For many people, oral health care comes down to regularly brushing and flossing their teeth, and visiting the dentist twice a year. The reality is that only some people brush their teeth regularly, or floss, and even with dental insurance, those biannual dental visits are only sometimes attended.
In truth, oral health care often takes a backseat to other aspects of wellness. While exercise, diet, primary care, and mental health are widely recognized as essential, oral health care is frequently overlooked or prioritized less.
"[People] don't understand that not going to the dentist every six months because you don't feel anything, doesn't mean things aren't going on in your mouth," said Dr. Quodarrius Toney, an Atlanta-based dentist and founder of The Art of Aesthetics Dental Studio. "There is more to your mouth than just your teeth. Things are all connected under your gums which can lead to other health problems."
"There have been studies that oral health is directly correlated to heart and brain health. A lot of times when we think, 'Hey, I have a broken down tooth, it's not bothering me. I can leave it in there.' It's like having an open wound in your mouth. If you get sick it's a direct correlation to affect your heart or brain. There are bacteria that are associated with dental caries that can lead to those types of problems."
Black (42%) people, ages 20-64, experience untreated tooth decay at a higher rate than their white (22%), Hispanic (36%), and Asian (17%) counterparts, according to the National Center for Health Statistics (NCHS).
Black children, according to the Centers for Disease Control and Prevention (CDC), make up 28% of all children, ages 2-5, to have cavities in their primary teeth. Hispanic children account for 33% and white children 18%.
Dr. Toney reports that approximately 70% of his patients are Black. A common dental hygiene issue among his patients is inconsistent brushing, particularly neglecting to brush before bed. He emphasizes the importance of nighttime brushing, as the mouth's closed environment and rising body temperature create optimal conditions for bacterial growth.
"When I look at the differences between ethnic backgrounds, a large majority of our community is suffering from periodontal disease, which is a chronic inflammatory infection that affects the bony structures that support your teeth," said Dr. Keith James, DDS, who serves as the Chief Innovation Officer for Dentfirst Dental Care.
Periodontal disease, also known as pyorrhea or more commonly gum disease, is a bacterial infection that affects the gums, bone, and ligaments of the teeth. Symptoms include swollen, red, or bleeding gums, bad breath, and an unpleasant taste.
Dr. Keith continues "If you're not an avid flosser or going to the dentist on a regular basis, you build up bacteria. If you've ever gone over a bridge and you see the pillars, you see those barnacles that are there. That is the type of stuff that surrounds people's teeth. The bacteria in the mouth coralize and become what are called capsules."
Periodontal disease disproportionately impacts African Americans. According to the CDC, approximately 60% of African Americans aged 45 to 74 suffer from moderate to severe periodontitis, a significantly higher rate compared to other racial groups.
Heart disease, hypertension, and diabetes are the three health conditions associated with Black people in the United States. Periodontal disease is connected to each of these health conditions.
The same build-up in a person's mouth is simultaneously happening to that individual's blood vessels, causing the blood vessels to constrict and making the heart pump harder to get blood to the body. As the heart pumps harder, it continues to grow, because it is a muscle. And that's how oral heathcare can increase someone's chances of heart disease.
"It can increase your chance of stroke if some of those barnacles break off into your bloodstream and hits your brain. You can have erectile dysfunction, or low-birth-weight babies or not be able to get pregnant at all. There are so many different ways that this affects us," Dr. Keith said.
A report from the American Dental Association's Health Policy Institute (HPI) reveals significant disparities in dental care access among Black adults. While approximately 41% of Black adults aged 19-64 visit a dentist annually, a concerning 20% are unable to obtain necessary dental care due to cost-related barriers.
Common barriers to getting quality dental care include lack of dental insurance or insufficient dental insurance coverage, and inability to find dentists who accept a particular dental insurance provider.
However, people have more options to obtain quality dental care than they realize.
Dr. Keith says that some dental offices have discount plans, which are membership plans where people can get discounted rates on procedures. The way that it works is people pay an annual fee instead of a monthly or annual premium, and with this plan, they should receive lower prices on dental services.
Additionally, patients can use CareCredit, which is a credit card specifically for medical expenses. CareCredit can be used for dental work and it allows the patient to spread out their dental payments.
"Go to your dentist or find a dentist that you're comfortable with, and just ask those questions like, 'If I don't have dental insurance what are other ways that I can afford treatment here, or what are other vehicles that I can use to get treatment done in your facility,'" Dr. Keith said.
Outside of going to a traditional dentist's office, patients can also go to their local health department which will either provide dental services or recommend affordable options.
"Find your nearest dental school, they have all dental treatment at a reduced price," said Dr. Toney. "When I was in my teens, my grandmother used to take me with her to the University of Tennessee Health Center in downtown Memphis. The student doctors would work on my grandmother. It would cut down the cost by 60%-70%."
"We want our entire body to be healthy. Just as you see your physician make sure you go see your dentist. Brush twice a day, floss once a day."