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Students Expand the Borders of Health
The Most Surprising Chronic Disease
Even if you're a parent, you probably don't know what one of the leading causes of grade-school absences is. It's not just the usual suspects — colds or flu or stomach viruses.
It's oral health problems: toothaches and tooth decay.
“Tooth decay is the number one most common chronic disease in children in the United States — five times more common than asthma,” said Dr. Catherine M. Flaitz, dean of The University of Texas Dental Branch at Houston. “And it's one of the most common reasons for school absences among poor children.”
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Catherine M. Flaitz, dean of The University of Texas Dental Branch at Houston, examines a young patient |
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Even when students with dental problems manage to come to school, they still struggle to learn, Dean Flaitz said.
“How can you learn when you have a toothache?” she said. “You can't concentrate. We see kids who try to distract themselves by acting out. They get labeled as problem kids. These are kids who badly need education – or they're doomed from the start.”
With a long history of service to the underserved, UT Dental Branch has expanded these services in recent years. At the same time, though, its administrators, faculty and students worry about public unawareness of the significance of good dental care. Most people don't understand, they say, how important oral health is to overall good health.
For example, oral health is linked to systemic diseases, such as diabetes and heart disease, and periodontal – or gum – infections are linked to increased risk for premature births, heart and lung disease and strokes. Equally distressing, as a recent article in The New Yorker pointed out, lack of dental care produces powerful social and economic consequences. The poor, who can't afford dental care, often lose their teeth; in a society like this country's, which values and expects healthy smiles, this loss causes them to be less employable and more isolated.
“Nothing smacks more of poverty than someone with a smile of decayed and fractured teeth,” said Dean Flaitz. “Nothing offends people more than someone who has chronic bad breath because of gum disease. Telling those people to get a job and work harder is an unfair expectation in a society that often makes hiring decisions on first impressions. There's a real social stigma associated with oral disease.
“It's something that's very, very obvious, too. You can hide other diseases – but not oral disease.”
Nationwide, 150 million people lack dental insurance – or more than three times the 46 million who have no health insurance, said Doug Simmons, an associate professor at UT Dental Branch. The need for dental care among the uninsured is painfully evident when UT Dental Branch opens its doors for the annual Centennial Smiles program or takes its dental van to schools, health fairs and other community gatherings.
In April, when UT Dental Branch and the Greater Houston Dental Society hosted their Centennial Smiles II program, many low-income families came at midnight to wait in line to see one of the 78 volunteer dentists and other professionals and paraprofessionals the next morning. Volunteers were able to provide basic dental care to about 500 people that day; another 1,500 were urged to return at a later time.
Similarly, the Dental Branch's Community Dental Van, with its three dental chairs, brings pediatric, adolescent, adult and geriatric care to needy areas in Houston. In the aftermath of Hurricane Katrina, the van stayed in the George R. Brown Convention Center next to where evacuees were housed. “We were open all day, every day, for the evacuees,” said Peter Triolo, associate dean for patient care. “The individuals whom we treated were truly the underserved in America and the poor condition of their mouths spoke volumes.”
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