Link between oral health and systemic health

Dental practices have a continuous flow of patients that allows them a channel to create higher levels of total health awareness. Using the right communications, tools and desire dentists can bring more awareness with disease prevention and with disease management.

Oral and systemic health are closely related to each other. On the one hand, oral diseases are potentially associated with different general health conditions. Thereby, an influence of oral conditions on systemic health or vice versa as well as different bidirectional relationships have been uncovered. Moreover, medications can show distinct side effects in the oral cavity, such as xerostomia or gingival overgrowth, or affect the patient’s immune system as well as bone metabolism. On the other hand, dental care of patients with systemic diseases is a relevant issue, because a sufficient oral health situation is necessary to decrease their risk of systemic complications. However, the dental care situation of these patients is often inadequate. Patients who suffer from a severe general disease or condition often show a physical and psychological burden, making appropriate interdisciplinary care necessary.

The World Health Organization (WHO) states: “Oral health means more than good teeth; it is integral to general health and essential for wellbeing.”

The relationship between oral and general health is proven by evidence. It is interlinked and works both ways, meaning that poor oral health is associated with the onset of chronic diseases but also general health problems could cause or worsen oral health conditions.

Cardiovascular diseases

(CVDs) are diseases which are affecting the heart and blood vessels. It is hard to prove cause and effect between CVD and poor oral health (gum disease mainly), but there is a strong link, which is inflammation. Inflammation leads to hardened arteries causing the blood not flowing to the heart as effortlessly, which puts people at greater risk of heart attack and stroke.

Gum disease is an inflammatory disease, involving bacteria irritating the gums, causing inflammation and pockets, which allows the bacteria and the toxins they produce to advance further bellow the gum level and eventually entering the bloodstream. The bacteria then can travel from the mouth to any other part of the body, causing inflammation, therefore damage to the blood vessels. 

Diabetes

People with diabetes are more prone to infections; therefore they are more susceptible to periodontal disease, especially where the diabetes isn’t controlled effectively. Diabetes causes the blood vessels to thicken, which makes it difficult for the blood to deliver important nutrients and to remove waste products. This weakens the resistance to infections of the bone and soft tissues around the teeth; hence gum disease can develop easier. However it works both ways. Not treated gum disease can make it more difficult for diabetic people to regulate their blood glucose levels and can worsen the illness. So, this is a two-way relationship between the two conditions.

Respiratory infections

Bacteria in the mouth can travel not just via the bloodstream, but by the airway as well. Studies suggest that bacteria living in the mouth also can be found in the upper airway, where they can multiply and travel further down and play part in causing diseases like aspiration pneumonia especially in people with periodontal disease as those people have a higher number of bacteria in their mouth and saliva.

Alzheimer’s disease

This is a disease which damages the brain and causes dementia. Alzheimer’s disease leads to the loss of the connection between the billions of nerve cells in the brain due to the buildup of abnormal protein structures called ‘plaques’ and ‘tangles’, which eventually leads to brain tissue death. Studies have shown that the bacterium responsible for periodontitis (gum disease) can travel from the mouth to the brain via the bloodstream. Samples taken from people’s brains who suffered from Alzheimer’s disease has shown that traces of this bacterium and its toxins were more prevalent than that of from healthy people. Therefore this bacterium may actually contribute to the development of the disease.

In recent, the new coronavirus SARS-CoV-2 was first detected in late 2019 and has quickly developed into a global pandemic. Most patients with severe complications from COVID-19 have underlying conditions such as obesity, diabetes, and hypertension. In parallel, there is growing evidence for a link between periodontitis and non-oral systemic diseases. The oral cavity is also a reservoir for respiratory pathogens, and patients with periodontal disease are more likely to develop hospital-acquired pneumonia than healthy individuals. We therefore hypothesize that improving oral health could decrease the severity of COVID-19 symptoms and reduce the associated morbidity.

The oral cavity is a significant reservoir for respiratory pathogens, including Chlamydia pneumonia; and patients with periodontal disease are more likely to develop hospital-acquired pneumonia as a complication. Several mechanisms may explain the ability of oral pathogens to exacerbate lung infection, including aspiration of oral pathogens into the lower respiratory tract, especially in high-risk individuals; modification of mucosal surfaces along the respiratory tract by salivary enzymes, which thereby facilitate colonization by pathogens; and secretion of pro-inflammatory cytokines during periodontitis, which can promote adhesion to lung epithelium and lung colonization by respiratory pathogens. Improving oral hygiene may thus reduce oropharyngeal colonization and the risk of respiratory complications. It has also been shown that improved oral hygiene and frequent professional oral health care reduces the progression or occurrence of respiratory diseases, particularly in the elderly population and those in intensive care units. This population is also most at risk for developing serious complications related to COVID-19.

Older adults and people of any age who have serious medical conditions such as chronic lung disease, diabetes, heart conditions or chronic kidney disease are at high risk for developing severe illness due to SARS-CoV-2 infection. At the same time, poor oral health increases the risk of developing the same medical conditions. Therefore, improving oral health in people of any age, by reducing their risk of developing non-oral systemic diseases, may reduce the morbidity of COVID-19]. Although the association between oral health and severity of COVID-19 symptoms appears logical, more research is needed to demonstrate the association empirically.

 A healthy mouth plays an important role in the everyday life and socializing, as it allows the person to enjoy eating regularly and healthily, permits clear speech, boosts the confidence in appearing in public and allows the person to live without pain and discomfort.

Pain in the mouth can prevent you from eating and drinking adequately, which can lead to lack of nutrition and dehydration. Poor oral health can badly affect the person’s quality of life and self-confidence and can stop people from smiling, talking or kissing loved ones. If you ever had toothache you will know how antisocial one can become until the pain is gone. Toothache or pain in the mouth is definitely not a joyride.

Just like any vital organs, the mouth is a vital part of the body, and it is definitely beneficial to look after it by brushing twice a day, flossing or cleaning interdentally daily and visiting the dentist/hygienist regularly (in order to maintain good oral health, to minimise the risk of developing any of the above mentioned systemic diseases and to achieve a general wellbeing).