A great opportunity to shine a spotlight on men 

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  Posted by: The Probe      17th March 2021

Is there a gender gap in oral health? The last, large-scale survey of adults in England, Northern Ireland and Wales indicated that a bigger proportion of men than women had obvious decay, coronal decay or root caries.[i] It also found that more men than women had presented with periodontal disease, also with either moderate or severe tooth wear.

All these issues are preventable with good oral hygiene, something either gender is capable of, so is it merely that fewer men are engaging with their oral health?

We know from more recent research that older men are at a higher risk of developing oral cancer. It is unclear why rates are so high for this group, but a “greater exposure to risk factors” including smoking and alcohol could be a reason why.[ii]

This all sounds rather bleak for men. When choosing just one determinant to measure outcomes we must exercise caution, however. There are significant regional variations across the UK, with social and economic factors having a massive impact. In certain areas, just getting access to an NHS dentist has been an impossible task for some time and that was long before the pandemic plunged services into an even deeper “crisis”.[iii],[iv]

That said, the wider picture does show that men tend to exhibit more of the behaviours that will not only put them at greater risk of oral disease but will also affect their general health too. According to the latest release for adult smoking habits in the UK, more men than women smoke – 15.9% compared with 12.5%.[v] Previous statistics have shown that men are also more likely to drink alcohol and be classified as overweight (however, obesity, including morbid obesity, was more common in women).[vi],[vii] Smoking and drinking to excess, as well as a nutritionally compromised diet and lack of exercise, are linked to life-limiting co-morbidities like diabetes and cardiovascular disease, as well as inhibiting oral health.

So, do we have a wider problem here? Last summer an article in The Lancet stated that the pandemic had shone a “cruel light on the state of men’s health globally”.[viii] It went to on to list some of the factors responsible for “men’s excess burden of premature and avoidable mortality”, including the behavioural health risks previously mentioned, also the prevalent “strong beliefs, norms, attitudes, and stereotypes of masculinity that prevent men from seeking medical services”. The article was a call to arms, to raise the profile of men’s health and for policy makers around the world to put it higher on the agenda.

So, it’s time to help men in our communities improve their health and wellbeing. An appointment with the dentist isn’t just about fixing a problem, or dealing with an emergency, it is about developing an understanding that being in good oral health is essential for enjoying a better quality of life.   

In fact, and although it is maybe too early to tell, we could even see more of an interest in our services as patients – male and female – decide to take control and deal with any behavioural factors that are holding them back from being the person they want to be. This year, many people – maybe including yourself! – will have likely made a commitment to be a heathier and happier person. Certainly, more practices are seeing a higher volume of queries about things like whitening, or restorative treatments. If male patients are asking about how to improve their smile, don’t waste the opportunity to discuss their oral health and what they can do to elevate it, which will lead to better clinical outcomes and enduring results, too. Smoking cessation, alcohol and diet should form part of every preventive-maintenance consultation, which can be a relaxed environment to talk about how to make changes without feeling judged, or under pressure.

Maybe you could offer family consultations; video calling comes in useful here. It is more often the mother who accompanies children on dental appointments, so this is a way to get everyone involved so they can all learn how to clean correctly and effectively and the best lifestyle choices to make. Good quality tools will enhance a daily routine; TANDEX makes oral hygiene aids including everyday brushes for all ages, interdental brushes and adjuncts for adult patients.

Is gender a good predictor for oral health? Past statistics would seem to indicate that men are more vulnerable than women to oral disease, for a host of reasons, many of which are linked to behaviours. Male patients need to appreciate how just a few changes are often all that is needed – as with all our patients, engagement and better relationships are key. It’s about simple, practical advice and understanding that effective oral health prevention will pay huge dividends and improve all-round health and wellbeing.

 

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Author Kimberley Lloyd- Rees on behalf of Tandex

Kimberley graduated from the University of Sheffield in 2010, where she now works as a clinical tutor in Dental Hygiene and Therapy as well as working in practice. She has spent her career working across a variety of specialist private and mixed dental practices, for the MOD and volunteering her time to a dental charity in Nepal.

 

[i] Disease and related disorders – a report from the Adult Dental Health Survey 2009. The Health and Social Care Information Centre, 2011. Link: https://files.digital.nhs.uk/publicationimport/pub01xxx/pub01086/adul-dent-heal-surv-summ-them-the2-2009-rep4.pdf (accessed January 2021).

[ii] State of Mouth Cancer UK Report 2020/2021. Report produced by the Oral Health Foundation, link: https://www.dentalhealth.org/thestateofmouthcancer (accessed January 2021).

[iii] NHS Dentistry: Crisis mounts as patients offered appointments in Aug 2020. BDA, 17 September 2019. Link: https://www.bda.org/news-centre/press-releases/Pages/NHS-dentistry-crisis-mounts-as-patients-offered-appointments-in-Aug-2020.aspx#:~:text=Three%20out%20of%20five%20dental,BDA%20analysis%20of%20official%20figures. (accessed January 2021).

[iv] Coronavirus: Dental services at ‘crisis point’. BBC, 18 December 2020. Link: https://www.bbc.co.uk/news/uk-england-bristol-55317252 (accessed January 2021).

[v] Adult smoking habits in the UK: 2019. Office for National Statistics, 7 July 2020. Link: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/bulletins/adultsmokinghabitsingreatbritain/2019#:~:text=In%202019%2C%20the%20proportion%20of,falling%20smoking%20prevalence%20since%202011 (accessed January 2021).

[vi] Adult drinking habits in Great Britain: 2017. Office for National Statistics, 1 May 2018. Link: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/drugusealcoholandsmoking/bulletins/opinionsandlifestylesurveyadultdrinkinghabitsingreatbritain/2017 (accessed January 2021).

[vii] Statistics on Obesity, Physical Activity and Diet, England, 2020. NHS Digital, 5 May 2020. Link: https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-obesity-physical-activity-and-diet/england-2020/part-3-adult-obesity-copy (accessed January 2021).

[viii] Men’s health: COVID-19 pandemic highlights need for overdue policy action. The Lancet 20 June 2020. DOI: https://doi.org/10.1016/S0140-6736(20)31303-9


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