Think of oral health and general health as a two-way street, each signalling problems with the other. Particular problems with the mouth hint at parallel problems in the body.
Tooth loss is usually connected with one of two issues – smoking or poorly controlled diabetes. Only about five to ten per cent of the adult population in any country have been found to suffer from moderate to severe gum disease. If you have such gum disease, you fall into a select group and likely either smoke or have poorly controlled diabetes.
The relationship between smoking and tooth loss is massive. Of those with severe gum disease under the age of 40, about half are smokers. The condition is called smoking-associated periodontitis (gum disease).
Smoking damages the support of the teeth in the jaws. Recent research has shown that those who smoke cannot control the growth of bacteria between their teeth and gums nearly as well as non-smokers. As a result, smokers lose teeth much earlier, and three to nine times faster, than non-smokers.
If you smoke, the fact that smoking can make your teeth fall out provides yet another good reason to quit.
If you do not smoke, but have significant and perhaps painful gum disease, you should be tested for diabetes. This is especially true if you have a relative with diabetes, even one as distant as a great-grandparent.
Medical and dental professionals have known since the 1960s that gum disease is encouraged by poorly controlled diabetes. However, the average person is not necessarily aware of this. More recent research has proved that there is a two-way interaction between diabetes and serious gum disease. Poorly controlled diabetes leads to serious gum disease and tooth loss. At the same time, ongoing treatment of gum disease can improve the control of diabetes.
Often, serious gum disease has linked genetic factors. They influence many defence mechanisms in the body, especially those that lead to increased inflammation. Such inflammation is a problem not only in the gums, but in many other systems of the body. The cardiovascular system is particularly affected.
The association between serious gum disease and cardiovascular problems (heart and stroke) is not a cause-and-effect relationship. Most likely the two have a common underlying mechanism. Much research is being done in this area.
Since there is a connection, use this information to your advantage if you or another family member have serious gum disease. Consider it a warning to pay attention to and manage any cardiovascular symptoms.
Of course, having your teeth cleaned helps keep gums healthy and monitors your periodontal (gum) health. Regular visits to the dental office may also reduce any possible impact that gum inflammation might have on the rest of your body. While keeping gums healthy is important, quitting smoking, exercising and watching your diet are just as essential.
Gum disease may also point to problems with a baby’s weight at birth. Studies in the U.S. show an association between increased gum disease in the mother and her baby being born early (preterm) and with a low birth weight. However, other studies in Europe have found no such association. These differences may reflect the genetic background of people in the various studies.
While research continues in this area, maintaining healthy gums during pregnancy is a good idea. As with heart and stroke, if you have clinically important gum disease and are either planning a pregnancy or are pregnant, your gum disease should be treated.
Elderly individuals with poor oral hygiene have an increased risk of serious chest infections and pneumonia. It is likely that bacteria in poorly maintained mouths can be inhaled directly into the lungs, where they can cause serious infections.
The elderly and those that care for them should make a special effort to keep the mouth clean and healthy. The reward might be a longer life.
Dental treatment and operations can drive bacteria from around the teeth into the blood stream. Those who have internal damage to the heart must be particularly careful. Damage includes heart valve injury or repair for malformations present at birth. People who have had an artificial joint placed within two years should also be concerned.
The problem is that some bacteria in the mouth are able to stick to the sides of teeth and other surfaces in the mouth. These same bacteria are driven into the blood stream during some dental procedures. They are so good at sticking that they can attach to the inside of damaged hearts and artificial joints. They then produce infections in these places.
Infections inside hearts (infectious endocarditis) or artificial joints are very serious. Patients with these concerns must take antibiotics before some types of dental procedures. The antibiotics will kill any bacteria that enter the circulating blood stream, preventing infection.
Happily, most dental decay can be prevented with modern techniques of preventive dentistry, such as fluoride, sealants and low-sugar alternatives. Much gum disease can also be prevented by not smoking and by controlling diabetes. Preventing dental decay and gum disease is the best way to avoid the problems that dental treatment would pose for those with damaged hearts or new artificial joints.
Thanks to modern dentistry and healthy living, many of us keep our mouths healthy for a lifetime. Now, recognizing and preventing oral health problems early on can help us preserve our general health too.