Canada may have one ofthe best oral health caresystems in the world, and

the oral health of Canadians as awhole has improved considerablyover the past 30 years, but Dr.Robert MacGregor, president ofthe Canadian Dental Association(CDA), says that’s no reason forcomplacency.

“We need to not only maintainour current high standard of oralhealth care, but also work hard tohelp ensure that all communitiesacross Canada have access to oralhealth care,” says Dr. MacGregor.

This is important because theCDA believes that oral health isan integral part of general healthand that all Canadians have aright to good oral health. Whiledental decay is a preventablechronic disease, a collaborativeapproach is needed among oral,medical and other health careproviders, provincial and federalhealth departments and educatorsto combat it.

“Research has shown that thereis a link between oral disease andother health problems such asdiabetes, heart disease and stroke,as well as pre-term and low-birth-weight babies,” says Dr. Mac-Gregor. “Although researchersare just beginning to understandthe link, evidence shows thatoral disease can aggravate otherhealth problems and that keepinga healthy mouth is an importantpart of leading a healthy life.”

The CDA recommends afive-step process to help ensure ahealthy lifestyle and reduce therisk of oral disease:

1. See your dentist regularly-regular dental exams and profes-sional cleanings are the best wayto prevent problems or to stopsmall problems from gettingworse.

2. Keep your mouth clean-brush your teeth and tongue at leasttwice a day, and floss once a day.

3. Eat, drink and be wary-healthy food is good for your gen-eral health and your oral health.The nutrients that come fromhealthy foods help fight cavitiesand gum disease.

4. Check your mouth regularly– look for warning signs of gumdisease and oral cancer.

5. Avoid tobacco products –smoking and chewing tobaccocan cause oral cancer as well asmany other types of cancer anddisease.

“Dentists are trained to look for

signs of oral disease, which oftengoes unnoticed and may leadto or be a sign of serious healthproblems in other parts of thebody,” says Dr. MacGregor.

However, while regular dentalexaminations by a dentist are es-sential to maintain oral health, Dr.MacGregor says people shouldalso examine their own mouthsoften to pick up early signs ofpotential problems.

“For example, sore or sensitivegums, bleeding when you brushor floss, or bad breath that won’tgo away could be signs of gumdisease, which is one of the mainreasons why adults lose theirteeth.

“People should also look forwarning signs of oral cancer,which usually occurs on the sidesand bottom of the tongue andthe floor of the mouth. These caninclude symptoms such as bleed-ing that can’t be explained, opensores that don’t heal within sevento 10 days, white or red patches,numbness or tingling, or smalllumps and thickening on the sidesor bottom of the tongue, the flooror roof of the mouth, the inside ofthe cheeks or on the gums,” saysDr. MacGregor.

The CDA says maintaining ahealthy diet is good for generalhealth as well as dental health.Sugar is one of the main causes ofdental problems, so the consump-tion of foods that contain sugarshould be limited.

Dr. MacGregor says teachingchildren good oral health habitsfrom an early age is the best wayto help ensure that they will con-tinue to care for their teeth andmouths throughout their lives.

“While dental decay is notreversible, it is preventable in

most cases. If people look aftertheir teeth, brush them twicea day, visit their dentist forregular exams and eat sen-sibly, there’s no reason whythey should not keep their teeththroughout their lives,” says. Dr.MacGregor.

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inside: Regular exams catch morethan just cavities

All kids deservegood dental care

Tobacco use andoral cancer linked2 4 6

online? Visit the Canadian Dental Association at cda-adc.ca, on Facebook (Canadian Dental Health) or Twitter at @MyDentalHealth.

It starts in childhood,butmaintaininggoodoralhealthcalls for lifelongcare

There are nine recognized dental specialties in Canada.

Depending on specific treatment needs, dentists may refer

patients to a specialist in one of the nine areas of specialization.

Dentists become specialists by successfully completing an

accredited advanced education program in the specialty field of

their choice and hold such specialty designation from a Provincial

Dental Regulatory Authority. The nine specialties are:

1. Dental Public Health

2. Endodontics

3. Oral and Maxillofacial Surgery

4. Oral Medicine and Pathology

5. Oral and Maxillofacial Radiology

6. Orthodontics and DentofacialOrthopedics

7. Pediatric Dentistry

8. Periodontics

9. Prosthodontics

Specialists for all patients’ needsDr. RobertMacGregor

FACTS AND BENEFITS

T he Canadian Dental As-sociation (CDA) has nodoubt that adding fluoride

to public drinking water is oneof the single most importantmeasures to help reduce theincidence of dental decay.

