Dental

Bad Breath: More Than Just a Foul Smell? Research Affirms the Need For Regular Dental Care
by Karen Gustin, LLIF

Bad breath; it’s a delicate subject. Few people readily volunteer to tell someone that their breath smells bad. An offer of a piece of gum or a mint can be a tactful way to approach the problem. However, for more than 50 million people whose bad breath may be a symptom of periodontal disease, breath odor won’t be solved easily with chewing gum or mints.

Periodontal disease, or gum disease, is caused by bacteria that progressively attack the gums and hidden roots of teeth, according to the American Academy of Periodontology. It begins with bacteria in the mouth forming a sticky plaque that hardens into tartar on the teeth. Tartar can irritate and infect the gums when it forms under the gum line. If it’s not removed regularly, this serious oral condition destroys the soft tissue and bone that supports teeth, making it a major cause of bone loss.

Periodontal disease has often been characterized as a disease that only affects older people, but recent dental and medical research has shown that it can attack the gums of younger people as well. Periodontal disease is estimated to affect more than one in three people over age 30.
Periodontal disease has a significant effect on oral health. But dental and medical professionals also believe it is a risk factor for other serious health concerns as well, such as cardiovascular disease, diabetes, rheumatoid arthritis, chronic kidney disease, and even some forms of cancer.

New Communications Opportunities for Producers

Americans spend $8 billion to $12 billion each year just for periodontal care, not to mention medical expenses incurred for other health concerns, according to the National Institute of Dental and Craniofacial Research. Producers have a unique opportunity to explain to employers how dental insurance can address the growing concern about how periodontal disease affects employees and productivity, performance, and associated higher medical costs. Consider the following ways periodontal disease affects the health of employees:

Women’s Oral Health Issues

Periodontal disease may be a health risk for women due to hormonal fluctuations at various stages of life, according to the Journal of Periodontology. The rise in hormone levels during puberty can lead to swollen and sensitive gums and mouth sores. Women who are taking oral contraceptives may have gingivitis and dry socket, whereas women who are pregnant are at risk of developing inflamed gums, which can result in gum disease. Pregnant women, who are diagnosed with gum disease, are more likely to have pre-term, low-birth-weight babies. Women commonly develop dry mouth and sore and sensitive gums during menopause. The American Academy of Periodontology advises women to take extra steps to maintain good oral health during the transitional stages of their lives in order to avoid periodontal disease.

Periodontal Concerns for Men

Men are less likely to brush their teeth regularly or seek preventive dental care, according to the Academy of General Dentistry. They often ignore their oral health for years, scheduling a dental visit only when problems arise, which makes them more likely candidates for periodontal disease. Men need to pay close attention to changes in their oral health, such as persistent bad breath, loose teeth, or red, swollen, sore or bleeding gums, and promptly seek assistance from a dental professional.
Older Workers Face Coronary Issues

Researchers with the American Academy of Periodontology have determined that people with periodontal disease have a higher risk for coronary heart disease, with twice the risk of having a fatal heart attack. More than 700 types of bacteria are found in the mouth. When bacteria travels from bleeding gums into an open blood vessel, they cling to platelets inside the blood and may eventually cause a partial blockage in the blood flowing to the heart, resulting in a heart attack. About 85% of heart attack patients have periodontal disease.

Other Major Health Care Concerns

• Cancer – The National Cancer Institute (NCI) reports that pancreatic cancer is the fourth leading cause of cancer-related death in the United States, with more than 30,000 Americans succumbing each year. Less than 5% of people diagnosed with pancreatic cancer survive more than five years. Pancreatic cancer is extremely difficult to treat and little is known about exact causes. However, NCI researchers found that people with periodontal disease have higher levels of oral bacteria, which may contribute to the development of pancreatic cancer. The studies also report that men with periodontal disease have an increased risk for getting this type of cancer.

• Rheumatoid Arthritis -- More than 1.3 million Americans suffer from rheumatoid arthritis, which is a chronic inflammatory disease of the joints. This disabling condition, which often leads to long-term joint damage, is accompanied by pain and loss of function in affected areas. Researchers with the American Academy of Periodontology have discovered that people with rheumatoid arthritis are eight times more likely to have a higher incidence of periodontal disease.

• Type 2 Diabetes -- People diagnosed with periodontal disease are twice as likely to become diabetic in the following 20 years, according to medical researchers at Columbia University Mailman School of Public Health. Periodontal disease is believed to alter people’s metabolic condition, contributing to the progression of Type 2 diabetes. Gum infections allow bacteria to enter the bloodstream and affect the body’s ability to remove glucose, which is sugar from the blood. This makes it harder for people to control their diabetes and may eventually lead to increased vision problems, cardiovascular and kidney disease, and circulation issues that could result in amputation.

Periodontal Treatments Control the Problems

Periodontal disease is a serious health concern. But the good news is that it is preventable. In additional to regular dental checkups for cleaning and oral health evaluations, people should always brush after meals, floss daily, and use an antiseptic mouthwash to maintain good oral health and keep the rest of the body healthy. For some people, periodontal disease is serious enough to require some type of advanced treatment, such as surgery.

The Need for Dental Insurance

Dental insurance can influence employees’ use of dental care options, according to the Dept. of Labor’s Bureau of Labor Statistics. About 80% of workers will participate in benefit programs if dental care is included in their benefits package. However, only 46% of employees nationwide have access to dental care through their employers’ benefit programs.

The National Association of Dental Plans (NADP) reinforces the importance of dental benefits in a new report, “The State of the Dental Benefits Market, 2007.” It explains that employees want quality dental plans with extensive services instead of plans with limited coverage features. This is true even if the benefits are offered as voluntary options. Employees also want immediate access to dental benefits and they don’t want to wait to meet plan use restrictions. NADP reports that employees are more likely to choose the higher-benefit plan option when they have a choice between a high-benefit voluntary option and a low-benefit one.

The Importance of Communication and Education

Producers have an excellent opportunity to communicate with employers about the health risks of periodontal disease and how dental benefits can help employees prevent or treat this serious oral health concern. Dental carriers offer different benefit plan options, which means that producers have to evaluate plan designs carefully to find the right choices for their clients. As you evaluate the dental needs of employer groups, you may find it easier to work with experienced insurance carriers that can design customized plan solutions to serve the needs of employers and employees.
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Karen M. Gustin, LLIF, is vice president-group marketing and managed care for Ameritas Group, a division of Ameritas Life Insurance Corp. (a UNIFI Company), with headquarters in Lincoln, Neb. Ameritas is a provider of dental and eye care products and services. Gustin’s tenure with Ameritas Group spans 25 years. She is involved with the National Association of Dental Plans (NADP), serving on the board and as the vice-chair of the Research Commission.