It has been reported that 3 out of every 4 Americans have signs of mild periodontal disease or gingivitis. Almost 30% show signs of the more severe disease, chronic periodontitis. We now have reason to believe that the health of your teeth and gums may have a significant effect on the overall health of your body. Recent scientific literature suggests a strong relationship between oral disease and other systemic diseases and medical conditions.
According to numerous studies, there are three ways oral disease may affect your overall health. First, bacteria from your gums enter the saliva. From the saliva it may adhere to water droplets within the air you inhale each time you breathe. These bacteria laden water droplets may be aspirated into the lungs, potentially causing pulmonary infection and pneumonia. This can be very troublesome for the elderly or those who may suffer from generalized weakened immunity, associated with chronic obstructive pulmonary disease (COPD).
Inflammatory mediators found in inflamed gums called “cytokines” can also enter your saliva. As they too are aspirated into the lungs, they have pro-inflammatory effects on the lower airway, which can contribute to further pulmonary complications.
Secondly, bacteria associated with periodontal disease can enter the body’s circulatory system through the gums (periodontium) around teeth and travel to all parts of the body. As the oral bacteria travels, it may cause secondary infections or it may contribute to the disease process in other tissues and organ systems. Finally, inflammation associated with periodontal disease may stimulate a second systemic inflammatory response within the body and contribute to or complicate other disease entities that may have an inflammatory origin such as, cardiovascular disease, diabetes, orthopedic implant failure and kidney disease. Whatever the route oral bacterial may influence, it is in every patient’s best interest to maintain their mouth in an optimum state of health.
The goal of many studies being conducted at universities and research centers throughout the world is to understand just how oral bacteria affect overall health. As these studies are published, health care professionals will begin to better understand the underlying biological mechanisms that are responsible for this oral systemic connection.
A new paradigm between dentistry and medicine is now developing regarding patient care. As the oral systemic connection is more clearly understood, dentists who are trained in diagnosing oral and periodontal disease will play a greater role in the overall health of their patients. Many times, the first signs of unnatural systemic health conditions reveal themselves in changes within the oral cavity. Medical histories should be carefully reviewed when “at risk” patients are identified. A comprehensive Periodontal Risk Evaluation should be performed and results should be sent to the patient’s treating physician(s).
Physicians will play a more active role in the oral systemic connection. They will screen at risk patients for the common signs of periodontal disease, which include bleeding gums, swollen gums, pus, shifting teeth, chronic bad breath and family history of periodontal disease. When appropriate, they will refer them to dentists who are uniquely qualified to evaluate and treat their patient’s oral conditions. This new era of interdisciplinary dental/medical cooperation will undoubtedly result in improved patient health, as well as an improvement in overall patient longevity.
The most significant areas identified to-date to have a suspected oral systemic connection are:
Orthopedic Implant Failure
In all of the above mentioned medical conditions, oral bacteria and periodontal disease are suspected contributing factors. In some cases, it may be the periodontal pathogenic bacteria or their associated cytokines that are the culprits. In other cases, it may be the secondary inflammatory response within the body that may initiate or aggravate an underlying medical condition. Whatever the pathway, it is imperative that patients understand periodontal disease, and how it may be treated or prevented.