CDA manager for DentalPrograms, Dr. Euan Swan, saysthere is clear evidence that fluo-ride helps natural tooth enamelremineralize, and it is importantthat Canadians understand thefacts and the benefits of fluoride.

“The appropriate use of fluo-rides in dentistry is one of themost successful preventive health

measures in the history of healthcare. Over 50 years of extensiveresearch throughout the worldhas consistently demonstratedthe safety and effectiveness offluorides in the prevention ofdental decay,” says Dr. Swan.

The CDA has supported thefluoridation of community watersince it was introduced in 1953.The association believes fluoridein drinking water is a safe andeffective preventative measure,particularly for communities athigh risk of tooth decay.

Dr. Arthur Conn, assistantchief dental officer, Health

Canada, says drinking waterthat is optimally fluoridated issafe and will help protect chil-dren’s teeth.

Dr. Swan says research hasshown that fluoride can reducedental decay by between 20 percent and 40 per cent in childrenby protecting and strengtheningtheir tooth enamel. Provincialand territorial governmentsregulate the quality of drink-ing water in their jurisdiction.Decisions on fluoridation aremade by each municipality incollaboration with the appro-priate provincial or territorial

authority. The current level inCanada is set at 0.7 mg per litreof water.

“Science clearly indicates thatexposure to fluoride in drinkingwater at levels below the maxi-mum acceptable concentrationof 1.5 mg per litre providesprotection against cavities anddoes not result in any adversehealth effects. Scientific reviewsconducted by Health Canadaand by a number of internation-al agencies also supports thesefindings,” he says.

Experts agree: water fluoridation saves teeth

Fluoride, Page CDA 3

Dental health

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This report was produced by RandallAnthony Communications Inc. (www.randallanthony.com) in conjunction with the advertising department of The Globe and Mail. Richard Deacon, National Business Development Manager, rdeacon@globeandmail.com.

A nyone who has sufferedthrough the agony of atoothache because they

didn’t catch a small problembefore it became a big problemwill have learned a valuable les-son the hard way – don’t neglectyour regular dental examination.

It’s an issue that dentistscan’t stress strongly enough:regular dental examinations notonly catch tooth decay at anearly stage, but also help identifymany other potential oral healthproblems before they becomeserious.

Dr. Bruce Ward, presidentof the British Columbia DentalAssociation, says dentistry isall about prevention and earlydetection.

“Dentistry is focused on keep-ing patients healthy throughpreventive care. Unlike manyother diseases or illnesses, dentaldisease is not reversible. By thetime a patient recognizes that anissue exists, it may be more seri-ous and require more extensivetreatment than if identified anddiagnosed earlier through a den-tal exam,” says Dr. Ward.

Aging baby boomers in partic-ular need to pay careful attentionto their oral health because of thephysiological changes that occuras they get older.

“Gums recede as we age androots are exposed, which makes

them more susceptible to decay.Many people don’t realize thattheir gums are receding becauseit happens slowly. Regular examsare the best way to identify thatthe process has started, and whatcan be done to slow it down,”says Dr. Ward.

In addition, older adults maybe exposed to other oral risksthat they don’t face when theyare younger, such as sore spotsfrom dentures and the effectsof diabetes, which can includebleeding gums.

“In general, baby boomersneed more maintenance to helpprevent periodontal disease, andthat means regular examina-tions,” says Dr. Ward.

Obviously, dental exams arenot exactly the same for every-one. Factors such as age, dentalhealth status, level of generalhealth, medication use and life-style choices influence what thedentist will include in the dentalexam.

During the exam, the dentistalso looks beyond the teeth andthe gums. They will examine allof the soft tissues of the mouthincluding the lips, tongue,cheeks, upper and lower surfacesof the mouth, and the area of thethroat at the back of the mouthlooking for anything unusualthat could suggest oral disease orsigns of other health conditions.

For Dr. Lynn Tomkins,president of the Ontario DentalAssociation, the importance ofregular dental exams becamevery personal when a routinedental exam for her father, Law-rence Preston Tomkins, identifieda small swollen area on his lip.She referred the 85-year-old vet-eran to an oral surgeon. A biopsyrevealed dysplasia, a precursor tooral cancer.

