Oral Health: A Doorway to General Well-being

*Lawrence O. Igbinosa, Richard Evbuomwan, Martins A. Okoromu and Uwa S. Osarenkhoe*

#### **Abstract**

At every stage of life, oral health is crucial to overall health and well-being. Good oral health is beyond being free of pain. Maintaining good mental and social health also includes maintaining a healthy grin. The essential actions for observing proper oral hygiene are achieved by brushing, flossing, and consuming sugar-free, healthy foods, quitting smoking to enhance oral health and overall health, and scheduling a routine dental visit. The events of oral health range from Oral health education, primary prevention methods, and secondary prevention measures, and these forms the ingredients for oral health. Tooth decay, gum disease, and oral malignancies are the main illnesses that can have detrimental impacts on oral health. Most of these conditions can be prevented. Diabetes, heart disease, cognitive health, and nutritional deficiencies have all been linked to poor oral health, not necessarily as causative agents but as conditions that may worsen in poor oral health.

**Keywords:** oral health, general well-being, dental caries, periodontal diseases, diabetes, cognitive health

#### **1. Introduction**

The World Health Organization defined health in 1948 as a method that is still used today by world authorities. "Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." Additional refinements were added to the definition in 1986: "A resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities." This indicates that health is a resource to support a person's role in larger society rather than being a goal in and of itself. The ability to live a full life with meaning and purpose is made possible by a healthy lifestyle [1].

Speaking, smiling, smelling, tasting, touching, chewing, swallowing, and being able to communicate a variety of emotions through facial expressions with confidence and without suffering from pain, discomfort, or diseases of the craniofacial complex (head, face, and oral cavity) are all aspects of having good oral health [2]. Regardless of the age of a person, oral health is vital to general health and well-being [3].

The majority of oral health disorders can be treated when they are young and are mainly avoidable. Dental caries (tooth decay), periodontal disorders, tooth loss, and oral malignancies account for the majority of occurrences. Orofacial clefts, noma (a severe gangrenous disease that begins in the mouth and primarily affects young people), and oro-dental trauma are further oral disorders of public health significance.

According to the WHO Global Oral Health Status report from 2022, close to 3.5 billion people worldwide suffer from oral disorders, with three out of every four of these individuals residing in middle-income nations. 514 million children worldwide suffer from primary tooth decay, while 2 billion people are thought to have permanent tooth decay.

Oral diseases globally, have been on the rise. This has been due to increased urbanization and lifestyle changes. The combination of insufficient exposure to fluoride, widespread food with high sugar content, alcohol, tobacco, and reduction in community access to oral healthcare services has led to an increase in disease conditions [4].

#### **2. Components of oral hygiene routine**

Oral hygiene is the practice of keeping the mouth clean and disease-free. It involves brushing and flossing the teeth as well as visiting the dentist regularly for dental checkups.

The most popular oral hygiene technique is using a toothbrush to remove plaque. Brushing the teeth at least twice a day for two to three minutes with gentle pressure, preferably using the Bass technique or its modification, is advised as part of a healthy oral hygiene practice [5].

By flossing, one may get rid of food particles and other debris stuck in tight spaces between the teeth that the toothbrush can not access. This helps to prevent decay from spreading there [6].

Every six months, one should go to the dentist for a thorough examination and prophylactic cleaning. All the brushing in the world will not be able to get rid of calculus buildup. Frequent visiting will enable the dentist to spot and address emerging dental health issues before they worsen [7].

Healthy eating benefits the entire body, including the teeth. The teeth will remain strong and healthy far into old life if one eats a healthy diet high in calcium and other nutrients. This will boost health generally.

Additional dental care supplies might also improve oral health. Overall dental health can benefit from using products like mouthwash, interdental cleaners, and oral irrigators. These items are to complement brushing and flossing rather than replace them [8].

#### **2.1 Elements in oral health programs**

The majority of oral health regimens consist of three primary components. They are;

i.Oral health education/instruction

ii.Primary prevention methods (chair-side and non-chair-side).

iii.Secondary prevention measures [9].

