The Status of Oral Health in People with Spinal Cord Injury in the United States

Oral health is integral to our general health and well-being, according to the U.S. Surgeon General's Report on Oral Health published in 20002 and the World Health Organization in 2003.16 The Report highlighted numerous oral health disparities among individuals with disabilities. Evidence in the two decades since show that individuals with disabilities continue to report poorer access to dental care and poorer oral health, yet SCI-specific data are limited.33-39 Poor oral health is linked to numerous health problems that include infections and respiratory issues, which are common secondary conditions after SCI.9,13,48 People with SCI have indicated that obtaining dental care is a top need.1 Numerous factors may serve as barriers for people with SCI in maintaining good oral health or accessing appropriate and timely oral health care. Injury-related functional limitations, such as impaired finger movement and decreased strength can impair one’s ability to brush and floss or can result in needing assistive mobility aids and devices (e.g., power wheelchairs), which may pose barriers to accessing care in the built environment.40-44 Medications to treat common conditions and complications after SCI, including spasticity and neurogenic bladder, can lead to dry mouth that increases the risk of dental cavities.40 Oral problems such as pain and tooth loss may make using mouth-held adaptive devices more difficult; similarly, devices such as mouthsticks can damage the teeth and cause oral injuries.47 Depending on the nature of the catastrophic event that resulted in SCI, people also may have significant trauma to the mouth, which medical insurance typically does not cover.