Oral – Systemic Disease Connections
Dental health may be a specialty on its own, but mounting evidence shows that oral health has a much stronger relation to your overall health than researchers previously thought. The chronic inflammation of periodontal disease has been linked to diseases such as cardiovascular disease, respiratory disease, diabetes, orthopedic implant failure, kidney disease, maternal difficulties and some types of cancer.
If pathogenic bacteria from your mouth enters your bloodstream, it can trigger inflammatory processes that contribute to chronic disease.
As the link between oral and systemic health has become better understood, researchers now believe the long-term inflammation of chronic periodontal disease triggers and intensifies many different systemic diseases. Periodontal disease is even thought to create problems with the management of some chronic diseases. With these new research findings, scientists are more convinced than ever that the first sign of systemic health problems are often seen in your mouth!
Understanding the “Mouth-Body” Connection
Your mouth is home to a countless number of bacteria. Most of the time, these bacteria are kept in a healthy balance by your body’s natural defenses and good oral hygiene practices. However when harmful bacteria grow out of control, they can cause oral infections, such as cavities and gum disease (periodontal disease or periodontitis). Additionally, certain kinds of medications, a reduction in saliva flow and certain dental procedures can also disrupt the normal bacterial balance in your mouth and create exposed gum tissue.
There are at least 30 kinds of pathogenic bacteria that contribute to inflammatory periodontitis. Each of these bacteria exists in varying forms and each one is extremely hard to eradicate. When you have periodontal disease, millions of these bacteria are in direct contact with ulcerated and exposed gum tissue, which provides easy access for bacteria to enter your bloodstream. These conditions actually present the “perfect storm” for bacteria to enter your bloodstream, and, once there, they can easily begin to affect or contribute to certain systemic diseases.
In fact, once periodontal pathogens enter your bloodstream, they have been shown to increase your risk of heart disease and even hinder glycemic control in diabetics.
There are also elevated levels of inflammatory markers in the blood of people with periodontitis. This occurs when any of those pathogenic bacteria, their byproducts and cytokines enter into the blood from the open periodontal pockets. In reaction to this invasion, your liver and white blood cells increase their own production of inflammatory proteins. Your blood coagulation and thickness is affected, along with your lipid levels. All of these increases and responses are known risk factors for developing heart disease.
Periodontitis and Periodontal Disease
Periodontitis and periodontal disease are both forms of gum disease. Periodontitis is a disease that involves severe inflammation of your gum tissue, does harm to gingival tissue and can injure underlying bone. Teeth can become loose or even fall out due to the bone damage caused by periodontitis. While periodontitis was already linked to many heart-related conditions, recent studies have now linked it to several different diseases as well.
Because periodontitis may be painless in the beginning stages, it can often go unnoticed for long periods of time in patients. It may not be diagnosed until it presents itself with abscesses, bleeding gums and bad breath. While periodontitis is a disease that involves severe inflammation of the gums, periodontal disease is the name of a bacterial infection in your mouth or gums. The prevalence of periodontal disease is affected by genetics, immune health and the inflammatory status of your body, as well as lifestyle factors (such as diet) and attention to oral hygiene.
The Oral-Systemic Health Link
Periodontitis is a chronic inflammatory disease that affects around 75% of all U.S. adults at some point during their lives. The disease is thought to have negative effects on systemic health conditions due to the accumulation of oral gram-negative bacteria. It is the inflammatory response and the resulting bacteria that enter into your bloodstream that can affect your overall health. This link is significant because it clearly shows the importance of oral health for quality of life. Scientists are just now beginning to learn how important the link between oral health and overall health is for you.
Knowledge is so very important to healthcare and when researchers understand the links between diseases, we can eventually learn to prevent them. So how could all this research affect your overall health?
Along with regular visits to your dentist and regular brushing and flossing, a healthy diet, rich in vegetables, will protect your oral (and overall) health.
Your Heart Health …
There is a link between the inflammatory processes related to gum disease and your risk for cardiovascular problems. Naturally, research suggests that good oral care may decrease the incidence of heart disease.
According to new research, there are also now possible links between gum disease and anemia. Chronic periodontitis causes the body to produce certain proteins that negatively react with blood, causing a decrease in red blood cell production.
Some studies suggest that women who suffer from tooth loss caused by periodontal disease may have a higher incidence of breast cancer.
Since diabetes reduces your ability to fight off infection, your gum tissue is put at risk. People who have diabetes struggle due to having very little blood sugar control and they develop frequent gum infections. It is thought that diabetics may lose more teeth than people without diabetes who have steady blood sugar levels. Periodontitis has been called the sixth complication of diabetes mellitus because it is twice as prevalent in diabetics.
Prostate Health …
Men who suffer from prostatitis produce high inflammation markers. In a study comparing men who had both prostatitis and periodontitis, they were found to have significantly higher PSA (Prostate Specific Antigen) levels than the men who had prostatitis or periodontitis alone. It is now thought that when a man has periodontal disease it can worsen prostatitis, and vice versa.
Periodontitis has been linked to premature birth and a low birth weight in some children. Studies show that pregnant women with periodontitis were more likely to have preterm low-birth-weight children than were pregnant women who did not suffer from periodontitis. It has also been suggested that the periodontal bacteria can gain access to the fetus after entering the mother’s bloodstream. Therefore, researchers suggest that good oral health can decrease the number of these early or low-weight births. Many would consider good oral health an essential part of prenatal care.
Memory Loss and Alzheimer’s Disease …
Poor oral hygiene has been linked to memory loss and dementia. Even more interesting is that during one study, participants with the least number of remaining natural teeth were at a higher risk for memory loss and early Alzheimer’s disease.
Researchers found that people who have lost many of their teeth were at a higher risk for memory loss, dementia or Alzheimer’s disease. In questioning the participants of the study, those who had signs of early memory loss also reported that they hardly ever visited a dentist. In a different study, participants with dementia came into the study with an average of 18 teeth, while those who did not have dementia had an average of 20 teeth. It is thought that tooth loss before the age of 35 may be a risk factor for Alzheimer’s disease.
Rheumatoid Arthritis …
Your oral health may also be related to your joint health. Studies show that people with moderate to very severe periodontitis have an increased risk for rheumatoid arthritis. This link is thought to be from the underlying inflammatory response.
General Lifestyle …
Many lifestyle factors can play a role in promoting, or worsening, oral health as well. Smoking, high levels of stress and lack of exercise can all increase the risk of periodontal disease as well as heart disease, diabetes and other chronic illness.
While oral health has always played an important role in overall health, it is becoming more and more obvious that the link between systemic health and oral health plays a much larger role than was first thought. Although some additional research is no doubt needed in order to understand the exact mechanisms behind these links, the research is undeniable. Making an effort to ensure your good oral health will pay off in immeasurable ways, and both your mouth and your body will thank you for it. As stated by researcher Nabil F. Bissada in the October 2011 issue of Inside Dentistry:
“I think the most important issue or message here is that although in the past dentists focused on saving teeth and keeping them healthy, today we now have a broader dimension for why it is more important to maintain a healthy mouth. If you have an inflammatory condition, which the most popular example here is periodontal disease, it puts the individual at a higher risk for a more serious systemic problem, whether it’s heart problems, diabetes, or rheumatoid arthritis. As we take care of the mouth, not only do we save teeth, which is a very good objective, but we also protect our general health.”
Inside Dentistry, Volume 7, Issue 9
Inside Dentistry, Volume 7, Issue 9
Inside Dentistry, Volume 7, Issue 9
Breast Cancer Res Treat;127(2):497-502.