“I see my father often andnever noticed the swelling untilI had him in the right environ-ment – the dental chair,” saysDr. Tomkins. “The early signsof oral cancer are very easy tomiss, and it concerns me whenpeople aren’t seeing their dentistregularly.”

Dr. Tomkins says dentists,as oral health experts, are in aunique position to help in theearly diagnosis of many medicalconditions, including oral cancer.

It’s critical that oral cancer bediagnosed as early as possible toincrease a patient’s chances ofa full recovery. But signs of oralcancer can be easy to miss unlessyou know what you are lookingfor, says Dr. Tomkins.

“Most people see their dentistregularly, so he or she is oftenthe first health care professionalto have an opportunity to detectthe early signs of oral cancer,”she says.

The Canadian Dental Associa-

tion defines oral health as a

state of the oral and related

tissues and structures that

contributes positively to

physical, mental and social

well-being and the enjoy-

ment of life’s possibilities, by

allowing the individual to

speak, eat and socialize un-

hindered by pain, discomfort

or embarrassment.

What doesoral healthmean to you?

Dr. LynnTomkins

“The earlysigns of oralcancer arevery easytomiss, andit concernsmewhenpeople aren’tseeing theirdentistregularly.”

Regularexamscatchmore than just cavities

l love howa real cleansmilesmiles backat you.�

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Health care professionals have long recognizedthe link between oral health care and the over-all health of Canadians.

They say there is a proven connectionbetween poor oral health and systemic diseasesuch as diabetes in people of all ages andrespiratory diseases particularly among elderlypeople. And now there is new research point-ing to possible links between oral health andother systemic conditions such as heart diseaseand preterm, low-birth-weight babies.

But while awareness of the need to paymoreattention to oral health is growing, consumersremain confused about the best options to carefor their teeth and gums – and the situationis likely to become evenmore challenging as

ongoing innovation in oral health care bringsnew products to market.

TheWall Street Journal reported earlier thisyear that market-research firmMintel Interna-tional Group found that 69 new toothpasteshit store shelves in the U.S. in 2010. Althoughthat number was down from 102 in 2007, itstill left more than 350 distinct types or sizes oftoothpaste on store shelves.

Somemanufacturers of oral health careproducts such as GlaxoSmithKline (GSK) wantto help consumers understand the differencesbetween themany options now available tothem.

GSK research has identified a growing shift inthe public perception of oral care from personal

care (fresh breath and whiteness) to overallhealth care (disease treatment and preventionand condition treatment/management).

But the research has also shown that in spiteof the changing attitudes, most consumers arestill buying oral care products with a“one-size-fits-all”approach.

The range of options and difficulty in un-derstanding what’s best for individual familymembers means many people simply buy onebrand of toothpaste for everyone, which canlead to some people with specific oral healthcare needs not getting the right products.

While asking for professional advice froma dentist is still the best way to determinewhich oral health care products are most

suitable for each member of the family, GSKbelieves manufacturers also have an impor-tant role to play.

That’s why GSK is currently running a nation-al oral health care program aimed at educatingconsumers about the differences in oral healthcare products. The program includes an easy touse online tool that helps shoppers assess theirwhole families’oral care needs. The site www.expertsmiles.ca provides a simple checklist ofneeds to help determine the best oral healthproducts for eachmember of the family. Thesite also offers tips to better oral health care tohelp drive an easier andmore informed pur-chasing decision with the hopes of improvingoral health care for all Canadians.

Take care when choosing toothpasteADVERTORIAL

Dental Health

Dr. Swan says parents who have ques-tions about fluoride for their childrenshould talk to their dentist or to publichealth officials who specialize in dentalhealth care.

“The CDA’s position is that the weightof scientific evidence indicates that thereare no health risks associated with fluori-dation at the appropriate levels and thatthe benefits are very significant,” saysDr. Swan.

In a letter on the Health Canadawebsite, Canada’s chief dental officer,Dr. Peter Cooney, says the safety andefficacy of water fluoridation has beenfrequently studied and continues to besupported by current science.

“Canadian and international studiesagree that water that was fluoridated atoptimum levels does not cause adversehealth effects. Canada has one of the

best systems in the world to ensure waterquality. Health Canada supports waterfluoridation as a public health measureto prevent dental decay. Dental disease isthe number one chronic disease amongchildren and adolescents in NorthAmerica; fluoridation can therefore bean important public health measure,”wrote Dr. Cooney.

