Dental Health is Part of Your Overall Health
There is a strong association between dental disease and overall systemic health. After all, the mouth is part of the body made up of nerves, skin, blood vessels, and cells—the same as the rest of our bodies. There is an old adage, “Healthy mouth means a healthy body.” That’s not far from the truth because it is not uncommon for dentists to catch systemic diseases before medical doctors do.
Medical and dental journals are replete with articles correlating gum disease (periodontitis) and heart disease, stroke, premature births, low birth weights of infants, diabetes, some kinds of cancer, and depression. Many systemic problems like candidiasis, lichen planus, and some allergic reactions often present in the mouth before anywhere else. Dental disease itself can make people more prone to other systemic problems.
For example, I once had a patient whose life was on the line because he was rejecting a liver transplant. The patient presented to me with “a little toothache.” A thorough exam revealed not one but multiple dental abscesses. Once those were managed, the patient’s health miraculously recovered. We just celebrated 20 years of that organ transplant together!
Everyone—including denture wearers—should have regular dental exams might, which should involve an evaluation of current dental x-rays that clearly show each tooth from top to bottom, a gum disease assessment, and an oral soft tissue examination. It is also important to seek dental clearance prior to being placed on certain medications. For example, some medications used to treat cancer pain and osteoporosis may pose risks for future dental treatments like extractions or periodontal surgery. Ideally, these procedures should be done prior to beginning these medications.
Dentists are actually doctors of dental surgery or doctors of medical dentistry, this is what the designations DDS or DMD mean. We are trained to evaluate the mouth as part of the body—not just to fix cavities in teeth. In fact, medical doctors and dentists often have to work together to make sure our patients receive the best care possible. This is why we routinely ask our patients about their medical history and the name of their doctors.
More on the Oral-Systemic Connection
What Is the Oral-Systemic Link?
It’s frequently said that the mouth is the gateway to the body. More and more, medical professionals have been discovering just how true this really is. This is referred to as the oral-systemic link or oral-systemic connection.
Dentists are often the first to detect conditions such as Crohn’s disease, diabetes, or cancer because the early symptoms may first show up in the mouth. Going in the other direction, we’re learning more and more how what happens in your mouth affects the health of the rest of your body.
The brain has the blood-brain barrier which protects it from toxins in the blood. In our mouths, there is a barrier between our gums and teeth and the rest of our body as well. In the case of periodontal disease, this barrier can break down and may cause disease or other problems in the rest of the body. Previously, it was thought that bacteria were the main factor in this, but more recent research has been indicating that inflammation may play a bigger role.
While the details of this connection between oral health and the health of the rest of the body is still being explored, it’s becoming increasingly clear that treating the inflammation of periodontal disease can help with the treatment of other inflammatory conditions (and, in some cases, vice versa).
Diseases with oral connections
Some conditions with strong connections to oral health include:
Diabetes – Gum disease can make diabetes harder to control, and diabetes can exacerbate gum disease. We explore the topic in more detail below.
Heart disease and stroke – Conditions causing chronic inflammation, such as periodontal disease, have connections to the likelihood of heart disease and stroke. Below, you can read more about this topic.
Respiratory disease – The bacteria that grow in the mouth can find its way into the lungs as well. Respiratory diseases, such as pneumonia, can be caused by the same bacteria responsible for periodontal disease.
Cancer – According to the American Academy of Periodontology, those with periodontal disease were more likely to develop cancer than those without:
- 54% more likely to develop pancreatic cancer
- 49% more likely to develop kidney cancer
- 30% more likely to develop blood cancers
Other diseases that may be caused or complicated by oral infections include:
- Breast cancer
- Prostate cancer
- Weight gain
- Alzheimer’s and dementia
- Low birth weight and premature birth
- Rheumatoid arthritis
Some diseases can influence your oral health, as well, such as osteoporosis. Osteoporosis can lead to bone loss in the jaw which, in turn, can result in tooth loss, as there is no longer sufficient bone to support the teeth.
It’s critical to understand how important oral health truly is to our wellbeing, and to take it seriously in order to help prevent, or reduce the effects of other conditions.
Below, we’ll look at some of these conditions in a little more detail.
The health of your mouth and the rest of your body are linked, and there’s an especially strong connection when it comes to diabetes and periodontal disease. For those who are suffering from diabetes, gum disease is often more likely and cases can be more severe.
How is diabetes linked to gum disease?
