Veterans Dental Health — Common Oral Conditions & Diseases

Evidence Based
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How Can Serving In The Military Impact Your Oral Health?

Veterans are more likely to develop general health conditions, certain cancers, and mental illnesses than non-veterans. These conditions can also lead to poor oral health issues, such as cavities, gum disease, and other oral infections. In particular, long-term exposure to harmful chemicals (e.g. herbicides and asbestos) and explosions impact a veteran’s general and oral health greatly. Vets are also more likely to experience chronic pain, joint pain, and organ-related issues. Lastly, mental health illnesses are also common in vets, which can result in poor oral and general health outcomes over time. Sometimes, health conditions do not manifest until long after retirement.

Common dental conditions, such as cavities and periodontal disease, affect both elderly war veterans (vets) and non-veterans in similar ways. Additionally, oral care and hygiene needs are no different for vets compared to non-vets. For example, brushing twice a day, flossing regularly, and visiting the dentist for professional teeth cleanings every six months is essential for good oral hygiene.

health

The Correlation Between General & Oral Health in Vets

Many veterans suffer from general health complications after returning home from war. This may include cancer, AL amyloidosis, Hodgkin’s disease, and Parkinson’s disease, among others. All of these conditions can also negatively impact your oral health standing:

Respiratory Cancers

Exposure to herbicides (weedkillers) increases your chance of developing respiratory cancer affecting the lungs, trachea, larynx, or bronchus. Many veterans from Afghanistan and previous wars had long-term exposure to herbicides, chemicals, dust, smoke, and other particles during deployment. As a result, many of them develop serious lung diseases or cancer after retirement.

“Veterans are 25 to 75 percent more likely to develop lung cancer than non-veterans.”

If you have lung cancer, you may also notice extreme changes in your mouth. This is because chemotherapy (cancer treatment) can also negatively impact the oral cavity. In addition to hair loss, weight loss, vomiting, and nausea, chemotherapy may cause:

  • Dry Mouth
  • Cavities
  • Increased Risk for Gum Disease
  • Tooth Sensitivity
  • Bleeding and/or Sensitive Gums
  • Mouth Sores (Ulcers)
  • Jaw Pain
  • Changes in Taste
  • Bone Disease
  • Difficulties Chewing, Swallowing & Speaking
  • Pain and Inflammation Inside the Mouth

Mesothelioma

In particular, mesothelioma is a type of cancer that affects the lungs, heart, or abdomen and forms due to long-term asbestos exposure. During the Korean War, the Vietnam War, and World War II, asbestos products were widely used because of their ability to fireproof and insulate. In particular, it was used in the construction of ships, planes, tanks, and barracks. Although, if asbestos fibers are inhaled long-term, lung cancer commonly develops after retirement. Mesothelioma can also result in serious oral health complications (listed above).

Hodgkin’s Disease

Veterans who were exposed to herbicides are at risk of Hodgkin’s disease, a cancer of the lymphatic system. Symptoms include fever, swollen lymph nodes, fatigue, itching, and weight loss. Additionally, cancer treatment for the disease (chemotherapy and radiation) can lead to oral health complications. This includes mouth ulcers, cavities, gum disease, dry mouth, and soft-tissue inflammation, among others.

AL Amyloidosis

Veterans who were exposed to herbicides are also at risk of AL amyloidosis. This condition occurs when amyloid proteins are deposited in organs or tissues. It can affect the heart, liver, lungs, joints, and kidneys. In terms of oral health, AL can directly affect the tongue, resulting in enlargement and tenderness (macroglossia). It also weakens your immune system, which increases your risk of oral thrush (a fungal infection) and other infections. Let your dentist or doctor know if you are experiencing any of the following symptoms:

  • Unusual dryness in the mouth
  • Mouth ulcers or sores on the lips
  • Tongue redness or swelling
  • Altered taste or sensation in the mouth
  • White plaque coating on the tongue
  • Numbness and/or pain in the jaw
  • Damaged or loose teeth
  • Gums that bleed easily on probing

Parkinson’s Disease

Long-term exposure to herbicides increases your risk of Parkinson’s disease (PD), which causes stiffness, shaking, and walking challenges. PD symptoms can also affect the teeth, mouth, and jaw. For example, the inability to control the body makes it difficult to receive dental treatment and brush your teeth. This can result in poor oral hygiene, gum disease, and cavities. Lastly, veterans with PD are more likely to grind their teeth, which can cause thin enamel, and tooth cracks which increases your risk for cavities.

