A nonprofit publication of the Kentucky Center for Public Service Journalism

Jeff Rubin: Believe this — your key to better health and quality of life may be right under your nose


Say the words “oral hygiene” to someone and the first thought that comes to mind might be “brushing and flossing.”

However, the term encompasses much more than simply avoiding cavities. So much so, that today more than 200 national dental organizations, including the American Dental Association, have adopted a new definition to draw attention to the term’s significance.

Traditionally, oral health had been defined as the absence of disease. However, as The Journal of the American Dental Association (JADA), recently pointed out, a new definition was necessary “to expand on its many facets,” and convey oral health as a “fundamental human right.” It is a declaration that many people believe is the driving force behind much of what is occurring in oral health today, and part of a major push forward in Kentucky.

As defined by the FDI Dental World Federation, the largest membership-based dental organization in the world, oral health is now described as the ability to “speak, smile, smell, taste, touch, chew, swallow, and convey a range of emotions through facial expressions with confidence and without pain, discomfort, and disease . . .” Coming up with a common definition does more than define the scope of the Federation’s work. It also serves to draw attention to the relationship between oral health, general health, and the quality of a person’s life.

The magnitude of the problem is worldwide, fueled in part by unhealthy diets, tobacco and alcohol abuse, poor oral hygiene, and general environmental and social conditions.

According to the World Health Organization, 60–90 percent of all school children and nearly 100 percent of all adults have dental cavities. Of middle-aged (35-44 years) adults, 15–20 percent suffer from severe periodontal (gum) disease, and about 30 percent of people aged 65–74 have no natural teeth at all.

Here in the United States, despite advancements in dental care and prevention, the state of oral health, particularly among children and older adults, remains equally as alarming. One in five children experience cavities before the age of 17, making tooth decay the No. 1 health issue among our nation’s youth.

One in four older adults 65 and older have lost most, if not all, of their teeth. And overall, 75 percent of our population suffers from some form of periodontal gum disease, according to Oral Health America.

Kentucky: Fifth highest rate of tooth loss

Where does Kentucky rank? In 2012, Kentucky had the fifth highest rate of tooth loss among people 65 and over in the nation. Four out of 10 of our children reportedly never visited a dentist, and over 16,000 uninsured residents turned to an ER rather than a dentist for dental pain.

Lack of dental coverage and affordability are just a part of the equation. A lack of education regarding the importance of oral health, fear of visiting a dentist, inconvenient location or time, particularly among working families with school age children, lack of transportation, distance to, and trouble finding a dentist are all contributing factors.

That is why the work of the Kentucky Oral Health Program (KOHP), and more recently, the Kentucky Oral Health Coalition, is so significant. A part of the Kentucky Cabinet for Health and Family Services, the Kentucky Oral Health Program has a longstanding history of service to Kentucky. At the time it was formed in 1928, KOHP was only the third state public dental health program in the nation.

Over the years, KOHP has made water fluoridation one of its major priorities. Today, our state is considered a national leader in that area, providing approximately 96 percent of Kentuckians with fluoridated water. In addition, KOHP also offers a fluoride supplement program for preschool children whose home drinking water supply is fluoride deficient. The American Dental Society, the Centers for Disease Control, and the Association of State and Territorial Dental Directors have all recognized Kentucky for its efforts.

In 2002, Kentucky also became one of the first states in the nation to introduce a school-based Dental Sealant program for children who might otherwise not have access to regular dental care. Dental sealants are thin plastic coatings applied to the chewing surfaces of back teeth to protect them against tooth decay. Sealants have been associated with reducing the incidence of tooth decay by as much as 40-60 percent.

In more recent years, KOHP has been working in conjunction with the Kentucky Health Coalition and other stakeholders to achieve both state and national objectives. At the heart of its mission are the core beliefs that oral health is an essential component of overall health, access to care is necessary, and oral health is achievable for all Kentuckians.

Working together, they have set priorities to: 1) improve oral health awareness; 2) expand school-based oral health services; and 3) increase access to oral health care by 2020.

The correlation between oral health and wellbeing touches every aspect of our lives. However, some 100 million Americans fail to see a dentist each year, even though regular dental examinations and good oral hygiene can prevent most dental disease. It can also make the difference in how you interact with the world, and how the world interacts with you.

Jeff Rubin is an advocate and adviser on community and aging issues, having spent over 20 years as a director and facilitator of community service programs at the local, state and national levels. An advocate for “Age-friendly” and “Livable” communities, Mr. Rubin is currently working to advance these initiatives statewide in Kentucky and invites your comments, involvement, and support. He can be reached at Jeffrubin515@gmail.com.


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