 (Dec 1, 2010): 1381-8. PMID: 21121523 17 Abid, M.; Javed, F. “Knowledge of Medical Prac- titioners about Periodontal Diseases and Its Im- pact on Overall Health: A Cross-sectional Study.” Cureus 10, issue 5 (May 28, 2018): e2694. doi: 10.7759/cureus.2694 18 Burroughs, A. Dry. June 2023. https://libquotes. com/augusten-burroughs/quote/lbk5e4t referral to a physician. On exam, the den- tist may find tissue changes such as atro- phic glossitis, mucosal pallor or candidia- sis, which could be a sign of anemia or an auto-immune disease. Unexplained ulcers intraorally may be associated with pemphi- gus vulgaris or Crohn’s disease. Variegated or alteredmelanin pigmentation could be an early manifestation of Addison’s disease. 16 Periodontal inflammation or bleeding could be present in patients with diabetes, throm- bocytopenia, or leukemia. 17 Erosion of teeth could be the result of bulimia, anorexia ner- vosa, or gastroesophageal reflux disease and often requires complex restoration when the erosion is advanced. In summary, Augusten Burroughs said it well, “When you have your health, you have everything. When you do not have your health, nothing else matters at all.” 18 Delay- ing dental care often delivers poor health outcomes, which include lengthy appoint- ment times that, in turn, equal lost time. Time lost takes on a new meaning when considering health conditions, such as dia- betes or heart disease, which can worsen with delayed dental treatment. Time is a cov- eted commodity that cannot be regained, so it is better spent by keeping regular dental visits. n REFERENCES 1 Kranz, A.M.; Gahlon, G.; Dick, A.W.; Stein, B.D. “Characteristics of US Adults Delaying Dental Care Due to the COVID-19 Pandemic.” JDR Clini- cal and Translational Research 6, issue 1 (January 2021):8-14. doi: 10.1177/2380084420962778 2 Choi, S.E.; Mo, E.; Sima, C., Wu, H., et al. “Im- pact of COVID-19 on Dental Care Utiliza- tion and Oral Health Conditions in the United States.” JDR Clinical Translational Research. 2023 April 21, 2023: 23800844231165016. doi: 10.1177/23800844231165016 3 American Dental Association. “Dental mar- ket FAQs.” Accessed November 2023. https:// www.ada.org/resources/research/health-policy- institute/dental-care-market 4 Svartdal, F.; Granmo, S.; Færevaag, F.S. “On the Behavioral Side of Procrastination: Exploring Be- havioral Delay in Real-Life Settings.” Frontiers in Psychology 9 (May 16, 2018): 746. doi: 10.3389/ good oral hygiene, these lesions can and most likely will grow. If the carious lesion is allowed to thrive, it can reach the nerve of the tooth, becoming painful to the patient or even infecting the nerve. Lesions that reach the nerve infect the tooth, and root canal intervention is re- quired in order to save the tooth. In some cases, the tooth is so infected and damaged that extraction is the only option. Losing a tooth as a result from decay is unfortunate, as it is an entirely preventable and manage- able disease when caught early. Procrasti- nating dental visits can be a poor choice and can result in harsh outcomes the person must deal with for a lifetime. One of the most important reasons of not delaying dental visits, if not the most impor- tant, is the oral cancer screening the dentist performs. Early detection is essential in all types of cancers, and oral cancer is no ex- ception. The dental healthcare professional checks for irregularities that can occur in the mouth and throat, and externally on the neck, cheeks, and under the chin. Color variances, lumps, bumps, swelling, and any suspicious area on these tissues are carefully examined by the dentist. In Arkansas, there are an estimated 570 new cases and 100 deaths for the category of oral and oropharyngeal cancer for 2023. 15 The majority of cases are not difficult to treat, but many are diagnosed at later stages, and the malignancy has progressed. As with oth- er types of cancers, if not diagnosed early, it grows and is not detected until the advanced stages. Advanced cancers require more of an aggressive approach, which can result in the loss of teeth, jaws, or regrettably, a life. Nothing is worth losing a life, be it cost, fear, or convenient appointment times. There are other conditions that occur in the oral cavity that signal the need for