IN THE LATE 1990s, the dental and medical communities were hit with a revolutionary research outcome that showed a link between oral health and systemic health. The culprit? Bacteria. Today, it all seems second nature. Many say that the eyes are the windows to the soul, which means that they could be seen as the window to the body – or better yet, the door.
It only makes sense that what a person ingests will lead to either a healthy lifestyle, or an unhealthy lifestyle. The oral cavity is not separated from the rest of the body, and why it took centuries to realize that oral bacteria could contribute to declining health may forever be a mystery.
There will be short-term and long-term effects of what one does today, as a result of their diet and exercise routine. Yet many people would rather live for today than worry about tomorrow. For the dental professional, it will be imperative to influence patients to make a change in their eating habits, if they want to save their teeth. For other healthcare providers, it will be imperative to influence patients to make a change in their lifestyle in order to live a longer, healthier life.
But what is oral health? Is it the same for everyone, since many people have different oral conditions, such as missing teeth, restored teeth, and so on? These are good questions to consider, since everyone has different existing conditions.
According to the World Health Organization (1982), “Oral health is a standard of the oral and related tissues which enables an individual to eat, speak and socialize without active disease, discomfort or embarrassment and which contributes to general wellbeing.”
Society in general has always viewed a pretty smile as an indicator for good teeth and healthy gums. Yet, statistics are indicating otherwise, and all professional dental organizations have begun to advocate for optimal oral health. Few people die from oral diseases, yet the costs of treating it is astronomical at all levels: Individuals, families, third-party insurance companies, and government agencies. For example, in the United Kingdom, costs for treating dental disease outweigh the cost for treating all cancers and heart disease.
The American Dental Association, of which this author is a member, is among those who promote the importance of oral health, recognizing that more than 90 per cent of all systemic diseases have oral manifestations, and that oral infections can affect major organs, the classic example being bacterial endocarditis.
Global studies indicate that some types of periodontal disease or gingivitis affect more than 75 per cent of the world’s population. The statistics reveal the significance of the dental professional in preventing and treating oral diseases, as they may be the first healthcare provider to diagnose a problem. The importance for regular oral healthcare and education becomes imperative for improving oral health, and will impact the wellbeing of all.
For many years, it has become more apparent, with continued research, that not only is cardiovascular disease linked to oral disease, but so too is respiratory disease and preterm low birth weight (PLBW) babies.
There are good or normal bacteria thriving in the same environment as infectious microorganisms. As medical research continues to assist in better understanding this link, oral health practitioners must continue to educate patients in the relationship that exists between oral and systemic health.
Of course, bacteria are not the single influence to systemic diseases that take the life of millions each year. Other known risk factors still include stress, tobacco use, high blood pressure, family history, genetics, obesity, alcohol use, and lack of physical activity.
There are more and more risk factors being discovered each year that can shorten one’s lifespan, and perhaps the simplest way to start is by examining one’s oral health status.
Cardiovascular disease may be exacerbated by periodontal inflammation. The National Institute of Dental Craniofacial Research (NIDCR) reports that scientific theories site opportunistic infectious bacteria that colonize in the mouth form biofilms. These biofilms can activate white blood cells, releasing inflammatory mediators that can enter circulation and either enhance or perpetuate systemic effects. This inflammation, along with other risk factors, taxes the body’s ability to fight systemic disease.
In a periodontal pocket, bacterial biofilm directly contacts ulcerated epithelium. The more advanced the periodontal condition, the more surface area for bacteria to enter the bloodstream.
According to the American Academy of Periodontology, more recent studies are now indicating that elevated levels of C-reactive proteins are better at determining the risk for cardiovascular disease associated with periodontal disease. The liver makes c-reactive proteins, after being triggered by the number of bacterial by-products in the bloodstream. This trigger response system causes increased arterial inflammation.