By Lisa J. Gotto
Heart Disease. It is the leading killer of men and women in the United States according to the Centers for Disease Control and Prevention, CDC. On that sobering note, if you knew there was something you could do to lessen your chances of developing heart disease, would you do it? Chances are you would and you can with regular check-ups, not just to your physician—but to your dentist, as well.
Unfortunately, there are a lot of reasons why many of us do NOT visit our dentist regularly—and that not only means that possible conditions like cavities, gingivitis, and dry mouth go undetected and untreated, but more serious underlying conditions that start in the mouth and later affect the body are not being addressed as well.
Also, you could have conditions going on in your body that a dentist may see telltale signs of by way of your regular dental exam, but if that is not happening, the chance to catch things and start treating them is diminished.
So what is this connection between the body, our mouths, and our health? Dr. Stephen Labbe, DDS, of Labbe Family Orthodontics, called a recent study reported in The Journal of the American Dental Association to our attention. The report states:
“The evidence is there. Dentists can play a significant role in the systematic health of their patients beyond stabilization and prevention of oral disease. Many medical conditions can be first observed intra-orally, which provides an avenue for early diagnosis and treatment.”
When it comes to heart disease, there are definitely things that people at risk for the disease should know about and should do.
“Researchers are continuing to investigate the possible relationship between gum disease and heart disease. Some studies suggest the bacteria in the mouth from gum disease may move through the bloodstream and cause inflammation to the blood vessels that can possibly contribute to heart disease and stroke. Regular dental checkups and cleanings as well as good home care are essential for those who are at-risk,” Labbe says.
Another risk can result from a cleaning itself, so your dentist needs to know if you have coronary issues.
“The biggest factor that people with heart conditions need to know is that with any type of bleeding, from an extraction or even a cleaning, bacteria can travel through the blood and lodge itself in replaced joints and heart valves, which can have life-threatening consequences,” says Dr. Bruce Auslander of Auslander Dental in Gam ills.
Auslander adds that taking antibiotics prophylactically can help control the amount of bacteria released into the blood.
“A single dose of preventative antibiotics taken one hour prior to certain dental procedures is recommended for patients with prosthetic heart valves, cardiac transplant, certain congenital heart defects, or a history of infective endocarditis,” adds Christopher Anderson, DDS of Scott Finley DDS & Associates, Arnold.
“Dental plaque is the filmy material that builds up on teeth consisting of bacteria and other microorganisms. It is a biofilm that produces acids that can cause tooth decay and contribute to gum disease and eventually bone loss. The plaque in arteries consists of fatty deposits that collect on the inside lining of blood vessels, narrowing the arteries and contributing to coronary artery disease.”—Christopher Anderson, DDS
Beyond the Heart
What else can be derived from that regular dental check-up?
“The mouth is a mirror of the whole body,” says Auslander. “Conditions in the body can manifest themselves in the mouth. For example, a vitamin deficiency can show up as redness of the gums and possibly as a cracked tongue.”
By way of an exam, dentists can examine the condition of the lips, tongue, gingiva, mucosal surfaces, and dentition—all tissues that can raise your doctor’s level of suspicion even before a systemic disease, itself is suspected, says Labbe.
“GERD can manifest itself as enamel loss, as sometimes digestive acids will come up and eat away at the outer layers of teeth,” Auslander says. “Cancers can metastasize and present in the mouth.”
“There are many subtle changes that can occur within the mouth that can be indicators for greater health concerns, such as changes in the appearance of gum tissues, dry mouth, ulcerations and changes to tooth structure. Your dental providers have the unique opportunity to evaluate for any of these changes multiple times a year,” explains Anderson. “We also review each patient’s medical history, touch on dietary concerns, and take blood pressure regularly to look for any oral-systemic connections.”
“It is also known that patients with diabetes have a harder time controlling their blood glucose due to chronic inflammation of the oral tissues,” Anderson says. “Current research indicates that systemic inflammation is related to many factors including periodontal disease, as well as, a diet high in red meat, processed foods, refined carbohydrates and saturated fatty acids, food sensitivities, stress, smoking, poor sleeping habits, environmental toxins, infection, and obesity. All of these factors increase one’s inflammatory burden and overall cardiometabolic risk.”
This Just In…
One of the most recent connections between dental and general health was examined in a 2015 Johns Hopkins Arthritis Center study. The study provided complete oral health exams for 100 patients who were also Rheumatoid Arthritis sufferers. Forty healthy volunteers took part in the study, as well, to provide a basis for comparison. The results were significant.
The results showed that 70 percent of the patients with RA also exhibited signs of moderate gum disease, with 30 percent of the group having severe gum disease. By comparison, only 35 percent of the general population has any gum disease at all, and just five percent have severe gum disease.
More studies are currently being conducted to determine (1) if the biologic medications used to treat RA are contributing to the problem, and (2) what gum inflammation can tell us about RA and whether bacteria in the mouth is related to the development of RA or exacerbates the condition.
In the meantime, dentists have special recommendations for their patients with RA, that include using a battery-powered tooth ush if pain in their hands or wrists keeps them from practicing effective, daily oral hygiene—essential for all of us.
“Maintaining good oral health with regular dental visits and good hygiene is an integral part of a holistic approach to a healthy heart, along with other healthy behaviors like a healthy diet, exercise and abstaining from tobacco use,” says Anderson.
This Rheumatoid Arthritis example points yet again to how dentists can play significant roles in the systematic health of their patients, whether it’s factoring in heart or a number of other medical conditions.
Never a Good Thing…
Unlike receiving an honor that is presented to you as a plaque that can be showcased on a wall in your office, “plaque” in any form associated with your general health is never a good thing. The two types of plaque that we generally hear about that are closely associated with health are dental plaque and arterial plaque.
Examples of Systemic Conditions That Can Negatively Impact Oral Health Include:
Acid reflux causes erosion of the enamel
Osteoporosis contributes to the loss of supporting bone around teeth
Viruses like HIV and herpes cause ulcerations, inflammation, and changes in the color of the gums
HPV can cause cancers in the back of the throat, most commonly in the base of the tongue and tonsils
Pregnancy can cause gingivitis due to hormonal changes
Crohn’s disease can cause ulcerations of the mouth
There are also many oral effects of taking medications, including dry mouth.
Without the protective presence of saliva, that naturally cleans our teeth and provides them with the elements needed to re-mineralize, tooth decay is more prevalent.
Any condition that reduces the body’s resistance to infection, such as diabetes or an immunosuppressive condition, is correlated with gum disease.
—Christopher Anderson, DDS
Rheumatoid Arthritis
is an autoimmune disease in which the body’s immune system—which normally protects its health by attacking foreign substances like bacteria and viruses—mistakenly attacks the joints.
—Arthritis Foundation
A complete oral health exam includes…
looking at the number of teeth a patient has, if there is any gum inflammation, bleeding, or recession. The base of the teeth is also examined to see if there is any sign of bone loss or risk of tooth loss.
—Johns Hopkins Arthritis Center