FROM PAGE 1

Waterfluoridationsaves teethTooth decay a pathway to serious issuesWhile good oral hygiene, including twice daily brushing and once daily floss-

ing, and a well-balanced diet are the best way to help ensure healthy teeth

and gums, cavities can and do occur for a variety of reasons. Catching them

early and preventing them from becoming worse is a primary reason for hav-

ing regular dental dental exam.

Tooth decay, which can lead to cavities, typically starts just below the surface

of the tooth. If left untreated, it can damage the structure of the tooth and even-

tually lead to a hole. A dental filling is the most common treatment for a cavity.

Dentists identify decay by looking for pits and grooves or soft spots on the

teeth. Sometimes they take X-rays to check inside the teeth for areas that can’t

be seen by a visual exam. If signs of tooth decay are found, it is important to stop

it from spreading.

Depending on the stage of the disease, the dentist may try to heal it with fluo-

ride applications. He or she may also suggest changes to a patient’s oral hygiene

routine or diet. If left untreated, decay can lead to large cavities that may not

only cause serious pain, but can result in infection, loss of the tooth and damage

to the gums.

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Most parents know howimportant it is to teachtheir children to care for

their teeth, but for many youngCanadians, particularly in FirstNations and Inuit communities,access to professional dental carecan be difficult.

That’s why the Canadian gov-ernment launched the Children’sOral Health Initiative (COHI) in2004. From an initial base of 38communities, the program nowincludes 259 communities acrossCanada.

The objective is to address thedisparity between the oral healthof First Nations and Inuit and thatof the general Canadian popula-tion.

Health Canada spokespersonGary Holub says COHI has suc-ceeded in broadening the avail-ability of oral health care to thetarget communities. For example,the number of children undereight receiving fluoride varnishapplications grew from 7,100 in2003-04 to 16,300 in 2006-07.

While fluoride treatments areimportant to meet COHI’s goalof reducing tooth decay amongchildren, its objectives go wellbeyond that.

“COHI’s aim is to improveoral health for First Nation andInuit children to support overallgood health. In doing so, we be-lieve we will reduce the need forcomplex dental treatments requir-ing general anesthesia in hospital

settings,” says Mr. Holub.The remoteness of many First

Nation and Inuit communities,and a lack of infrastructure toprovide a full range of dentalservices in many locations is achallenge when it comes to ac-cessing services.

To help overcome these po-tential obstacles, a key elementof COHI is the use of commu-nity-based individuals, known asCOHI Aides, who are trained toprovide specific COHI ser-vices. This approach supports thedevelopment of capacity at thecommunity level and provides anongoing link to oral health withinthe community, says Mr. Holub.

The Canadian Dental Associa-tion agrees that capacity buildingin First Nation and Inuit commu-nities is important to improvedoral health.

In a position paper publishedlast year, the CDA said theCOHI program could be furtherimproved by increasing thenumber of dental health work-

ers on reserves and attractingmore Aboriginal people to dentalprofessions.

The paper called for the cre-ation and support of educationalprograms to promote culturallyappropriate education programsto help prevent oral disease andtooth loss at all stages of life.

Also last year, the CDA and theAssembly of First Nations joinedforces to call for better access tooral health care.

In a statement announcing ameeting with First Nations lead-ers, the CDA said First Nationspeople experience much higherrates of dental disease than otherCanadians. Cavity rates are fourto five times higher and gum dis-eases are widespread. Rampantoral disease negatively affectsquality of life in areas such as edu-cation, employment and nutri-tion. Additionally, the diseasecycle of gum diseases can be anexacerbating factor in diabetescontrol, a significant health issueFirst Nation communities.

All kids deserve good dental care

Addressing disparities is essentialOral health is an integral part of general health and should be

available to all Canadians, according to the Canadian Dental As-

sociation (CDA).

In a position statement on access to oral health care for all

Canadians adopted last year, the CDA acknowledges that finding

solutions to themultitude of problems of access to oral health

care is not simple, and no single organization, government

agency or community can solely address the disparities in the oral

health of Canadians.

The CDA believes that only a collaborative approach among

those who have the capacity to contribute to the challenge will

lead to equitable access to dental care and ensure good oral and

general health for more Canadians.