#### *2.1.1 Oral health education/instruction*

Oral health education/instruction usually refers to oral hygiene instruction and/or oral health education. These educational exercises are designed to encourage good oral hygiene habits and to change people's perceptions of and attitudes regarding dental health. Not only do they target kids, but also their parents, teachers, and medical professionals. Schools and clinics frequently conduct oral health education and instructional programs for kids, parents, teachers, and healthcare professionals. The primary objective of oral hygiene training is generally acknowledged to be reinforcing and teaching toothbrushing. The most common methods used to spread oral health awareness are presentations, games, and printed materials. Schools are frequently chosen because they offer easy access to students, parents, teachers, and healthcare professionals [10].

#### *2.1.2 Primary prevention measures*

As a main preventive strategy, fluoride compounds are frequently employed. There is widespread agreement that the use of fluoride has significantly reduced dental cavities. Fluoride is most helpful at preventing dental cavities when a low level of fluoride is consistently maintained in the mouth, according to research. Fluoride can be provided in a variety of ways, including salt, mouthwash, toothpaste, and gels and varnishes that are professionally administered. Water fluoridation is thought to be the most economical method among these treatments for preventing caries. It has been hypothesized that the most significant impact of water fluoridation is not so much the prevention of new lesions but the remineralization of existing carious lesions, which slows or even stops their progression [11].

In poor nations, there are challenges in the implementation of water fluoridation. These challenges include a lack of a secure networked water delivery system and a lack of government backing or willingness. The decision to add fluoride to the water may be influenced in industrialized nations by anxiety over unfounded reports of negative effects and freedom of choice and autonomy arguments from "antifluoridationists" [12].

#### *2.1.3 Secondary prevention measures*

The typical approach utilized in early detection and treatment services is dental screening. Early detection and prevention of caries in primary dentition are crucial in maintaining high preventive levels. Dental procedures are frequently performed in industrialized nations either in permanent dental clinics or through "mobile dental clinics" located in vans that travel to different locations. In impoverished nations, where the price of basic instrument sets, dental supplies, and infection control items is too high and primary health workers are not adequately trained to perform basic oral care, these procedures are neither accessible nor economical. A novel approach to oral healthcare is required in these circumstances [13].

#### **2.2 Risk assessment**

A patient's susceptibility to infection, inadequate healing, bleeding, medication interactions, and physical and emotional capacity to tolerate dental treatment are all factors that must be taken into account in the patient's risk assessment. All these can be done during the preoperative, intraoperative, and postoperative phases. A patient's systemic disease's relative severity can be determined using common medical classification schemes (e.g., angina, heart failure, asthma, chronic kidney disease). Important diagnostic information is also provided by the quantity and kind of medications, test findings, and trips to the hospital or doctor. One approach to creating an international evaluation of the medical state is the American Society of Anesthesiologists physical classification system ASA.

ASA I—Normal healthy patient

ASA II—Patient with mild systemic disease. No significant impact on daily activity; unlikely to have an impact on anesthesia and surgery.

ASA III—Patient with significant or severe systemic disease that impacts daily activity; probable impact on anesthesia and surgery.

ASA IV—Patient with severe systemic disease that is a constant threat to life. Serious limitation on daily activity; major impact on anesthesia and surgery.

ASA V—A moribund patient who is not expected to survive without the operation.

ASA VI—A declared brain-dead patient whose organs are being removed for donor purposes [14].

#### **3. How can oral health affect general well-being?**

Oral conditions are frequently considered separate from other chronic conditions, but these are interrelated. Poor oral health is associated with other chronic diseases such as diabetes and heart disease. Oral disease also is associated with risk behaviors such as using tobacco and consuming sugary foods and beverages.

The link between oral health and general health is complex, multifaceted, and intertwined in such ways that the pathology of one may progress and influence the other. The changes in oral health can impact general health and well-being in various ways.

