The mouth has been compared to a mirror and a gateway for the body. In 2000, the first U.S Surgeon General’s Report on Oral Health connected the importance of oral health with general health and well being. This report noted “the mouth senses and responds to the external world and at the same time reflects what is happening deep inside the body.”
The mouth may show signs of nutrition problems, or give early warning of immune (defence) system problems, general infection or stress. Oral health and the health of the body are interconnected. To be truly healthy, both mouth and body should be in good shape.
For decades we’ve known diseases of the body can cause oral health changes. Now, new findings show that oral disease may indeed cause health problems. However, further research is necessary before we can be sure that oral infections cause disease of the body.
There has been great progress during the last several decades in reducing tooth decay in middle class populations. Even so, 75 per cent of adult Canadians currently experience various forms of periodontal disease. The early form is gingivitis, where the gums are inflamed and bleed easily. This can progress to the more destructive periodontitis, with infection and damage to the soft tissues and bone supporting the teeth.
New research suggests that the harmful bacteria causing gum disease may pose serious threats to health. Gum disease may be more than just a danger to your gums. Early evidence points to what many dental care providers have suspected for decades: good oral health is essential to achieve good general health.
It is believed that periodontal bacteria enter the blood stream and circulate to many organs and areas of the body. This may affect the body.
The more times that you answer 'yes', the greater your risk for gum disease.
(Adapted from Medical Science Systems Inc and the American Academy of Periodontology.)
Heart disease and stroke are leading causes of death in Canada. Poor oral health may be linked with cardiovascular disease. Prevention of these diseases could be helped thanks to this knowledge. Recent studies looking at the link between gum disease and heart disease have suggested several theories. The Canadian (CAP) and American (AAP) Academy of Periodontology have suggested that oral bacteria enter the blood stream. Bacteria then attach to the fatty deposits in the coronary (heart) arteries. These deposits contribute to clogging the arteries, causing the artery wall to thicken and swell. Another theory is that oral bacteria attach to fatty deposits in the coronary arteries and contribute to blood clots forming. These clots block normal blood flow, restricting the nutrients and oxygen the heart needs to work properly.
The AAP report that people with gum disease are almost twice as likely to suffer from coronary artery disease as those without gum disease. Another study showed men with gum disease as 25 per cent more likely to develop coronary artery disease.
The Alberta Dental Hygienists’ Association (ADHA) summary of the new evidence notes that strokes and death from strokes are higher in patients with gum disease. Even after controlling for other risk factors, such as smoking and poor diet, patients with gum disease are more at risk for stroke than those without gum disease. As well, studies on younger age groups illustrate that people with severe gum disease, including gum pockets infected with periodontal bacteria, have more heart valve abnormalities.
It is well known that gum disease can also affect existing heart conditions. Some people with heart problems, such as those with heart valve damage, may require antibiotics prior to certain dental or other surgical procedures. Your dentist and heart doctor will be able to tell if this is the case for you.
Acute infections in the body raise blood sugar levels. Recent suggestions say that gum infections may do the same. Research has shown a two-way relationship between diabetes and gum disease. People with poorly controlled diabetes are much more likely to develop severe forms of gum disease. The reverse is also true. People with diabetes who have gum disease may have greater difficulty controlling their blood sugar levels.
It is still unclear why diabetes increases the risk for severe gum disease. The good news is that people with diabetes, who maintain good control of their diabetes and receive regular dental and dental hygiene care, are no more likely to develop severe gum disease than people without diabetes.
Severe gum disease can raise blood sugar and make it difficult to control blood sugar levels. Those with diabetes and gum disease are at increased risk for complications from diabetes. Although more research is needed to confirm the gum disease and diabetes link, it is recommended that all people with diabetes have a periodontal exam. People with diabetes who have gum disease should be treated to stop the gum infection. They should have regular oral health appointments to prevent the gum disease from returning.
Risk factors, such as smoking, alcohol and drug use, are already linked to problems in pregnancy. Outcomes can include babies being born early with a low birth weight. New evidence says that pregnant women with gum disease may be seven times more likely to give birth to a premature, underweight baby.
More research is needed to confirm how gum disease may affect pregnancy outcomes. Research suggests gum disease may "trigger increased levels of biological fluids that induce (start) labour." Women whose gum condition worsens during pregnancy run an even higher risk of having a premature baby. Women considering pregnancy should have a periodontal exam.
Recent studies show a high percent of Canadians over the age of 30 have some form of gum disease. Hopefully people are becoming more aware of the need for thorough daily oral care and regular visits to the dentist and dental hygienist. This may help them to reach better levels of general health. Although further research is needed to better understand the worrisome findings, it is not too soon to attack gum disease. With proper treatment and prevention, gum disease can be controlled and in some cases even reversed.
American Academy of Periodontology
Alberta Dental Hygienists’ Association
Canadian Academy of Periodontology
Canadian Dental Association
Canadian Dental Hygienists Association
The Surgeon General Report on Oral Health
Current recommendations from Canadian and American professional associations of periodontists and dental hygienists follow. If you suspect that you may have gum disease, visit your dental care provider for a periodontal exam. The dentist and dental hygienist will do the following.
To help you decide if you may be at risk, answer the quiz above. The more times that you answer “yes” the greater your risk for developing gum disease.