Diabetes is a disease that occurs when the amount of glucose, or blood sugar, in the body is too high. A hormone known as insulin is responsible for helping the cells in your body to use this glucose for energy. For those with diabetes, the body doesn’t produce enough insulin, so too much glucose stays in the bloodstream.
Inflammation in the mouth, such as the type responsible for periodontal disease, have an impact on the body’s ability to regulate blood sugar levels as well. This means that people with diabetes, whose bodies are already struggling with processing sugar, can find themselves having an even harder time if they are suffering from gum disease.
This link can go both ways, too, as high blood sugar levels provide an environment that can make gum infections more likely.
Heart Disease & Stroke
The potential links between periodontal disease and heart disease and stroke have been the subject of medical research in recent years. While a clear cause-and-effect relationship has yet to be established, findings lend a lot of credibility to the connection between oral inflammation and cardiovascular disease.
Researchers have found that chronic inflammation in the body is a major contributor to health problems in the body. This means that long-term inflammation, such as that in gum disease, may lead to narrowing or blockages in blood vessels—a situation that can lead to a heart attack or stroke.
In an article that looked at a number of related studies, it was found that having periodontal disease increases a person’s risk of cardiovascular disease by around 20%. One stroke expert reported that periodontal disease could make a person almost twice as likely to experience a stroke.
While research is still ongoing, what’s already been discovered should only put more emphasis on the need for a healthy mouth and gums.
If you have any concerns about the health of your mouth, or if you haven’t had a dental appointment in a while, make sure to get in touch to schedule your next visit.
Links have been established between gum disease and many types of cancers.
Studies performed at Brown University, Harvard, New York University, and others have looked into the link between gum disease and pancreatic cancer. Pancreatic cancer is extremely hard to detect and causes death within six months of diagnosis. It is approximated that pancreatic cancer is responsible for nearly 40,000 deaths per year in the US. So, what is the connection between gum disease and pancreatic cancer?
The connection comes from changes in the microbial mix in your mouth. Those who have porphyromonas gingivalis in their mouth were at a 59% higher risk of developing pancreatic cancer. In addition to prophyromonas gingivalis, those who had aggregatibacter actinomycetemcomitans were one 50% more likely to develop pancreatic cancer.
While the names may not mean much to the average person, the important thing to understand is that both of these types of bacteria have been tied to gum disease.
Unfortunately, the majority of Americans do not take proper care of their gums. It is reported that nearly half of American adults over the age of 30 have some form of periodontal disease. If you look at Americans over the age of 65, the percentage suffering from periodontal disease increases to 65%. Although not nearly as talked about, gum disease is almost 2.5 times more common than diabetes.
However, there is some good news! Gum disease responds extremely well to treatment and can easily be reversed after detected by your dentist.
A study done by the Federal University of Santa Maria Dental School in Brazil found that women with periodontitis are 2-3x more likely to develop breast cancer. In this instance, the researchers believe that breast cancer may be triggered due to systemic inflammation resulting from gum disease.
The study was based on 67 women who have been diagnosed with breast cancer and 134 controls from 2013 to 2015. It is important to remember that this study has not proven that gum disease causes breast cancer, but the findings do provide further support for the idea that oral health is vital to our overall wellbeing.
In the United States, for every 100,000 women, there are 124.9 new cases of breast cancer. Breast cancer continues to be studied, and this possible connection to oral health provides another avenue to be explored when learning to treat this type of cancer.
A 10-year study performed by NYU Langone Health’s Perlmutter Cancer Center has found that two types of bacteria that are present in individuals with gum disease can increase the chances of being affected by esophageal cancer.
The eight most common type of cancer in the world, esophageal cancer can be highly fatal and is the sixth most common cause of cancer-related deaths. In the US, it affects around 1 in 125 in men and 1 in 417 in women. The American Cancer Society says that currently, only around 20% of those diagnosed with this form of cancer will live for more than five years following diagnosis.
The study by NYU Langone found that bacteria associated with periodontal (gum) disease can find its way into the upper digestive tract, and in the case of one of the types of bacteria in the study, tannerella forsythia, its presence may increase the chances of this kind of cancer by 21%.
It is important to note that while the bacteria involved demonstrates a link between gum disease and esophageal cancer, it has not yet been proven that periodontal disease directly causes the cancer. However, the connection should be reason enough to reinforce the importance of proper oral hygiene and treatment of gum disease.