Why a healthy smile is the key to long-term vitality

fOr, much of human history, aging meant losing teeth. Many historical portraits feature stoic, tiny herd subjects, and do their best to hide rotten teeth. The advances in dentistry and public health made it a large part of the time. For Americans, Edenturism, or complete loss of teeth, is no longer considered inevitable, and we can expect to maintain our teeth for most of our lives today.

Despite these developments, important room for improvement remains. Between 2009 and 2014, the Centers for Disease Control and Prevention found that approximately 40% of American adults over the age of 30 and 60% of Americans over the age of 65 suffered from periodontitis and severe gum inflammation caused by tooth decay.

This problem goes far beyond oral hygiene. As dentists and researchers uncover the link between oral health and chronic diseases, they discover that the healthier the teeth and gums, the healthier the body becomes. For a longer and better life, our teeth and gums deserve to be seen better.

Gateway to Health

At that root, periodontal disease is an inflammatory state. Invasion of anaerobic bacteria at the teeth-bone junctions unleashes a cascade of immune responses. Once oral bacteria enter the system, they can further promote inflammation either through the airways or wounds.

Research over the past few decades has demonstrated a link between poor oral health and diabetes, heart disease, autoimmune disorders, and even dementia. All of these are suspected to be inflammatory diseases. This makes sense. The surface area of ​​oral tissue is roughly the same as that of the palm of your hand. Inflammation to such areas has been shown to exacerbate the effects of high sugars in diabetes and to damage the endothelium of the arteries in vascular disease. Periodontal therapy is known to reduce the levels of inflammatory markers in the blood, such as C-reactive proteins.

Inflammation is not the only way to affect oral health. In a systematic review, 15 studies have found that daily toothbrushes reduce the incidence of death in patients admitted to intensive care units. Older people with teeth are more likely to develop depression and report social isolation. Because having teeth makes us talk a lot and fully engaged in the community. These nutrients are usually found in nutritious foods such as meat and vegetables, and therefore have been discovered at low levels of iron and vitamins A and C in the blood of elderly people with dentures. Both are difficult to chew.

Teeth even plays a role in financial security and success. Economist Shelley Gray, a study by Matthew Niedel found that women from low-income households who grew up in counties with water fluorination earn 4% more wages than wages without fluoride access. The authors ruled out factors such as these groups choosing different jobs or being more or less productive to each other. They concluded that the difference in wages was primarily that the healthier smiles of subjects meant that employers (and possibly tilting customers) prefer them.

The Golden Age of Dentistry

Over the past 20 years, dentistry has made incredible technological advances. Teeth-colored composites can barely see the filling. They need to survive longer in the mouth and remove healthier dental structures than older materials, as they have less risk of new decay. The crown can be color matched using artificial intelligence and fit with custom scans. The first human trial of drugs that regrowth lost teeth began in September 2024. Scientists are developing a cavity vaccine that could potentially target it Streptococcus mutanbacteria that cause teeth decay.

Patients can receive the crown generated from the 3D mouse scan within the same day as the visit. Rather than needing to be anesthetized in the operating room, very young children could be completely arrested with a thin coat of silver diamine diamine fluoride.

Dental implants revolutionized tooth replacement by providing a natural look that is fully integrated with the jawbone. For people who lack all teeth, dentures attached to only two implants in the lower jaw can dramatically improve their ability to chew while making the denture look more natural. In the future, laboratory-grown teeth may offer biological replacements that can fully restore smiles.

The question today is how can good dental treatment be reached for everyone?

Health delegation

Dental problems were more common among the wealthy than among the poor, mainly because the rich people access sugar and promote cavities. George Washington had multiple dentures in his life. While it is hard to imagine a US president today to shorten teeth, vulnerable groups such as low-income, rural and marginalized elderly people are far more likely to experience tooth loss. These individuals often face barriers to dental care throughout their lives, from childhood toothaches that have been locked out of school to jobs that do not provide dental insurance.

To exacerbate these issues, Medicare, the leading insurance company for Americans over the age of 65, does not cover routine dental care. The Social Security Act law, implemented in 1965, blocks Medicare from covering dental care. My research shows that when individuals lose access to employer-sponsored dental insurance and sign up for Medicare, they have an almost 5% increase in missing teeth. Today, only half of adults over the age of 65 visit dentists every year. President Joe Biden proposed Medicare dental benefits at the 2021 Build Back Better Building, but was removed before the law was passed. The efforts that followed have been stagnant.

Dental care must be accessible from a childhood in order for everyone to benefit. Evidence-based strategies for improving oral hygiene include increasing the number of dentists accepting Medicaid, expanding the types of dental services they cover, and adding professional enforcers to the workforce that resemble nurse practitioners.

Less than a third of dentists accept Medicaid. This is the main insurance for low-income Americans. In many states, Medicaid doesn't provide limited dental coverage to adults or at all. The rural dentist's workforce is generally as old as the rural workforce, and younger dentists are more likely to practice in urban and suburban areas.

Even the fluorination of water in communities, the bedrock of dental public health, has been attacked due to concerns about neurotoxicity, despite fluoride in public water supply far below dangerous levels. Fluorination, which has been formed in children and continues to prevent cavities in adulthood, explains many advances in oral hygiene in the 20th century. The baby boomer generation was the first to benefit from fluoride in water as a child. Today, many rural communities rely on well water or other decentralized water sources that have not yet been interfered with.

Ultimately, the future of oral hygiene may rely on cutting-edge innovations to make basics available to everyone, such as access to fluoride, routine dental care, and affordable treatments. Our smiles and our health span can depend on it.

Explore the emerging science of health span in other stories This special report.