Mind Your Mouth: How Oral Health Affects Overall Health
Failing to give your mouth the proper attention can have a negative impact on your overall health.
Good oral health means more than a mouth full of pearly whites and fresh breath; it can also be the difference between life and death. Your mouth is a hotbed of bacteria, which can be controlled with good oral hygiene. But neglect your teeth and gums, and it’s not just your mouth that will suffer. Studies suggest your overall health may also be on the line.
“Periodontal disease is a chronic inflammatory disease caused by the more than 500 bacterial species found in plaque below the gum line,” says Joan Otomo-Corgel, president of the American Academy of Periodontology and associate clinical professor in the department of periodontics at University of California–Los Angeles.
Periodontal disease – a fancy term for gum disease, including gingivitis – can cause swollen gums, irritation and bleeding. The more advanced form, periodontitis, can lead to receding gums, damaged tissue and bone around the teeth, and even tooth loss.
“Periodontal disease is the sixth most prevalent chronic condition in the world, affecting 743 million people,” Otomo-Corgel says. “In the United States [alone], [it] affects one in every two adults and 2.5 times more people than diabetes.”
At the American Society of Nephrology’s Kidney Week meeting in November, a study was presented showing that within a population of African-Americans with normal kidney function, those with severe periodontal disease went on to develop chronic kidney disease at four times the rate as those without severe periodontal disease after an average of nearly five years. Research like this continues to strengthen the link between periodontal disease and various ailments affecting the body, including heart disease, stroke, Alzheimer’s disease and diabetes.
“Periodontal disease is now recognized by the cardiology community to be a direct risk factor for coronary arterial disease, peripheral arterial disease and stroke,” says Sam Shamardi, a dentist at the Boston Center for Oral Health and clinical instructor in the Harvard School of Dental Medicine’s division of periodontology. “The common link to these and other diseases is inflammation.”
In 2012, the American Heart Association released a statement acknowledging an association between periodontal disease and cardiovascular disease, but stopped short of affirming a causal connection, citing a need for further study.
At the annual meeting of the American Society for Microbiology in May, researchers from the University of Florida and University of British Columbia presented further evidence of a connection. They found that after six months, mice infected with four different types of bacteria known to cause gum disease experienced an increase in inflammation and cholesterol levels, both linked to cardiovascular disease. In addition, these bacteria traveled from their mouths to the hearts, kidneys, lungs and livers.
While that study was in mice, a large body of evidence also suggests periodontal disease may be a risk factor for stroke. “Bacteria associated with deeper periodontal lesions have been shown to be attracted to platelets, [forming] small clots that may be problematic for a person susceptible to stroke,” Otomo-Corgel says.
In a large study tracking some 720,000 Taiwanese adults, researchers found that patients with periodontal disease who received treatment for it lowered their risk of stroke.
In fact, periodontal disease is often the reason people learn they have been living with diabetes. “Hundreds of patients a year are first identified [as] diabetes patients because of their gingival presentation. There are distinct oral signs on the [gums], and oftentimes as periodontists, we are the first ones to identify this,” Shamardi says. After getting tested, “[these patients] find they were undiagnosed diabetics.”
That’s because people with diabetes are more likely to develop periodontal disease, and vice versa. “Periodontal disease and diabetes feed off each other,” Shamardi says. “Poorly controlled diabetes will worsen periodontal disease, and poorly controlled periodontal disease will worsen people’s diabetes.”
Though research has demonstrated an association between periodontal disease and Alzheimer’s disease, says Otomo-Corgel, a direct causal link between the two has yet to be established. “Advanced cases of periodontal disease can turn the mouth into a bacterial gateway, allowing bacteria to gain access to other parts of the body through the bloodstream. One study found that such bacteria can travel to the brain, causing the brain tissue deterioration that is reflective of Alzheimer’s.”
Periodontal disease can even impact the health of an unborn child. “There are endless studies linking periodontal disease to pre-term or low-birth-weight babies. Poor periodontal control has been found to lead to this and other issues, such as pregnancy, gingivitis and diabetes,” Shamardi says. According to the Centers for Disease Control and Prevention, babies born weighing less than 5.5 pounds have an increased risk of health problems during their first few days of life, or may suffer delayed motor and social development or learning disabilities down the road. Similar complications may occur for pre-term babies.
Says Otomo-Corgel: “If a woman finds she needs to have dental treatment during her pregnancy, the ideal time is during her second trimester. According to recommendations from the American College of Obstetricians and Gynecologists, teeth cleanings and dental X-rays are safe for pregnant women. Non-surgical periodontal therapy is also safe.”
Bottom line? “Take care of your oral health like you would your whole body,” Shamardi says. “Be consistent with your homecare – brush twice a day and floss daily.”
And do note that early warning signs of periodontal disease can be silent. “It’s often when a patient experiences pain and visible symptoms that the disease has progressed to its advanced stages,” Otomo-Corgel says. “These symptoms include red, swollen or tender gums or other pain in the mouth; bleeding while brushing, flossing or eating hard food; gums that are receding or pulling away from the teeth, causing them to look longer than before; sores in the mouth and pus between the teeth and gums; and persistent bad breath or foul taste.”
Don’t assume that after being treated by a dentist, you’re off the hook. “If you don’t maintain your oral health, it will deteriorate back to harmful levels,” Shamardi says.
In the first-ever oral health report in 2000, the Surgeon General declared that the “mouth is the center of vital tissues and functions that are critical to total health and well-being across the life span.” In other words, Shamardi says, “Everything in our body is linked.”
So brush. Do it often. And floss, too. Your mouth – and health – will thank you.