More to a mouth than a smile

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THE greying population is on the increase in Malaysia. Come 2025, we can expect some 15% to 20% of the estimated 32 million people to be expanding the population pyramid. Are we ready to serve them? How much do we know about them, be it physically, economically, environmentally or health wise?

Realising the upcoming dilemma, the Faculty of Dentistry at Lincoln University College together with MySihat and MAB Academy joined forces as part of their corporate social responsibility to organise a National Symposium On Older Population for the public.

Many issues related to the older population from mental health, chronic and oral diseases, keeping fit as well as newer nursing option innovations were highlighted. The event was graced by keynote speaker Datuk Dr Azman Abu Bakar, who is deputy director-general (Medical) at the Health Ministry. He also launched the Tabung Rawatan Mulut Warga Mas, Lincoln University College. The fund supports the eligible older generation who seek oral treatment and care at the 60-dental chair facilities at the Faculty of Dentistry at Lincoln University College in Kelana Jaya.

Why did the Faculty of Dentistry decide to initiate the conference? A short reflection will tell you the mouth perhaps is one of the most important organs in the whole body. The first cry tells you a new life is born. The mouth is needed for the baby to grow into a toddler, young child, teenager, adult and subsequently journeying graciously into the greying world. In short, everything goes first into the mouth before it reaches the respective organ destinations. It goes without saying that if the mouth is not there, you wouldn’t be walking around today!

Needless to say, poor oral health affects people’s everyday lives by causing pain and suffering, disrupting sleep patterns, and affecting the ability to eat and speak, socialise and feel happy with their appearance. This, in turn, affects self esteem, social interaction, the ability to work and reduced quality of life.

Like your face, your mouth needs nurturing to produce that beautiful smile and happy laughter. An uncared mouth can create a different problem of bad smell, bleeding gums, thick tartar and an unattractive smile, all of which can also be the cause of depression setting in, often times serious enough to require psychiatric treatment. Tooth loss before the age of 35 and unattended have also been linked to Alzheimer’s disease and dementia.

Poor oral health is scientifically linked to the increased risk of cardiovascular disease, stroke and aspiration pneumonia. Chronic oral infection can complicate the medical management of health illnesses, such as diabetes, chronic heart failure, and respiratory diseases. How can this be? The millions of bacteria in an uncared mouth reaches the heart via your bloodstream causing inflammation, clotting and infection. Even a respiratory infection can happen just by breathing bacteria from infected teeth and gums over a long period! Poor oral hygiene significantly increases the risk of patients with swallowing impairments (dysphagia) developing pneumonia.

Severe Inflammation of the gums due to poor oral hygiene for example, can lead to premature birth or low birth rates in the young but is also a contributor to diabetes as well as osteoporosis as one gets older. Gum inflammation increases the production of cytokines needed to inhibit insulin activity to work on liver and muscle cells thus interfering with glucose intake resulting in increased blood sugar levels. Recent studies by the Oral Health Division Malaysia indicated a pattern of little change in the prevalence of periodontal disease among Malaysian adults (90% in 2000; 94% in 2010).

Dental problems in older people are a common cause of speech impairment, eating difficulties, pain when eating, and/or signs of mouth discomfort. Tooth loss, poorly fitting dentures and oral infections can result in poor nutrition and persistent mouth pain – they can affect appetite, food enjoyment and ability to chew, which impacts on food intake and food selection.

Recent study findings by Tufts-John Hopkins Universities (2018) showed that among patients who had no teeth – which can be a sign of severe periodontics – the increase in risk was 28 percent.

A mouth with no teeth also means saliva will not flow in easily and saliva is a natural mouth and teeth cleanser. It has all the immunity elements to protect against more than 600 species and the millions of bacteria naturally in the mouth all the time. Bacteria feeds on food remnants and if not enough of it is available around, it is not impossible for the soft tissue to fall prey to it too, creating mouth ulcers.

Having a dry mouth will not help one in the swallowing mechanism or in speech. It is always good to have a bottle of water handy if an elderly person is speaking to an audience in a seminar

Sadly, available information from surveys show at least 40% to 50% of Malaysians above 60 years do not have teeth in total or have few left standing teeth (six to seven teeth) on the jaws.Many think it is alright not to have dentures. For those with uncontrolled diabetes, a poor oral mouth condition can aggravate the diabetic condition. Topped with high blood pressure, even a simple extraction can create complexities in terms of excessive bleeding and wound healing.

Perhaps it is time for you to go and have a check up at your dentist.


Founding Dean and

Senior Professor and Consultant (Clinical Preventive Dentistry)

Faculty of Dentistry, Lincoln University College

October 24, 2020

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