DENTISTRY X PRIMARY CARE

Oral health is an integral part of overall health and well-being. The mouth is not separate from the rest of the body; rather, oral conditions can reflect, contribute to, or be affected by systemic diseases. Many chronic medical conditions have important oral health implications, and early recognition of oral changes can support timely diagnosis, prevention, and treatment.

Despite this connection, oral health is sometimes overlooked within routine medical care. Strong collaboration between primary care providers, physicians, nurse practitioners, dentists, dental hygienists, and other healthcare professionals is essential to ensure that patients receive comprehensive, whole-person care. By incorporating oral health assessment and dental referrals into primary care practice, healthcare teams can help prevent complications, improve quality of life, and support better management of chronic diseases.

If you are living with diabetes, asthma, COPD, diabetes during pregnancy (gestational diabetes), GERD (acid reflux), an eating disorder such as bulimia nervosa, Sjögren's syndrome, or another chronic condition that may affect oral health, consider discussing your oral health needs with your primary care provider. Your healthcare provider can determine whether a referral to a dentist or dental professional is appropriate.

Dental Resources from Ottawa Public Health:

https://www.ottawapublichealth.ca/en/public-health-topics/dental-health.aspx#Oral-Health-Resources

Free Dental Screening:

https://www.ottawapublichealth.ca/en/public-health-topics/dental-health.aspx#Free-Dental-Screenings

https://www.ottawapublichealth.ca/en/public-health-topics/dental-health.aspx#Find-a-dentist

Find a Dentist:

https://www.ottawapublichealth.ca/en/public-health-topics/dental-health.aspx#Find-a-dentist

Resources By Age Groups:

https://www.ottawapublichealth.ca/en/public-health-topics/dental-health.aspx#For-All-Age-Groups

https://www.ottawapublichealth.ca/en/public-health-topics/dental-health.aspx#For-Adults_1

https://www.ottawapublichealth.ca/en/public-health-topics/dental-health.aspx#For-Youth

https://www.ottawapublichealth.ca/en/public-health-topics/dental-health.aspx#For-Children_1

https://www.ottawapublichealth.ca/en/public-health-topics/dental-health.aspx#For-Babies-and-Toddlers

Other reources from Ottawa Public Health:

It depends on your age group that you are eligible for these programs:

• https://www.ontario.ca/page/get-dental-care

• https://www.ontario.ca/page/dental-care-seniors

• https://ottawa.ca/en/family-and-social-services/financial-and-social-assistance/apply-financial-assistance/ontario-works

• http://ottawa.ca/en/family-and-social-services/financial-and-social-assistance/apply-financial-assistance/essential-health-and-social-supports-ehss

• https://www.canada.ca/en/services/benefits/dental/dental-care-plan.html

Dental Services Resources from Champlain Healthline:

https://www.champlainhealthline.ca/listServices.aspx?id=10076&region=Ottawa

Dental Services Resources from Canadian Dental Association:

https://ottawadentalsociety.org/patient-education/

https://ottawadentalsociety.org/patient-education-videos/
https://www.oda.ca/visiting-the-dentist/government-dental-programs/

Canadian Dental Organizations that are responsible for educational dental resources:

http://dentalhygienecanada.ca/

Canadian Dental Hygiene Association: 

https://www.cdha.ca/

Ontario Dental Association:

https://www.oda.ca/visiting-the-dentist/government-dental-programs/

Canadian Dental Association:

https://www.cda-adc.ca/en/oral_health/index.asp

Ottawa Dental Society:

https://ottawadentalsociety.org/

Ottawa Dental Hygienist Association:
https://odhs.ca/

Diabetes and Oral Health

Diabetes mellitus has a significant relationship with oral health. Individuals with diabetes are at increased risk of developing periodontal disease (gum disease), which is one of the most common oral complications associated with diabetes. High blood glucose levels can impair the body's ability to fight infection, increasing susceptibility to bacterial growth in the mouth.

