Reasons to Not Avoid and Delay Dental Checkups

October 11, 2024

By Prof Seow Liang Lin, Dean, School of Dentistry of IMU University.

Dental phobia

Everyone knows they should get their teeth checked at least once a year, but how many do? After all, if it doesn’t hurt, there’s really no need is there?

Many adults may pass on their dental phobia to their children, which sets the stage for the same pattern to repeat itself. This can be detrimental to oral health, among people of all ages.

Sadly, too many people allow minor dental problems to escalate into bigger issues. At the end of the day, by the time most adults drag their feet to the dentists, they are in considerable pain or having functional issues, and the problem requires more extensive corrective action, which usually results in more pain and higher costs. Besides dental decay, gum disease is also prevalent among adults as well as older persons, leading to loosening of teeth and eventual tooth loss. This further reinforces the perception that visits to the dentists are usually painful and unpleasant.

Tooth decay among young children

Among babies and young children, early childhood caries (ECC)is common, and so is tooth decay in older children and teenagers, who are more likely to consume processed foods, sugary snacks and drinks. These, especially with frequent snacking that increases acid production in the mouth, all contribute to tooth decay. Early childhood caries remains a major challenge among the 5 to 6-year-olds in Malaysia. In the last national oral health survey of preschool children, conducted in 2015, the prevalence of caries was 71.3%, and another study showed that 63.4% of the pre-schoolers had at least one decayed tooth in their primary teeth.1

Here’s how to turn things around to encourage better dental care:
Get an early start – Children start to develop teeth from around 6 months of age, and parents should start to familiarise them with dental visits by the time they turn 1 year of age. There are several reasons for this.
Firstly, young children are unable to communicate to us if they are experiencing tooth or gum aches. When they fuss and cry, the more common thought is that they are hungry or colicky. Therefore, parents may not relate this behaviour with tooth or gum pain, and would not think to check inside their mouths. This may lead to unnecessary suffering for the child and allow the problem to worsen.
Secondly, when dental visits are routine and familiar, this allows dentists to reinforce with parents the proper care that is required to maintain the health of their children’s teeth and gums. This allows early detection of any possible problems, and early intervention could save the child a lot of pain, discomfort and other related problems such as malalignment of dentition.
As the child grows older, she advises parents to make use of the dental services available at schools for regular checks and updates on their child’s oral health.
Be proactive – For adults, meanwhile, it is never too late to begin the journey to better oral health, said Prof Seow. If you have always shied away from dental checkups, try bringing a friend along for support or plan for a small treat afterward to help turn a dental visit into something you can look forward to.

Lifestyle habits

Adults need to be more proactive with checkups as lifestyle habits, chronic conditions and other factors are more likely to have an impact on oral health, and may require more frequent visits.

These include:
● Smoking, which reduces blood supply to the gums. This aggravates gum problems and makes subsequent loss of teeth more common among smokers.
● Diabetes, which impacts healing ability. As a result, individuals with diabetes are more likely to have poor gum health. Meanwhile, good gum health has been shown to be related to better sugar control in diabetic patients.
● Cardiovascular disease, as evidence from epidemiological studies indicate a positive association between gum disease (periodontitis) and coronary heart disease. Research shows a close association between chronic infections and gum inflammatory reaction in periodontitis, with significantly higher risks of adverse cardiovascular events.2
● Taking calcium channel blockers, a common drug for hypertension, which carries a risk of developing overgrowth of gums known as gingival hyperplasia. This can make it harder to floss and brush effectively, allowing food particles to get trapped that can contribute to tooth decay and gum disease.
● Radiotherapy treatment, when used to treat cancers of the head and neck, affects the saliva glands. Saliva contains calcium and calcium carbonate to buffer the effects of acids that are produced by bacteria. As a result, with reduced saliva production, there is less protection against erosion and teeth are more prone to decay.
● Taking multiple treatments for different ailments and increasing age can contribute to reduced saliva production

Invest in the relationship – Patients, ranging from one so terrified of checkups that he needed his entire whole family along for emotional support, as well as one whose teeth showed signs of erosion due to self-induced vomiting characteristic of the eating disorder bulimia.

In such cases, a good dentist-patient relationship goes a long way in helping people feel at ease. This can make the overall experience more pleasant so that patients are more likely to go for regular checkups. However, it takes time for trust to develop.

At the end of the day, it is important to find a dentist that you can trust and are comfortable with, she said. Over time, through regular conversation and education, patients’ fears and concerns can be addressed, making them more receptive to guidance.

Moving forward, parents are encouraged to “act as role models” for their children, and work to overcome any personal trauma that prevents them – and their child – from getting regular dental checkups.

Lastly, remember that tooth decay and gum disease don’t develop overnight. In its early stages, tooth decay and gum problems are reversible. By being proactive, you can help to arrest and reverse the disease pattern, and begin your journey to better oral health, and subsequently better general health and wellbeing.

Sources:
1 Lee, Z.L., Gan, W.Y., Lim, P.Y. et al. Associations of nutritional status, sugar and second-hand smoke exposure with dental caries among 3- to 6-year old Malaysian pre-schoolers: a cross-sectional study. BMC Oral Health 20, 164 (2020). https://doi.org/10.1186/s12903-020-01152-0
2 Sanz, M., Marco del Castillo, A., Jepsen, S., et. al. Periodontitis and cardiovascular diseases: Consensus report. Journal of clinical periodontology, 47(3), 268-288(2020). https://doi.org/10.1111/jcpe.13189

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