How Oral Health can Influence Health and Hint of Problems in the Rest of the Body - QMI Agency

Feb 16, 2010
Marilyn Linton (QMI)

Published by 24 Hours (Ottawa) - Sloppy Oral Healthcare will Bite you in the End

They say the eyes are like a window to the soul, but it's the mouth that tells us a whole lot more.

Research in the past few years has demonstrated a definite mouth-body connection - one that now cannot be ignored. In fact, the state of one's oral health can indicate, even influence, the health of the rest of the body, says Dr. Jon Perlus, a Toronto-based periodontist who has long believed that periodontal disease may be implicated in everything from heart disease to stroke and adverse pregnancy outcomes.

For decades, all dentists have known that infections in the mouth are likely indicative of conditions elsewhere in the body. But it's only in the past few years that research has shown that there's an increased risk of diabetes in people with gum disease, and an elevated risk of heart disease (even fatal heart attacks) in those with periodontal infections.

Last month a researcher from Cleveland’s Case Western Reserve University’s School of Dental Medicine published the first documented link between a pregnant woman with gingivitis and her stillborn baby.

According to the science news service Eureka, bleeding associated with the gum disease allowed the bacteria, normally contained to the mouth because of the body's defense system, to enter the blood and work its way to the placenta.

The immune system is being recognized as playing a critical role in a variety of diseases, including Alzheimer's. And the common element in all this, says Dr. Perlus, is inflammation - the body's instinctive action to fight off infection, good in the short term because it helps with healing but bad in the long term because of its destructive capacity.

"You would never have thought that a heart attack could be caused by an inflammatory process," says Dr. Perlus, a past president of the Ontario Dental Association. "But there is thinking now that suggests that it could be the inflammatory process within the body which causes the plaque that has built up in the artery to break off and block the blood flow to the heart."

Periodontal disease, heart disease, and, many scientists believe, other conditions and diseases, are all rooted in this chronic inflammatory process. After all, says Dr. Perlus, gum disease begins with a microbial infection followed by a full-blown immune system response. Classic symptoms of gum disease? Inflamed gum tissues.

Ongoing research into this inflammatory process has also proven that active gum disease can affect systemic inflammatory blood markers such as C-reactive protein: If your C-reactive protein level is high, research has shown you could have twice the risk for heart attack as someone whose level is low.

What this means is a whole new role for dentists and doctors as partners working together to identify patients at risk for anything from diabetes to a heart attack. In fact, this is already being examined in Sweden where special software has been invented to help dentists calculate a patient's potential heart disease risk. And The American Academy of Periodontology, together with top cardiologists, has developed clinical recommendations as to how to treat and prevent diseases in patients.

It's now expected that dentists (and doctors) do a thorough examination of the mouth and dig deeper if they suspect that what they see might be linked to other conditions. "As dentists we do have the ability to detect mouth odours which may reflect illness. We have the ability to see in the mouth the body's healing potential," says Dr. Perlus. "We also have the ability to note the colour, contour and texture of oral tissues and to assess digestive processes. What we see may give us reason to call the doctor and say, 'Perhaps you should investigate this further.'"

It may be the beginning of a movement to retool the education of both doctors and dentists. "There is definitely a mouth-body connection and we have to be very vigilant and very observant," says Dr. Perlus. "It's not good enough anymore for dentists to do drilling and filling and pretty smiles. It's our responsibility to look at the mouth in the context of overall health."

Something to Chew On

According to the World Health Organization, about 750 million people suffer from severe periodontal disease. For more on gum disease, a quiz to determine if you're at risk, and information on the link between oral and systemic health, visit the following:

American Academy of Periodontology

Health Canada

Nothing to Laugh At

Comic Whoopi Goldberg has talked about her oral surgery and her experience of losing teeth to gum disease. Her message to viewers of The View, the daily TV show which she hosts: "Your mouth is connected to your immune system. If you are not taking care of your mouth, you are not taking care of your body."

Did You Know?

Periodontal diseases include gingivitis in which the gums are red, swollen and bleed easily; and periodontitis, a bacterially induced chronic inflammatory disease that destroys connective tissue and the bone that support the teeth. Gum disease is the major cause of tooth loss.

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