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Oral health management in times of climate change crisis

By Dental Tribune International
July 21, 2021

BOSTON, U.S./ KIGALI, Rwanda: Experts have been warning about the consequences of climate change for years, and with every year that the situation worsens, these consequences become increasingly difficult to reverse. The current rate of global warming is associated with higher risks for adverse health outcomes as well, and these are measurable today, according to a recent commentary.

In the paper, author Dr. Donna Hackley, who is a part-time instructor at the Harvard School of Dental Medicine in the Department of Oral Health Policy and Epidemiology and clinical faculty member of the University of Rwanda School of Dentistry in Kigali, addressed the question of how climate change and oral health are linked. Because there is currently no published data available regarding this topic, Hackley wrote that “Medical professionals are tasked with protecting the health of their patients and developing resilient health care delivery systems that can withstand challenges precipitated by climate crises” such as severe precipitation challenges and rising sea levels.

Hackley has identified the following six exposure pathways that lead to major health risks:

  • heat stress—for example, heat can contribute to increasing antibiotic resistance;
  • poor air quality—for example, dry mouths and asthma are associated with a higher risk of dental caries;
  • food or water insecurity—for example, malnutrition is associated with cancrum oris and its early signs of onset include gingivitis and ulcerative periodontal lesions;
  • extreme weather events—for example, oral health care providers may face infrastructure challenges owing to the destruction of dental clinics;
  • vector-borne illnesses—for example, several vector-borne diseases such as the Zika virus infection present with oral manifestations; and
  • social factors—for example, migrating populations who move to other countries in search of a better infrastructure lack access to health care and are at risk for an array of preventable and treatable illnesses and diseases including common oral diseases such as dental caries and periodontal disease.

In order to handle the exposure pathways and limit the health risks that come with them, it is suggested that medical professionals start thinking about the future now and consider next steps that may include:

  • planning for extended power outages, office destruction or closure, loss of patient records, downed communications and disrupted medical supply chains;
  • developing strategic plans utilizing teledentistry for managing patients with oral pain or acute emergencies when offices are closed;
  • establishing strategies for personal and professional financial security;
  • considering in-office medication storage;
  • avoiding antibiotic over-usage;
  • including climate-risk screening questions in the standard medical history and understanding possible renal, respiratory and cardiovascular implications; and
  • being cognizant of oral manifestations related to risk factors from climate change exposure pathways.

In summary, Hackley noted: “[P]rovider awareness is essential for recognition and management of climate impacts on individuals and communities. Practice preparedness is critical for securing health system resiliency and navigating adverse climate events to ensure positive health outcomes.”

The study, titled “Climate change and oral health,” was published in June 2021 in the International Dental Journal.

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