links between general and oral health

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‘It is time to put the mouth back into the body!’

This was a statement that I have heard by a professional on one of the recent dental conferences I have attended.
Although many people tend to forget this, the mouth IS part of the body and not looking after your teeth and gums could lead to conditions far more serious than toothache or gum disease.
This article considers the effect bad mouth care habits can have on your general health.

table of contents

links between oral and general health

The World Health Organization (WHO) states: ‘Oral health means more than good teeth; it is integral to general health and essential for wellbeing.’(1)

The relationship between oral and general health is proven by evidence. It is interlinked and works both ways, meaning that poor oral health is associated with the onset of chronic diseases but also general health problems could cause or worsen oral health conditions.

which systematic diseases are these?

cardiovascular diseases

(CVDs) are diseases which are affecting the heart and blood vessels.

It is hard to prove cause and effect between CVD and poor oral health (gum disease mainly), but there is a strong link, which is inflammation. Inflammation leads to hardened arteries causing the blood not flowing to the heart as effortlessly, which puts people at greater risk of heart attack and stroke.

Gum disease is an inflammatory disease, involving bacteria irritating the gums, causing inflammation and pockets, which allows the bacteria and the toxins they produce to advance further bellow the gum level and eventually entering the bloodstream.

The bacteria then can travel from the mouth to any other part of the body, causing inflammation, therefore damage to the blood vessels. (2)

Did you know?

CVDs are taking around 17.9 million lives every year, and are the number one cause of death globally. (3)

diabetes

People with diabetes are more prone to infections; therefore they are more susceptible to periodontal disease, especially where the diabetes isn’t controlled effectively.

Diabetes causes the blood vessels to thicken, which makes it difficult for the blood to deliver important nutrients and to remove waste products. This weakens the resistance to infections of the bone and soft tissues around the teeth; hence gum disease can develop easier.

However it works both ways. Not treated gum disease can make it more difficult for diabetic people to regulate their blood glucose levels and can worsen the illness. So, this is a two-way relationship between the two conditions. (4)

Did you know?

According to the World Health Organization the number of people living with diabetes was an estimated 422 million in 2014, and directly caused the death of 1.6 million people in 2016. (5)

respiratory infections

Bacteria in the mouth can travel not just via the bloodstream, but by the airway as well.

Studies suggest that bacteria living in the mouth also can be found in the upper airway, where they can multiply and travel further down and play part in causing diseases like aspiration pneumonia especially in people with periodontal disease as those people have a higher number of bacteria in their mouth and saliva.

links between general and oral health 2

alzheimer’s disease

This is a disease which damages the brain and causes dementia. Alzheimer’s disease leads to the loss of the connection between the billions of nerve cells in the brain due to the build up of abnormal protein structures called ‘plaques’ and ‘tangles’, which eventually leads to brain tissue death. (7)

Studies have shown that the bacterium responsible for peridontitis (gum disease) can travel from the mouth to the brain via the bloodstream. Samples taken from people’s brains who suffered from Alzheimer’s disease has shown that traces of this bacterium and its toxins were more prevalent than that of from healthy people. Therefore this bacterium may actually contribute to the development of the disease. (8)

These are just a few serious illnesses, which are having a relationship with the state of our oral health (see the figure bellow for the systemic outcomes periodontal disease can cause).

Connection between periodontal and systemic diseases

It is clear that one cannot think anymore of the mouth as a separate entity.

Furthermore the general well being of a person can also be greatly influenced by the state of our oral health.

A healthy mouth plays an important role in the everyday life and socialising, as it allows the person to enjoy eating regularly and healthily, permits clear speech, boosts the confidence in appearing in public and allows the person to live without pain and discomfort.

Pain in the mouth can prevent you from eating and drinking adequately, which can lead to lack of nutrition and dehydration.

Poor oral health can badly affect the person’s quality of life and self-confidence and can stop people from smiling, talking or kissing loved ones. If you ever had toothache you will know how antisocial one can become until the pain is gone.

Toothache or pain in the mouth is definitely not a joyride. I have experienced in my career many patients (who were considered as lovely and bubbly) become inpatient, withdrawn and almost angry due to dental pain. (10)

Just like any vital organs, the mouth is a vital part of the body, and it is definitely beneficial to look after it by brushing twice a day, flossing or cleaning interdentally daily and visiting the dentist/hygienist regularly (in order to maintain good oral health, to minimise the risk of developing any of the above mentioned systemic diseases and to achieve a general well being).

by Hajnalka Takacs (qualified dental nurse and oral health educator)

  1. World Health Organization (2003) The World Oral Health Report. (Accessed: 20 January 2020).
  2. WebMD (2015) Periodontal Disease and Heart Heath. (Accessed: 08 February 2020).
  3. World Health Organization (2017) Cardiovascular Diseases (CVDs). (Accessed: 09 February 2020).
  4. WebMD (2000) Diabetes and Periodontal Disease. (Accessed: 09 February 2020).
  5. World Health Organization (2018) Diabetes. (Accessed: 09 February 2020).
  6. Amar, S. and Han, X. (2003) ‘The impact of periodontal infection on systemic diseases’, Medical Science Monitor 9(12), pp. RA291-299.
  7. Alzheimer’s Society (2019) Alzheimer’s disease. (Accessed: 11 February 2020).
  8. Dental Nursing Journal (2019) Gum bacteria implicated in Alzheimer’s and other diseases. (Accessed: 11 February 2020).
  9. Abbayya, K., Puthanakar, N., Naduwinmani, S. and Chidambar, Y. (2015) ‘Association between Periodontitis and Alzheimer’s Disease’, Nothern American Journal of Medical Sciences, 7(6), pp. 241-246. doi: 4103/1947-2714.159325.
  10. Felton, A., Chapman, A. and Felton, S. (2014) Basic Guide to Oral Health Education and Promotion. 2nd Chichester: John Wiley and Sons Ltd.

N.B.: The author confirms that the content of this article is created solely for
educational purposes. The content is for non-commercial use only, and in no ways
the author has gained any financial benefit from the platform it has been uploaded to
or from any of the companies mentioned in the text of the article.

‘It is time to put the mouth back into the body!’

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