The Oral-systemic Connection
by George J. McAlpine, DDS
Associate Dean for Dental Medicine
University of Nevada School of Medicine
Can your mouth really make you sick?
Dentists have long known that there is a strong relationship between oral health and general health. Tobacco, alcohol and recreational drugs not only affect overall health but oral health, as well. Persons suffering dry mouth - a lack of saliva - whether from age, disease or medications, are at greatly increased risk for tooth decay. And if you have chronic dental pain or lack the ability to chew your food properly, you can't get the nutrition your body needs to stay healthy.
It's not news that the mouth is connected to the overall condition of your body. Oral health is an important part of overall health with many researchers studying how closely the two are connected.
For example, some researchers have found that periodontitis (gum disease) is associated with cardiovascular (heart) disease, stroke and bacterial pneumonia. Other research indicates that pregnant women with periodontitis may be at increased risk for delivering babies that are pre-term, have low birth weight or both. These conditions and diseases are complex and researchers are examining what happens when periodontitis is treated in persons who have other types of health problems.
There's substantial evidence that diabetics are more likely to develop periodontitis at a younger age in a more severe form than nondiabetics. People who smoke and drink alcohol are at increased risk for periodontitis and other conditions, such as oral cancer. Recent evidence has shown that oral bacteria can seed the lungs and, in some cases, cause pneumonia. A number of major medical procedures first require dental clearance to establish the patient's level of oral health.
A patient requiring a total joint replacement (hip or knee) prosthesis, heart valve replacement or radiation therapy to treat oral cancer should not have any active oral disease present. The risk is too great for a secondary infection (from bacteria in the patient's mouth) occurring at the surgical site that can be life threatening.
If there were a cause-and-effect relationship, we'd expect that improvements to periodontal health would, also, improve other health conditions. The results from initial studies are intriguing. Some studies have suggested that treating periodontitis in people with diabetes can actually improve their blood sugar control. However, other studies have not established this connection. The American Dental Association supports and encourages further research into what remains a promising but inconclusive question as to the effects of periodontal disease on some specific systemic conditions and diseases.
What does this mean for you? Given the potential link between oral health and systemic health problems, preventing periodontitis may turn out to be a significant step in maintaining your overall health. In most cases, this can be achieved with good daily oral hygiene (brushing, particularly with a sonic toothbrush, and flossing) and regular professional care. The majority of people should have their teeth cleaned twice yearly. However, if you have been diagnosed as having periodontal disease, it is essential to see your dentist on a regular basis and have your teeth cleaned 2-3 times per year.
Tell your dentist about any changes in your general health status, including any recent illnesses or chronic conditions. Provide an updated health history including medication use, both prescription and over-the-counter products. And if you smoke, talk to your dentist about options for quitting.
For more information, contact your primary care physician or University Health System, the clinical practice of the University of Nevada School of Medicine at www.UHSNevada.org .