Oral health is often overlooked. A quick brush, maybe flossing is all most people do daily. In fact, surveys have found that 27% of people lie to their dentists about flossing habits. More than 26% of adults have untreated cavities. Gum disease affects over 50% of adults ages 45-64. Sources share that untreated tooth decay cost the US about $45.9 billion in lost productivity in 2015 and often results in visits to hospital emergency rooms where care does not treat the root cause of problems. Despite how many of us can relate some story of an unrelenting tooth ache, sensitive gums or other oral discomfort, it all often goes untreated. Gum disease is a risk factor for nearly 60 other adverse health conditions, including Alzheimer’s disease, diabetes, and heart disease. Today we’ll explore how the world of our oral health can drastically impact our overall wellness.
The mouth is both the primary pathway into the body and also an ideal environment for bacteria to thrive. There are up to six million bacteria present in a typical person’s mouth. while most are controlled by our immune system, lack of hygiene can result in an uptick of bacteria and the risk of it entering the bloodstream and spreading throughout the body. Complications are a higher risk for people that are immunocompromised or persons with endoprotheses. Also, certain medications can reduce saliva flow which neutralizes acids, and the decreased saliva results in bacteria remaining stagnant and multiplying. Some medications that cause this include:
- decongestants
- antihistamines
- painkillers
- diuretics
- antidepressanants
According to the Mayo Clinic, studies suggest that oral bacteria and inflammation associated with gum disease may contribute to any number of serious conditions, including:
- Endocarditis. This is an infection of the inner lining of the heart chambers or valves, which can occur when bacteria or germs from your mouth spread through your bloodstream and attach to specific areas in your heart.
- Cardiovascular disease. While the connection is still being studied, research suggests that heart disease, clogged arteries, and stroke might be linked to the inflammation and infections of gum disease.
- Pregnancy and birth complications. Periodontitis (a severe form of gum disease) has been linked to premature birth and low birth weight.
- Pneumonia. This and other respiratory conditions can be caused when bacteria in your mouth are pulled into your lungs.
- Diabetes. People with diabetes are more susceptible to periodontal disease, making blood sugar management more complicated, and in turn, diabetes even worse. And links to other conditions are also being found, including rheumatoid arthritis, Alzheimer’s, and dementia.
- Cancer. There is a strong correlation between periodontal disease and cancer. Pancreatic cancer, lung cancer, and blood cancer are just a few cancers people with poor oral health have been studied to show higher risks.
- Osteoporosis. Later stages of periodontal disease cause a loss of bone tissue from inflammation and infection. Clinical studies uncover links that periodontal disease affects bones throughout the body, not just the jawbone and teeth. The American Academy for Oral and Systemic Health (AAOSH) shares that estrogen deficiency, low mineral bone density, and low vitamin D levels are a result of both osteoporosis and periodontal disease.
- Obstructive sleep apnea. One of the first signs of obstructive sleep apnea is teeth grinding; a sign dentists and hygienists should look for in all patients. Grinding teeth can cause cavities or inflamed gums, increasing susceptibility to infection. Sleep apnea is linked to high blood pressure, heart disease, and headaches.
Mouth wash and heart health
It seems counterintuitive- but mouthwash may harm your health. For many, mouthwash is the finishing touch when addressing daily oral health. Studies show that people who use mouthwash twice per day have a higher incidence of hypertension compared to those that use it less frequently. These results are independent of other risk factors for hypertension and other health issues.
In another study, researchers even found that mouthwash can largely undo the blood-pressure lowering benefits of exercise. The study was led by the University of Plymouth in collaboration with the Centre of Genomic Regulation in Barcelona, Spain, and was published in the journal Free Radical Biology and Medicine. The data revealed that when participants rinsed with the placebo, the average reduction in systolic blood pressure (the highest blood pressure level when the heart is circulating blood around the body) was -5.2 mmHg at one hour after exercise. However, when participants rinsed with the antibacterial mouthwash, the average systolic blood pressure was -2.0 mmHg at the same time point- a decrease of over 60%. The blood-pressure lowering effects of physical activity were completely gone two hours after exercise when participants used antibacterial mouthwash.