People living with diabetes may also experience:

• Increased risk of gum inflammation, bleeding, and periodontal tissue destruction

• Dry mouth (xerostomia), which can increase the risk of cavities and oral infections

• Oral fungal infections such as candidiasis (oral thrush)

• Delayed healing after dental procedures or oral injuries

• Increased risk of tooth loss if periodontal disease is untreated

More information is found here: https://www.ottawapublichealth.ca/en/public-health-topics/dental-health.aspx#Gum-Disease-and-Diabetes 

Gastroesophageal Reflux Disease (GERD), Morning sickness and Oral Health

Gastroesophageal reflux disease (GERD), commonly known as acid reflux, occurs when stomach contents flow back into the esophagus and may reach the oral cavity. Repeated exposure of teeth to stomach acid can gradually weaken and dissolve tooth enamel.

Potential oral health effects of GERD include:

• Dental enamel erosion

• Increased tooth sensitivity

• Higher risk of cavities due to weakened tooth structure

• Changes in tooth appearance and shape

• Oral discomfort or dryness

More information is found here: https://www.ottawapublichealth.ca/en/public-health-topics/dental-health.aspx#Pregnancy-and-Oral-Health 

Eating Disorders (Including Bulimia Nervosa) and Oral Health

Eating disorders can have significant effects on oral health, particularly when recurrent vomiting is involved. In conditions such as bulimia nervosa, repeated exposure of the teeth to stomach acid can cause progressive damage.

Oral manifestations may include:

• Erosion of tooth enamel, especially on the inner surfaces of teeth

• Increased tooth sensitivity

• Greater risk of cavities

• Changes in tooth shape, colour, or appearance

• Dry mouth and reduced saliva protection

• Irritation of oral tissues

• Enlargement of salivary glands

Dental professionals may sometimes identify early signs of eating disorders through oral examination. A collaborative approach involving primary care providers, mental health professionals, nutrition specialists, and dental professionals is essential to support recovery while protecting oral health.

Steroids Inhalers and Oral Health

Inhaled steroids (steroid puffers), commonly used to manage conditions such as asthma and COPD, are important medications that reduce airway inflammation and improve breathing. However, they can also affect oral health if proper preventive measures are not followed.

Because some medication may remain in the mouth and throat after inhalation, long-term use of inhaled corticosteroids may increase the risk of:

• Oral thrush (oral candidiasis) – caused by increased growth of yeast in the mouth, which may appear as white patches, redness, soreness, or burning sensations.

• Dry mouth (xerostomia) – reduced saliva can increase the risk of cavities, gum irritation, bad breath, and oral discomfort.

• Tooth decay and gum problems – changes in the oral environment and medication residue may contribute to increased plaque buildup and dental concerns.

To protect your oral health while using steroid puffers:

• Rinse your mouth with water and spit it out after each use.

• Maintain regular brushing and flossing with fluoride toothpaste.

• Clean your inhaler as recommended.

• Use a spacer device if advised by your healthcare provider.

• Attend regular dental check-ups, especially with long-term inhaler use.

References

1. National Institute of Dental and Craniofacial Research. (n.d.). Diabetes and Oral Health. National Institutes of Health.
   https://www.nidcr.nih.gov/health-info/diabetes

2. D’Aiuto, F., et al. (2020). Oral diseases and systemic health: An emerging interdisciplinary challenge. International Journal of Environmental Research and Public Health, 17(16), 5697.
   https://pmc.ncbi.nlm.nih.gov/articles/PMC7440954/

3. National Institute of Dental and Craniofacial Research. (n.d.). Sjögren’s Disease and Oral Health. National Institutes of Health.
   https://www.nidcr.nih.gov/health-info/sjogrens-disease

4. American Dental Association. (n.d.). Oral Health Topics: Oral-Systemic Health.
   https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics

5. Oral Health Foundation. (n.d.). Eating Disorders and Oral Health.
   https://www.dentalhealth.org

6. Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention. https://ginasthma.org/

7. National Health Service (NHS). Steroid inhalers. https://www.nhs.uk/medicines/steroid-inhalers/

8. Centers for Disease Control and Prevention (CDC). Asthma Management. https://www.cdc.gov/asthma/

9. Ottawa Public Health www.ottawapublichealth.ca/en/public-health-topics/dental-health.aspx