Dr. BERTRAND R. STUART DDS.
IT IS written in the Holy Bible that it is what comes out of a man’s mouth that defiles him and not what enters into it. In a literal context, the author obviously was unaware of the fact that it is precisely the opposite that is true. 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. We, dentists, are taught that we should not treat the oral cavity but we should treat the people with an oral cavity. The mouth is not separated from the rest of the body and why it took centuries to realise 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 health care 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? There are good questions to consider, since everyone has different existing conditions. According to the World Health Organisation (1982), “Oral health is a standard of the oral and related tissues which enables an individual to eat, speak and socialise without active disease, discomfort or embarrassment and which contributes to general well-being.” 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 organisations have begun to advocate for optimal oral health.

While it certainly occurs, 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 overweigh the cost for treating all cancers and heart disease (East Sussex, Brighton and Hove Health Authority, 2009).

The American Academy of General Dentistry is among those to promote the importance of oral health, recognising that more than 90 percent of all systemic diseases have oral manifestations and that oral infections can affect major organs (bacterial endocarditis). The Surgeon General reported that some type of periodontal disease or gingivitis affects more than 75 percent of the population. The statistics reveal the significance of the dental professional in preventing and treating oral diseases, as they may be the first health care provider to diagnose a problem. The importance for regular oral health care and education becomes imperative for improving oral health and will impact the well-being of all.

Since the late 1990s, as previously mentioned, it has become more apparent with continued research that not only is cardiovascular disease linked to oral disease, so 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 is not the only 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, weights, alcohol use, and lack of physical activity.

There are more and more risk factors being discovered each year that can shorten one’s lifespan.
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 colonise 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.