Research published in the journal Frontiers in Cellular and Infection Microbiology, shows that an antiseptic compound found in mouthwash destroys “friendly” oral bacteria that help maintain normal blood pressure levels. So the best bet is to brush and floss, but skip the mouthwash.
Preventative care is key
It is widely shared that preventative care can prevent or slow the progression of gum disease and consequently risks tied to diabetes, pregnancy, and heart disease. Tooth decay is one of the most prevalent diseases in America, and it is left untreated in 1 in 5 American adults. Even simple cavities can lead to loss of appetite, decreased focus, and depression.
Over 77% of people have dental insurance coverage, usually from an employer or group plan. The reality for many though, is that working in a lower income job or receiving Medicaid or Medicare coverage results in limited (or dependent on state policies) or no coverage, putting dental care out of reach. For those that do have dental coverage that includes preventative care the question remains why it is often left unused. For some, it may be fear- the pain is so great that it “must” be something severe. For others, it may be scheduling difficulties or fear of cost. And still for other people, it may come down to being timid about revealing the state of their oral health to dental providers.
How to maintain oral health
Even if your smile appears to be sparkling and bright, the reality of your oral health may be hidden. Some signs of poor oral hygiene include:
- Toothache
- Gum disease, including gingivitis and periodontitis
- Receding gums
- Sores in the mouth
- Bad breath
- Sensitivity to hot and cold foods
- Dry mouth and teeth
- Any other condition that creates discomfort and health issues
Regardless of whether you have any of these symptoms, to maintain your oral health and prevent any consequent health issues:
- Brush your teeth twice a day with a soft-bristle toothbrush
- Use a fluoride toothpaste
- floss regulary (at least once a day)
- See a dentist regularly to get a checkup and cleaning
- Pay attention to oral pain and other warning signs
Remember the statistic that over 27% of people lie to their dental provider about how often they floss? The American Academy of Periodontology released data from a survey that showed all the other things people would rather do or experience instead of flossing (see the image below).
While it may be comical to see just how much people truly dislike flossing, it, along with brushing and seeing your dental provider regularly could be some of the easiest things we can do to support our heart health and reduce the risk of other significant health risks. Make sure to share any concerns you may have with your dental provider- as with so many other health concerns, early detection of problems is key.
-https://www.guardianlife.com/oral-and-overall-health#
-https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7125030/#:~:text=People%20who%20used%20mouthwash%20twice,CI%3A%201.27%2C%203.71).
-https://www.sciencedaily.com/releases/2019/09/190903111242.htm
-https://www.medicalnewstoday.com/articles/324621#Mouthwash-may-do-more-harm-than-good
-https://www.frontiersin.org/articles/10.3389/fcimb.2019.00039/full
-https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/dental/art-20047475
-https://pubmed.ncbi.nlm.nih.gov/8131787/#:~:text=Oral%20bacteria%20may%20spread%20into%20the%20blood%20stream,especially%20for%20immunocompromised%20patients%20or%20persons%20with%20endoprotheses.
-Periodontics and Oral-Systemic Relationship. “Journal of the California Dental Association, January 2016, volume 44, number 1; pages 29-33.
-https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329699/
– https://pubmed.ncbi.nlm.nih.gov/9869350/
-https://www.aaosh.org/connect/15-health-issues-caused-by-poor-oral-health
-https://www.npr.org/sections/health-shots/2015/06/24/417184367/are-you-flossing-or-just-lying-about-flossing-the-dentist-knows
-https://scholar.google.com/scholar_lookup?title=Body+and+Soul&author=C+Gonzales-Marin&publication_year=2009&#d=gs_qabs&t=1690728053572&u=%23p%3DzhqrPFhwKU8J
-https://pubmed.ncbi.nlm.nih.gov/15602020/
-https://pubmed.ncbi.nlm.nih.gov/14121956/
-https://www.nidcr.nih.gov/research/oralhealthinamerica/section-3a-summary#:~:text=Tooth%20decay%2C%20affecting%2090%25%20of,the%20most%20prevalent%20oral%20diseases.
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