stress

The Correlation Between Mental & Oral Health in Vets

Some veterans may be at a higher risk of developing a poor oral health status if they have a serious mental illness. This includes anxiety disorder, depression, post-traumatic stress disorder (PTSD), drug abuse, and/or alcohol abuse:

Anxiety and Depression

At least 20 percent of veterans who served in Iraq or Afghanistan suffer from anxiety and depression. In addition, there was a 327 percent increase in anxiety disorders among vets between 2000 and 2012.

Vietnam veterans are twice as likely to have anxiety and/or depression compared to Korean War and World War II veterans.

If you have an anxiety disorder, it is likely you are also neglecting professional and at-home dental care. The medications you take for depression or anxiety can also negatively impact your oral health. For example, some anti-depressants decrease your mouth's ability to make saliva, resulting in dry mouth. Saliva prevents tooth decay by protecting tooth enamel and buffering acids produced by plaque. When the production of saliva decreases, dry mouth is more likely to occur, which may result in tooth decay, gum disease, or even tooth loss.

In addition, many people who struggle with anxiety suffer from bruxism, which is the habit of grinding and clenching the teeth (typically during sleep). Long-term bruxism results in worn down enamel, ultimately causing cavities and thin enamel.

Post-Traumatic Stress Disorder (PTSD)

Many veterans suffer from post-traumatic stress disorder (PTSD), which is when a person has difficulty recovering after encountering or observing a terrifying incident. Similar to veterans who suffer from anxiety and/or depression, the stress-related symptoms associated with PTSD are linked to serious oral damage.

For example, a study conducted by periodontists at the University at Buffalo School of Dental Medicine revealed significant enamel erosion in PTSD patients compared to those without PTSD. Enamel erosion occurs when an acidic substance comes into contact with a tooth. The acids from the substance demineralize the tooth’s enamel and tissues beneath the tooth (dentin), resulting in erosion. Dental plaque buildup (cavity-causing bacteria) and gingivitis (a mild form of gum disease) are also highly prevalent in veterans with PTSD.

alcohol

Drug & Alcohol Abuse

Drug abuse is when you take illegal or legal substances, such as alcohol, excessively or in the wrong way. Long-term abuse of certain drugs, such as opiates, amphetamines, and psychoactive drugs, can also cause serious oral health complications.

In 2013, 1 in 15 veterans over 17 years of age suffered from a substance abuse disorder to cope with mental illness.

Common dental conditions associated with alcohol and drug abuse include:

  • Plaque and tartar (hardened plaque) buildup, which results in cavities.
  • Dry mouth and bad breath.
  • Tooth discoloration and stains.
  • Gum diseases, such as gingivitis and periodontitis.
  • Loss of blood flow to the gums and tooth roots (silent gum disease).
  • Oral cancers (cancerous ulcers affecting the mouth and/or throat).

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Resources

1 In 15 Veterans Had a Substance Use Disorder in the Past Year, https://www.samhsa.gov/data/sites/default/files/report_1969/Spotlight-1969.html.

Gould, Christine E., et al., “Depression and Anxiety Symptoms in Male Veterans and Non-Veterans: the Health and Retirement Study.” International Journal of Geriatric Psychiatry, vol. 30, no. 6, 2014, pp. 623–630., doi:10.1002/gps.4193.

“PTSD Patients Damage Teeth Through Involuntary Grinding, Clenching, UB Study Finds.” PTSD Patients Damage Teeth Through Involuntary Grinding, Clenching, UB Study Finds - University at Buffalo, 8 Mar. 2001, http://www.buffalo.edu/news/releases/2001/03/5063.html.

“Mouth Care.” Myeloma UK, 2018. https://www.myeloma.org.uk/wp-content/uploads/2018/03/Myeloma-UK-AL-amyloidosis-Mouth-care-Infosheet.pdf.

“The Importance of Dental Health.” The Importance of Dental Health | Lungcancer.org, https://www.lungcancer.org/find_information/publications/269-the_importance_of_dental_health.

Updated on: June 9, 2020
Author
Alyssa Hill
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Medically Reviewed: November 27, 2019
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Lara Coseo
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