Brushing & Flossing: Powerful Preventative Medicine

By Tamela Thomas, Wellness Manager

Where would you rank dental hygiene as a contributor to your overall personal wellness? Would it surprise you to know that some of us are more susceptible to the effects of certain diseases if we have poor oral hygiene?

This month's article is written by Dr. Gerrarda O'Beirne, BDS, MSD. As the current president of the Washington State Society of Periodontists, she has a personal and professional interest in the latest research linking gum disease and health. Although this is a fairly new area of study, early results are showing statistically significant connections between your oral health and your overall health. In this article you'll find good reason to be much more concerned with your family's oral hygiene—beyond just lowering your dentist bills.

Oral Health Affects Overall Health

By Gerrarda O'Beirne, BDS, MSD

Writing an article for an athletic club about staying healthy is like preaching to the choir, but there is some new information linking gum disease with general health that is worth sharing. The latest research suggests that a low-grade infection in the mouth, as occurs with gum disease, can have a negative impact on conditions such as heart disease, diabetes and respiratory disease. Pregnancy and gum disease have always been linked, and now we are being told that not only is gum disease more common in pregnant women but there is also an increased incidence of premature labor and post natal complications for the infant.

How can a disease in the mouth have an affect on another part of the body?

To answer this question one first needs to understand the process that causes gum disease. Plaque, a sticky film that adheres to the surface, accumulates on a continuous basis. It is made up of bacteria, mucus and proteins and is a source of irritation for the gums causing them to become inflamed. When the gums are inflamed, they have a tendency to bleed and to become swollen and tender.

Gum disease progresses in stages. The earliest stage, called gingivitis, is characterized by inflammation of the soft tissues around the tooth with no loss of bone supporting the tooth. In the next stage, periodontitis, bone loss has occurred and the collar of tissue around the tooth is no longer snug against the root. The space that develops between the gum and the root is referred to as a pocket. Periodontal pockets are present when a space of 4mm or more exists. Pockets are a problem as brushing and flossing commonly reach a maximum of 3-4mm, so the base of deeper pockets do not get cleaned daily. Plaque accumulates in the depth of these pockets and causes inflammation that weakens the integrity of the tissues. Since the body is a closed system, bacteria or the byproducts of infection can enter the bloodstream through micro wounds in the periodontal pockets and course throughout the body.

Stroke & Heart Disease

The most likely consequence of bacteria and their byproducts in the bloodstream is an increased tendency toward clot formation. Blood vessels that are narrowed as a result of atherosclerosis (fatty protein buildup in the vessel walls) are particularly vulnerable. If the vessels of the brain are involved and become obstructed, the individual can suffer a stroke. A heart attack may result if the blood vessels in the heart are affected. Alternately, the bacteria can lodge directly on the inner surfaces of the heart causing inflammation of the heart. This is called infective endocarditis.

It is important to recognize that certain individuals are at risk for getting heart disease. We also know that certain lifestyle choices such as smoking, lack of exercise and poor diet can greatly increase this risk. Where does gum disease fit in? Research tells us that the presence of periodontal disease increases the chance of developing heart disease to a degree similar to these classical risk factors.

Diabetes

The link between diabetes and periodontal disease also has been well established. Diabetics are generally more susceptible to infections, consequently gum disease is more common in these individuals. The control of gum disease and diabetes are codependent—treatment of the gums will not be successful unless the blood sugar is also within normal range. Additionally, we know that the presence of uncontrolled periodontal disease may increase an individual's chance of becoming diabetic if they are on the borderline.

Pregnancy

We have known for some time that pregnant women are particularly prone to developing gum disease as a consequence of the hormonal changes associated with pregnancy. What's new is that research shows the presence of gum disease seems to increase the incidence of premature delivery and the possibility of post natal complications for the infant. Labor is induced by biological agents in the body, but these chemicals are also present in inflammation and in much higher quantities. Although many factors may bring about premature deliveries, research suggests that gum disease increases the risk by as much as sevenfold.

A chronic infection in one part of the body can impact another part of the body, therefore, a healthy mouth is necessary for overall wellness. From a dental professional standpoint, some individuals are at risk for developing gum disease and some will stay healthy often despite mediocre efforts. If, however, an individual is in the former category the disease can progress painlessly, often only becoming evident when it is quite severe. The prudent thing to do is to visit your dentist regularly for examination and cleaning.

If you have been diagnosed with gum disease, you should update your medical practitioner, or conversely, if you have been diagnosed with any of the aforementioned conditions, you should keep you dentist informed. Historically, medicine and dentistry have taken parallel yet independent paths treating the patient. An inclusive approach may now be more appropriate to facilitate complete care.

For more information or referrals, please contact Tamela Thomas, Wellness Manager, 206.464.4639.