As the organization that that advocates on behalf of one of the

leading providers of oral health care in Canada, the CDA recom-

mends the development of a national action plan to reduce the

barriers to dental care. The action plan should includeminimum

mandatory standards for Canadian dental public health programs

and the provision of sufficient resources tomeet those standards.

In addition, alternativemodels of care or funding should be

explored to alleviate access to care inequities.

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For dentists, the harmfulimpact of tobacco is clearlyvisible every day. From dis-

coloured teeth and bad breath togum disease and oral cancer, theysee it all in patients who smoke,chew tobacco or use snuff.

“The use of tobacco productshas a devastating effect on oralhealth,” says Dr. Phil Poon, chair-man of the Canadian Dental As-sociation’s Advocacy Committee.

“Practising dentists are uniquelypositioned to show patients whattobacco use can lead to, such aspre-cancerous lesions, oral cancerand gum diseases that may causetooth loss and bad breath,” saysDr. Poon.

The CDA feels so stronglyabout the detrimental effects ofsmoking on health that it has

adopted an official policy positionaffirming the need to eliminatethe use of all tobacco products inCanada and establish a norm ofnon-smoking as a social attitudefor Canadians.

Dr. Poon says the CDA encour-ages practising dentists to raise

the issue of tobacco use withtheir patients and offer cessationoptions and support to those pa-tients who are eager to quit usingtobacco products.

The association also advocatesto demand that Canada remain aworld leader in tobacco controlinitiatives, and played a part,through the Canadian Coalitionfor Action on Tobacco, in havinga photograph of a diseased mouthincluded in the graphic warninglabels on tobacco packages.

In line with its view that den-tists have a leading role to play inhelping patients quit using tobac-co products, the CDA encouragesits members to complete smokingcessation training programs tomeet the needs of their patients,says Dr. Poon.

“Just as a person’s decisionto use tobacco is the result of acomplex interaction of factorsthat varies from one individual toanother, the reduction of tobaccouse requires a comprehensive,strategy that includes preven-tion, cessation and protection fornon-smokers from second-handsmoke and other harmful effectsof tobacco,” he says.

According to Health Canada,it’s not only tobacco use thatincreases the risk of oral cancer;chewing betel quid, paan andareca nut is also risky.

The Canadian Cancer Societysays not smoking cigarettes, cigarsand pipes or using other tobaccoproducts such as smokeless to-bacco is the most effective way toprevent oral cancer.

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If a tooth is lost, it is usuallyimportant to replace it with afalse tooth as soon as possible.

This procedure will preventyour remaining teeth fromdrifting out of line and causingother problems. Two ways ofreplacing teeth are bridges anddentures. Both can be sup-ported by dental implants whenadequate support is not avail-able in the mouth or when there

is a need to preserve adjoiningnatural teeth.

A bridge can replace one ormore missing teeth and is heldfirmly in place by healthy teethon each side of the missing ones.Bridges are permanent and can-not be removed.

Dentures, on the other hand,can be removed. There are twotypes of dentures: partial andfull. Both types are made in a

dental lab, based on a mould ofyour mouth. A partial dentureis made up of one or more falseteeth, and held in place by claspsthat fit onto nearby teeth. Youcan take the partial dentureout yourself for cleaning and atnight. A partial denture may beused when nearby teeth are notstrong enough to hold a bridge,or when more than just a fewteeth are missing.

A full denture can be usedwhen all your natural teeth aremissing. Remember, you needto care for a denture as carefullyas you would look after yournatural teeth.

Plaque builds up on a denturejust as it does on natural teeth.Unless plaque is removed fromyour denture, it can spread toyour natural teeth and gums,causing gum disease and cavities.

Tobacco use increases risk of oral cancer

TheCanadianDental Associa-

tion’s Seal of Recognition is a

symbol that identifies prod-

ucts that are of benefit to the

oral health of consumers. The

seal is designed to help the

public and dental profession-

alsmake informed choices.

The CDA’s consumer product

and professional product

recognition programs provide

valuable information to

consumers and profession-

als on awide range of dental

products. Market research by

manufacturers has shown that

the CDA’s seal on a product

directly impacts purchasing

decisions of consumers and

dental professionals.

Theseproductsareof value

whenused inaconscientiously

appliedprogramoforalhygiene

and regularprofessional care.

Bridges and dentures help fill the gapsDID YOU KNOW?

Dr. Phil Poon