By: Jean Johnson for Dental1He reaches into his mouth and pulls out two partial dentures. “This delicate one for the bottom teeth is a temporary and too fragile to chew with,” said Jim Carson of Santa Fe, New Mexico. Once removed, gaps between his remaining front teeth and the back molars in Carson’s mouth make large statements. “I had to have this contraption to tide me over after I lost a couple more teeth last spring. It’s pretty awkward when I’m eating a meal with other people since I have to pull it out and then I look like a toothless old refuge.”
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“This top partial plate – it’s metal, and strong enough to bite on, no problem. I’ve had it for several years now. It bails me out since I lost all my chewing teeth on the upper side here. Also there’s this missing one over here too that it takes care of.” Carson points to the tooth just behind the canine on the opposite side. Despite the remaining upper and lower teeth that given the front of his mouth some semblance of normally, the gaps in the rest of Carson’s mouth are reminiscent of a toothless smile carved into a crooked-faced jack-o-lantern.
“Even these remaining teeth – there are eight on top and seven on the bottom, 15 out of the 28 normal teeth we all have to start with – are all crowned except for the four bottom ones in the front,” Carson said, reinstalling both of his partial plates.
“What it boils down to is that if I weren’t willing to take money I’d probably spend on replacing my 94 car at least a couple times, and funnel it into dental implants – I’d be clattering around in dentures like most folks in my situation do. But I just couldn’t see not biting into an apple or eating corn fresh off the cob any more. I’m only 52.”
If the Centers for Disease Control (CDC) has its way, today’s children will come of age with better prospects for oral health than Jim Carson did. Its recent report, complete with goals for the year 2010, states that dental caries or tooth decay “is the single most common chronic disease of childhood, occurring five to eight times as frequently as asthma.”
Experts also point out that “despite the reduction in cases of caries in recent years, more than half of all children have decayed teeth by the second grade. They add that “by the time students finish high school, about 80 percent have caries.” The report concludes by underscoring the obvious point that Jim Carson appreciates all too well. “Unless arrested early, caries is irreversible.”
Elevating tooth decay to the number one chronic disease facing children today and linking that to outcomes in oral health as people age has spurred the CDC to set targets for increasing rates of oral health education and reducing rates of decay in discrete populations within the nation. Those among the 60 percent of the population that reside in communities served by fluoridated water have a clear edge, and experts want to see this development, that grew most significantly between 1945 and 1980, resurrected so that underserved groups begin to benefit as well.
Further, although Jim Carson, with his biology degree and Caucasian heritage seems to be anomaly, the CDC report concludes that rates of oral health care are related to race, ethnicity, education level and disability status. “Since the early 1970s, the cases of dental caries in permanent teeth have declined dramatically among school-aged children.” Researchers go on to credit fluoride in both water and toothpaste as well as dental sealants applied to children’s teeth. Still, they note that “dental caries, however, remains a significant problem in some populations, particularly racial and ethnic groups and poor children.” They also note that children in households where adults have not graduated from high school tend to suffer disproportionately when it comes to their teeth.
The CDC has done all the responsible things in the oral health care section of its Healthy People 2010 report. The center included the tables that show the disparities, set targets for children, adolescents and adults, not to mention point out that the profession of dentistry lags behind multicultural trends and remains a largely white bastion.
Certainly good progress took place starting in the 1970s once problems were identified and solutions like education about brushing and eating habits, not to mention access to fluoridation were made available. That the remaining 40 percent of the population will be harder to reach simply complicates the task.
From Jim Carson’s perspective, though, all the trouble it will take is worth it. “Just look at me. The thousands and thousands of dollars I’ve spent over the years and continue to spend – it’s been a real handicap in my life,” Carson said. “And it wears on your ego, too. Especially in an urban, industrialized society like ours where appearance is important.” He adjusts one of his partial plates that’s come away from his gums. “We need to give all our kids a chance at an even start, and helping them learn how to take care of their teeth is one big way.”
