Prairie Doc Perspective: The disease that's hidden in plain sight

Debra Johnston, M.D.
The Prairie Doc
Debra Johnston, M.D.

If I asked you to name a chronic disease, you would probably think of conditions like high blood pressure, diabetes, cancer, or dementia. The odds are, one of the most common chronic diseases would never cross your mind.

World wide, this condition affects over 3 billion people, and causes significant physical and emotional suffering. Annually it costs the American economy upwards of 45 billion dollars in productivity. Our children miss nearly 35 million hours of school. Our emergency rooms field nearly 2 million visits.

So, what is it? Dental disease.

Those of us whose experiences with dental disease have been limited to the occasional cavity, or perhaps wearing braces for a year or two, may be tempted to dismiss it as an inconvenience or annoyance, not a threat. No doubt this impression is reinforced by the artificial distinction the insurance industry draws between our teeth and our bodies.

However, an unhealthy mouth can lead to what we all understand to be a serious medical illness: pneumonia, bloodstream infections, and malnutrition, to name a few. It is linked to heart disease and preterm birth. It can worsen other underlying diseases, such as diabetes. And many conditions, or their treatments, can in turn worsen oral health.

In addition to the physical suffering, dental disease can cause significant social consequences. How often do we say, without even thinking, “They have a nice smile?” Consciously or not, we assess people by their teeth. Those with visible dental disease are acutely aware of this judgement. I almost never saw my wonderful mother in law with a full smile on her face, no matter how happy she was. She was just too aware of her discolored and crooked front teeth. The consequences are more severe for many others: lost job or educational opportunities, lost social standing, relationships that don’t move forward. Dental diseases can affect not just the appearance but the function of the mouth, impacting speech and communication, and even the fundamental daily activity of eating.

Preventing dental disease begins very early in life, and continues indefinitely. Most people know brushing, flossing, and seeing a dentist regularly are important. They may know that sugar and tobacco are bad for their teeth, and athletes probably know they should wear mouth guards. Many people do not know that cavities are contagious: the bacteria that contributes is often spread from person to person, especially parent to child. They may not know that their sports drink or diet soda is acidic enough to damage the enamel protecting their teeth.

A healthy mouth is fundamental to health. When was your last trip to the dentist?

Debra Johnston, M.D. is part of The Prairie Doc® team of physicians and currently practices family medicine in Brookings, South Dakota. Follow The Prairie Doc® at and on Facebook.