The presence of oral diseases such as dental caries and periodontitis when left untreated are associated with an increased probability of systemic conditions like cardiovascular disease, pneumonia, and gastritis. Conditions such as diabetes mellitus and uncontrolled hypertension are believed to have oral repercussions which may lead to periodontal disease and tooth loss.

Systemic conditions can present in the orofacial region as initial manifestations of an acute or chronic undiagnosed condition [15]. These manifestations may be the most severe feature of the systemic condition or a dominant cause in reducing the quality of life. They can also vary in frequency and mode of presentation.

The mouth acts as a window to our overall health in so many ways. The oral cavity houses millions of different bacteria. With the proper practice of good oral hygiene, most of the bacteria in the mouth remain harmless [16].

As much as they can cause inflammation in the oral cavity, they can also travel through the bloodstream and instigate inflammation in other parts of the body, contributing to a wide range of problems.

#### **3.1 Diabetes**

Oral infections weaken the body's ability to control blood sugar. Since there is a problem with the regular soon of blood glucose with diabetes, hence this increases its *Oral Health: A Doorway to General Well-being DOI: http://dx.doi.org/10.5772/intechopen.109747*

complications. There's a two-way link between oral health and diabetes: poor blood sugar control increases the risk of gingivitis and periodontitis, while inflammation from gum disease can worsen the regulation of blood sugar [17]. The periodontal disease becomes severe in patients with poorly controlled diabetes. This can be due to the problem of delayed healing associated with inadequate glycemic control. Conditions such as oral ulcers and fungal infections (oral candidiasis) are commonly seen in patients with poorly controlled diabetes [15].

#### **3.2 Heart disease**

Previously, correlations have been found to exist between poor oral health and cardiovascular disease. Periodontitis and Cardiovascular disease are understood to be multifactorial with a significant range of local and general risk factors [18]. Some of these risk factors are believed to be common to both diseases. Associated bacterial infections such as gum diseases as a result of poor oral hygiene can also spread to the heart, stimulating several inflammatory processes in the blood vessels [19]. This will further promote atherosclerosis, which is a hallmark of heart disease.

#### **3.3 Cognitive health**

Maintaining good dental health becomes even more crucial with age. This is due to the connection between having healthy teeth and gums and cognitive wellness. According to clinical evidence, maintaining good oral health may help to maintain brain function and prevent cognitive decline. Over time, brain cells may be harmed by molecules the body makes when it is in a chronic inflammatory condition [20].

#### **3.4 Gastrointestinal system**

More than just the smile might be lost to gum disease. The bacteria that cause gum disease can spread to the digestive tract. Once there, it may kill off helpful bacteria, upsetting the delicate balance required for gut health. It is even more important to take proper care of the mouth, teeth, and gums because of the special connection between the mouth and the digestive system. As the initial anatomic region of the gastrointestinal tract, the oral cavity may show systemic disorders involving the gut. In cases of gastroesophageal reflux disease, patients may present various complaints including halitosis, burning sensation of the tongue, dental erosion, and periodic sialorrhea [21].

#### **3.5 Immune health**

Failing to take care of the teeth and gums can even impact immune health. The inflammation caused by plaque buildup and gum disease can weaken the immune system and make it harder for the body to protect itself. This is bad news for everyone but is particularly harmful if one should have inflammatory or immune-related conditions like inflammatory bowel disease. Poor oral health may exacerbate symptoms and make conditions worse [22].

#### **3.6 Stress response**

One of the main causes of stress' negative effects on the body is the inflammatory process that occurs during the stress reaction. Health issues that heighten the body's

stress response cause a chain of events to occur that lead to low-grade chronic inflammation [23]. Gum disease and tooth decay-related bacteria can start the body's stress response, which increases stress hormones and inflammation [24].

