Connections between oral and physical health

Did you know that oral health can affect the rest of your body? According to the US Office of Disease Prevention and Health Promotion, a growing body of evidence links oral health to chronic illnesses, including diabetes, heart disease and stroke.

Whether we like it or not, bacteria exist in everyone’s body. Most of that bacteria is harmless but when you don’t have good oral hygiene, it can be linked to tooth decay, periodontal disease and periodontitis.

Mollie Day, DDS

“We’ve really started talking about oral health and systemic relationships in the last 20 years,” said Mollie Day, DDS, the chief dental officer at Heartland Community Health Center. “More research needs to be done, but we know that when you don’t properly care for your oral health, it leads to other problems.”

Periodontal disease, sometimes called gum disease, is the result of infections and inflammation of the gums and bone that surround and support the teeth. In its early stage, called gingivitis, your gums can become red, swollen and may bleed.

“If you haven’t brushed your teeth in a couple of days, plaque builds up and causes inflammation. Sometimes just improving your hygiene can make this go away on its own,” Day explained.

Its more serious form, periodontitis, is inflammation of the bone caused by bacteria. Your gums can pull away from the tooth, bone loss can occur and your teeth may become loose or fall out. The Centers for Disease Control (CDC) says that periodontal disease and tooth decay are the two biggest threats to dental health.

“You’ll have deep pockets where bacteria grow unchecked because your brush can’t get there,” Day said. “Be on the lookout for bleeding, swollen or tender gums, persistent bad breath, gums pulling away from your teeth and loose or separating teeth. If any of these happen, it’s time to go to your dentist for a deep cleaning.”

The American Dental Association (ADA) states that certain diseases raise your risk of developing periodontal disease. These include arthritis, diabetes, emphysema, heart disease, high blood pressure, Hepatitis C, obesity and prior strokes. Using tobacco also raises your risk. If you have any of these conditions, it’s important to visit both your primary care provider and your dentist regularly.

Correlation between poor oral health and systemic disease

Dental health is very important in cardiology, as oral health is linked with cardiovascular disease. Darcy Conaway, MD, a cardiologist with Cardiovascular Specialists of Lawrence, said poor oral health is associated with an increased risk of cardiovascular disease.

Darcy Conaway, MD

“People who have periodontal disease have higher rates of heart attack and stroke. One theory is that bacteria from the mouth travel into the bloodstream and into plaque that accumulates in your arteries. This makes those plaques more unstable and promotes acute coronary syndrome,” she said.

Patients who undergo cardiac valve surgery need to be particularly aware. Endocarditis – an infection of the heart valve with bacteria that often spread from the oral cavity – is a particular concern.

“Major dental issues need to be addressed prior to surgery whenever possible. This reduces the potential to infect newly implanted valves,” Conaway said.

Diabetes enters the frame

Having bad breath can be an indicator that something more severe might be going on. If your breath is sweet, fruity or smells like acetone (nail polish remover), you need to be seen by your primary care provider immediately. Mark Oertel, MD, an endocrinologist at Lawrence Endocrinology, said it’s possible that you could have a serious, life-threatening condition.

Mark Oertel, MD

“Diabetic ketoacidosis can happen when there is insufficient insulin in the body to allow blood sugar into your cells for use as energy. This causes acid to build up in the body, which can harm many of your vital organs,” he explained. “This can happen in patients more with type 1 diabetes, but can occur in patients with type 2 diabetes, especially if they require insulin to control their glucose values.” 

People with diabetes also have a harder time fighting off infections. Think of periodontal disease as an infection, which makes it harder for you to take care of and control blood sugars.

Oertel advises his patients to keep their A1C values less than 7 and most blood sugars lower than 180 after eating. This helps keep your body healthy and maintain its infection-fighting capabilities.

“When blood sugars are higher, the infection-fighting cells in our body work less vigorously. This can cause cuts and scrapes to take longer to heal or for periodontal disease to become more predominant,” he said.

What can you do to maintain good oral health?

Good oral health is an important component of your overall health, so what should you do to maintain it? Brushing your teeth daily is an important first step. Day explained that cavities are caused by bacteria taking sugar and turning it into an acid. It then adheres to the enamel in your teeth and decalcifies it.

“You want to decrease the bacteria in your mouth. Brush daily and never skip brushing before you go to bed. Saliva is the buffer to keep the pH in your mouth neutral but when you’re asleep, your saliva decreases. If you’ve got plaque there and the pH in your mouth is low, you’ll cause cavities,” she said. “I tell my patients, ‘Brush at night to keep your teeth, brush in the morning to keep your friends.’”

And how important is flossing? Day smiled and shared an easy way she explains the importance of flossing in addition to brushing.

“Floss between your teeth and then smell that floss. It’s going to smell terrible. That’s how you know your brush can’t get as far as you think it does,” she explained.

It’s also important to be mindful about the foods you’re putting into your body. Staying away from juice, soda, cookies, crackers, fruit snacks and Cheez-ITs are important due to their high sugar content. 

“It’s not just what you have, it’s how often you have it. If you’re looking for a snack, pick fruits and vegetables. An apple with peanut butter is a great choice,” Day said. “Drinking water is great. Water from the faucet is excellent because of its fluoride content.”

One other important step is making sure to visit your dentist regularly for a checkup and cleaning. While a good rule of thumb is to go in twice a year, check with your provider to determine your optimal schedule. It’s important for young children to visit the dentist as well. Day said that cavities are the number one chronic disease for kids.

“The younger we can start your child with a dentist, the better. Panda Pediatrics has a dental hygienist on staff, so whenever any teeth appear, we can take a look. We’ll talk to parents about how to clean their teeth, wipe their gums and provide nutritional counseling,” she said. “Prevention is key.”

Do you have questions about your oral health, physical health or the connection between the two? Contact your primary care provider today.