Oral diseases

There is a range of oral diseases that pose a major public health threat worldwide. If left untreated, oral diseases negatively impact the mouth as well as the rest of the body. Oral diseases can affect every aspect of life, including personal relationships, self-confidence, as well as school and work attendance and performance.

What causes oral diseases?

Although oral diseases begin in the mouth, they cannot be prevented by focusing on the mouth alone. The circumstances in which people live and their level of access to certain resources and opportunities also plays a role in oral disease development. These deeper roots underlying the disease process must be addressed to ensure a comprehensive and effective treatment approach.

Tooth decay

Untreated tooth decay (dental caries) is the most common chronic disease worldwide and a major global health problem. Tooth decay is widespread due to high sugar consumption, a lack of effective preventive strategies, and limited access to appropriate oral healthcare in many parts of the world.

Tooth decay is caused by the interaction between the tooth surface, biofilm bacteria in the mouth and the presence of sugars from food. Biofilm bacteria metabolize sugars and produce acids, which break down tooth enamel over time.

You may have tooth decay if you experience:

  • food trapped frequently between your teeth;
  • discomfort or pain in or around your mouth;
  • difficulty in biting down on certain foods;
  • sensitivity to hot, cold or even sweet foods;
  • bad breath;
  • white, then dark, spots on your teeth.

Gum disease

Periodontal (gum) disease is a major cause of tooth loss in adults. It begins as gingivitis (chronic inflammation of the gums caused by dental plaque), which can be easily treated if action is taken early. If left untreated, gingivitis can progress to periodontitis, a more serious infection that destroys tooth-supporting tissues and bone. Unlike gingivitis, the damage caused by periodontal disease is irreversible and permanent. It can have a huge impact on well-being and quality of life. Periodontal disease can lead to serious consequences such as problems with chewing, speaking and tooth loss.

You may have gum disease if you experience:

  • red and swollen gums that bleed easily, especially when you brush or clean between your teeth;
  • gums that have pulled away from the teeth;
  • constant bad breath;
  • pus between your teeth and gums;
  • teeth that are loose or moving away from one another;
  • changes in the way your teeth fit together when you bite;
  • changes in the way your partial dentures fit.

Oral cancer

Oral cancers begin in the mouth. Oral cancer is among the 10 most common cancers. It may significantly affect any part of the mouth including: lips, gums, tongue, throat, inner lining of the cheeks, roof of the mouth and floor of the mouth. Oral cancer can be life threatening if not diagnosed and treated early. Tobacco and alcohol use are two major causes of oral cancer worldwide.

Potential signs of oral cancer:

  • swellings/thickenings, lumps/bumps, rough spots/crusts or eroded areas on the lips, gums, or other areas inside the mouth;
  • swellings/thickenings, lumps/bumps, rough spots/crusts or eroded areas on the lips, gums, or other areas inside the mouth;
  • development of velvety white, red, or speckled (white and red) patches in the mouth;
  • unexplained bleeding in the mouth;
  • unexplained numbness or pain/tenderness in the face, mouth, or neck;
  • dramatic weight loss;
  • persistent sores on the face, neck, or mouth that bleed easily and do not heal within two weeks;
  • a soreness or feeling that something is caught in the back of the throat;
  • difficulty chewing, swallowing, speaking, or moving the jaw or tongue;
  • hoarseness, chronic sore throat, or change in voice;
  • ear pain;
  • change in the way your teeth or dentures fit together.

Risk factors

Oral diseases share a wide range of risk factors. Some, such as age and hereditary conditions, are known as non-modifiable risk factors. Non-modifiable means they cannot be changed or influenced.

A modifiable risk factor can be a practice or lifestyle behaviour that affects the chance of getting a disease, including oral diseases. These are considered modifiable, as individuals are often able to change these behaviours. Modifiable risk factors often overlap and build upon one another.

For example, the risk of getting oral cancer is higher in people who both smoke (or use other forms of tobacco) and drink alcohol, with the highest risk in heavy tobacco users and drinkers[1]. Tobacco users are also more likely to have a diet high in fat and sugars than non-tobacco users, likely leading to a higher prevalence of tooth decay.

The primary modifiable risk factors for developing oral diseases are diets high in sugar, tobacco and alcohol use, and poor oral hygiene and care. Oral diseases share many common modifiable risk factors with other noncommunicable diseases (NCDs).

Unhealthy diet – high in sugar

Consuming excessive amounts of sugar from snacks, processed food and soft drinks is a leading risk factor for oral disease. Soft drinks include any beverage with added sugar, such as sodas, fruit juices, sweetened powdered drinks, and sports and energy drinks.

Sugar consumption shifts the mix of bacteria in the mouth towards bacteria that converts sugars into acids that start to dissolve tooth enamel. Having sugar throughout the day increases the frequency of acid attacks as well as the risk of developing tooth decay.

Insert Sugars nutrition facts infographic from WOHD 2017 Brochure

The risk of dental caries increases if you consume sugar more than four times a day and/or when you consume more than 50 grams (approximately 12 teaspoons) per day. Beware of sugars added to food by the manufacturer as well as those naturally present in honey, syrups, fruit juices and fruit juice concentrates. Pay attention to how much sugar you are adding when preparing your own meals.

Tobacco use

Tobacco is one of the greatest public health challenges the world faces today.

Tobacco use also contributes to heart disease, respiratory disease, and other cancers, and is the leading cause of preventable death in the world.

Tobacco use puts your mouth at an increased risk of gum disease and oral cancer. It also causes teeth staining, bad breath, premature tooth loss, and loss of taste and smell.

Insert Types of tobacco use infographic from WOHD 2017 Brochure         

Alcohol abuse

Harmful use of alcohol is a major risk factor for cancers of the mouth, larynx, pharynx and oesophagus.

Alcohol can act as an irritant, especially in the mouth and throat. Cells that are damaged by the alcohol may try to repair themselves, which could lead to DNA changes that could be a step toward oral cancer[2].

Alcohol may cause other harmful chemicals, such as those in tobacco smoke, to enter the cells lining the upper digestive tract more easily. This might explain why the combination of smoking and drinking is much more likely to cause cancers in the mouth or throat than smoking or drinking alone[3].

Drinking too much alcohol also increases the risk of facial and dental injuries due to falls, road traffic crashes, and violent confrontations with others.

Furthermore, alcoholic drinks are often acidic and high in sugar, which increases the risk of tooth decay.

Poor oral hygiene

Poor oral hygiene has long term consequences on the mouth, mind, and body. Tooth decay can cause discomfort, pain, and social isolation. Untreated gum infection can eventually result in tooth loss and increase the risk of developing diabetes or heart disease.

Poor oral hygiene can lead to the build-up of harmful plaque-forming bacteria. Brushing your teeth twice-daily with a fluoride toothpaste helps reduce the bacteria and helps to prevent plaque formation. Teeth are then more resistant to acids that cause tooth decay. Early detection is key to helping prevent or manage oral conditions. Regular dental check-ups help to ensure that issues such as tooth decay, gingivitis and periodontitis are identified and treated as early as possible.


[1] American Cancer Society

[2] American Cancer Society

[3] American Cancer Society

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