#### **3.7 Nutritional deficiencies**

Impaired or reduced nutritional intake or absorption may lead to different general conditions that can present in the oral cavity. Vitamin A deficiency has been associated with increased severity of the periodontal disease. Vitamin B deficiencies are associated with atrophic glossitis, cheilitis, and burning sensation of the tongue. Vitamin C (Scurvy) deficiency can manifest as gingival bleeding, ulceration, and periodontal disease. Vitamin K deficiency will lead to gingival bleeding. Iron deficiency can lead to glossitis, and can be a risk factor for candidiasis [25].

#### **3.8 Psychological effects**

The presentation, diagnosis, and subsequent management of oral cancers may lead to detrimental effects on the mental health of patients. Management options such as surgical jaw resection and subsequent radiotherapy may leave patients with significant disabilities in their oral cavity. Substitutes such as reconstruction plates, obturators, and/or dentures may be introduced to such patients to help to mitigate the effects of these treatments and reduce the perception of disability [26]. However, such mitigation may not go all the way to providing relief and happiness to these patients. The need to now live a life with a significant oral disability may no longer be meaningful to such patients [27]. Depending on the severity of their deformity, patients may have varying levels of psychological disturbances. From being alone, and lost in their thoughts to developing and cultivating suicidal tendencies.

#### **3.9 Social effects**

Tooth loss and halitosis can greatly affect the way people socialize and communicate, with many withdrawing from social gatherings as frequently as possible. This may be due to their inability to adequately communicate the way they normally would, or difficulty in being understood by their peers [28]. This can lead to problems in maintaining jobs that require adequate communication skills. Socializing among peers may also be affected, as the fear of being ridiculed may push patients to hide within shells of themselves [29]. Patients with halitosis may develop habits of excessive oral hygiene routines which in the long run can be detrimental to their oral tissues. The use of a hard toothbrush to brush away "all smell" with increased frequency may subject the patient to tooth wear lesions (abrasion) [30]. The excessive use of mouth rinses, especially antibiotic mouth rinses may lead to disturbances in their oral microbial balance [31].

#### **3.10 Functional effects**

Feeding is a vital part of daily activities as it provides the necessary nutrients required by the body. The ability to feed and replenish nutrients can be greatly influenced by the state of one's oral health. To adequately feed, one would require the teeth, tongue, and mouth for proper mastication of food [32]. In the case where this may be hindered, nutritional deficiencies will occur. Growth, development, and adequate functioning of the body and mind will be affected generally [33].

#### **3.11 Economic effects**

Oral diseases have overall expenses that include both direct and indirect costs. The direct costs are related to the care provided by dental experts including public and private expenditures [34]. The indirect costs are related to time lost from work, school, or other regular activities as a result of dental problems and treatment [35].

#### **4. Conclusion**

Oral health is an important aspect of overall health and well-being. The mouth is a gateway to the body, and good oral hygiene is essential for maintaining the health of the entire body. Poor oral health can lead to a variety of problems, including cavities, gum disease, and tooth loss, which can cause pain, difficulty eating, and reduced quality of life.

There is a strong link between oral health and general health. Poor oral hygiene can also contribute to other health problems such as diabetes and malnutrition. This highlights the importance of preventive care, including regular dental check-ups, brushing, and flossing, as well as avoiding behaviors that can harm oral health, like smoking and excessive alcohol consumption.

Maintaining good oral health is not only important for individual health but also has economic implications. The cost of dental treatment can be expensive, and untreated oral health problems can result in missed work and reduced productivity.

Thus, oral health is a key component of overall health and well-being. It is important to prioritize oral hygiene and to take steps to protect and maintain it, including regular dental visits and practicing good oral hygiene. By doing so, we can ensure the health of our bodies and improve our quality of life.

#### **Author details**

Lawrence O. Igbinosa1,2\*, Richard Evbuomwan2 , Martins A. Okoromu2 and Uwa S. Osarenkhoe2

1 University of Benin, Benin City, Nigeria

2 University of Benin Teaching Hospital, Benin City, Nigeria

\*Address all correspondence to: surglaw@yahoo.com

© 2023 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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#### **Chapter 7**
