“In general, both in Canada and the United States, people have difficulty with oral health. If patients had better dental hygiene, there would be a lot less cavities and gum disease,” said Dr. Thomas Nguyen, periodontist, researcher and teacher at the Faculty of Dentistry at McGill University, in an interview.
This reality stems, in large part, from a lack of education and awareness. “People are busy and don’t have a lot of time. Often, they think that problems with the gums are not that serious, argued the specialist. However, the mouth is part of our body and directly affects our immune system.
Unusually, Dr. Nguyen emphasizes that Quebec is one of the places in the world where we find the greatest number of edentulous people.
“By tradition, teeth were often removed, especially young women who had cavities. Before getting married, it was a custom for parents to pay for the complete extraction of teeth to replace them with dentures. It spanned generations.”
Dr. Thomas Nguyen, periodontist, researcher and teacher at the Faculty of Dentistry of McGill University. (Provided by Dr. Nguyen)
More and more studies also show a correlation between gum disease and then diabetes, Alzheimer’s and cardiovascular disease. “Everything is interconnected,” summarized Dr. Nguyen. “With Alzheimer’s disease, we found during autopsies a bacteria in the brains of patients, called Porphyromonas gingivalis, which we only see in the gums,” explained the periodontist.
Dr. Nguyen is one of the researchers trying to determine how this bacteria ends up in the brain. “The theory right now is that when there is an infection in the mouth, the immune system reacts,” he said. It sends molecules that activate certain parts of the body through the blood flow. It can therefore be found in several organs.
Fortunately, the work upstream seems to be paying off. “We are seeing fewer and fewer cavities in children and young adults. Particularly because there is more fluoride in toothpaste. Whereas in adults, there is more gum disease,” said Dr. Nguyen.
Among the tips for preventing oral problems, we recommend at least two visits to the dentist annually. You must also have a good tooth brushing technique, lasting at least two minutes. Flossing your teeth and using antibacterial products are also a good idea. Not smoking and then reducing stress as much as possible also has a positive impact.
Accessibility
One of the keys to improving oral health is to promote better accessibility to care, said Dr. Nguyen. The Canadian Dental Care Plan (CDSP), unveiled by the federal government at the end of 2023, must be part of the solutions by reducing “financial barriers for nearly nine million Canadians whose annual income is less than $90,000 », Mentions Ottawa.
“We are very optimistic with the new regime that is being established,” said the specialist. And we hope that it will really help to improve accessibility.”
The implementation of the regime, however, generates a lot of turbulence in many dental offices, because the guidelines for the RSCD are not yet clear. We are therefore witnessing several cancellations of appointments since patients want to ensure that part of their dental bill is reimbursed. “It’s true that the process has been very criticized,” admitted Dr. Nguyen. It was done very quickly by the federal government, without having consulted the government of Quebec and the dentists.
The periodontist says nearly 5,000 healthcare professionals are enrolled in the plan. “The government is therefore in the negotiation phase to review the barriers to adoption of the program. This creates a lot of management problems at the clinic level. The bureaucratic process is very cumbersome,” he summarized.
At the moment, the delays in obtaining a clinic appointment are often very long. Moreover, all the dental offices in the region contacted by The Voice of the East in the context of this article declined our requests, claiming to be overwhelmed.
How will we be able to manage a marked increase in ridership if the RSCD is deployed? According to Dr. Nguyen, the number of dentists is not the issue, but their distribution. “It’s a real problem right now. We have a large concentration in large cities, while it is the opposite in the regions. In Sept-Îles, dentists no longer take patients, he cited the specialist as an example. They therefore have to take the plane to go to Montreal or Quebec to be treated.”
The new regime could therefore cause a lot of headaches for some dentists… and their patients, conceded Dr. Nguyen. A file to follow.
