The director of the National Institute of Dental Health told a Rockefeller Center audience last night that oral health is a crucial indicator of people's overall health in a speech titled "The Mouth as a Mirror."
"Without good oral health, we are not healthy," said Dr. Harald Loe. His speech was part of the "Visiting Scholars of the C. Everett Koop Institute at Dartmouth" program.
Loe called the recent improvement in American oral health "an oral hygiene miracle ... it is almost an unbelievable thing." He discussed this improvement, the mouth's importance for maintaining health and the mouth's function as a diagnostic tool.
Using slides, Loe illustrated the stages of periodontal disease, a progressive loss of the tissue that attaches the teeth to the jaw, which afflicts millions of Americans, including 300,000 under the age of 20.
He noted a significant improvement in American oral health in the last 30 years, which he attributed to dietary change, fluoridation of water, better hygiene and better understanding of the mouth and the function of saliva. "Saliva has more than meets the eye," Loe said.
Loe saw no end to this improvement in sight. "There will be ... more advances in the next 20 years than we have seen in the last 20 years," he said.
Edentulous, the loss of all one's teeth, has afflicted 40 percent of Americans over 65, according to Loe, but he predicted that "30 years from now edentulous will disappear as a public health problem."
America's dental health is third best in the world, Loe said. Fifty percent of American kids have no cavities, he said.
Dental health is best in the Southwest and worst in New England and the West Coast, and men have better dental health than women, but there are no solid explanations for this, according to Loe.
Knowledge of the mouth is useful in other areas of medicine, but these uses are often poorly understood. "Very few physicians really understand what's going on in the mouth," Loe said.
Many illnesses can be recognized by their symptoms in the mouth. This was significant during the first years after the AIDS virus was recognized.
In 1981 dentists reported incidents of unusual periodontal defects in homosexual men. In 1983 dentists began to notice a rare condition on the tongues of many homosexual men. These, and the cancer Karposi's Sarcoma, are now recognized to be symptoms of AIDS.
AIDS and other auto immune disorders, systemic diseases of the cardiac, renal and endocrine systems, diabetes and psychological stress all have manifestations in the oral cavity which can aid in diagnosis of these ailments.
Salivary tests for the HIV virus are now available that are "easier and as accurate as blood tests ... one can do these tests in the bedroom," Koe said.
Loe called the mouth's functions, including speaking, tasting, chewing, swallowing and demonstrating emotion, "quintessentially human."
He said "fear of loss of control of these functions" causes anxiety for many people when they visit the dentist.
Loe briefly discussed the impact of the Clinton health care proposal on dentistry. While noting that it would provide preventive care for children, he said dental care for adults who have periodontal disease as symptoms of other illnesses is not covered. "I don't think that this is the way it should be," Loe said.
Loe was introduced by John Duffy of the Koop Institute. Duffy called Loe "the most well-known and recognized in the world in his profession."
C. Everett Koop '37 briefly addressed the audience following the speech. "I've always been envious of the manner in which dentists approach prevention," he said.
Koop called more cooperation between the fields of medicine, public health and dentistry vital for the future of American medicine.
Loe has been knighted by the Queen of Denmark and was appointed Commander of the Royal Norwegian Order of Merit in 1989 at the request of King Olav V of Norway.
