There is a Chinese proverb that goes like this: "A smile will gain you ten more years of life." These words were written countless centuries ago, yet today they ring more true than ever. The links between oral health and overall health are being established on a near daily basis and the implications are astounding! Imagine if by simply brushing and flossing regularly, you were able to prevent a heart attack? We may not be there quite yet, however a definitive connection has been established between gum disease and heart disease, diabetes and pregnancy complications. And while the research moves forward, what we are learning today is that a healthy smile truly may add ten years to your life.
At the root of this research frenzy is something that scientists refer to as biofilm. If the word "biofilm" renders images of horror films or sci-fi scream fests, then you aren't far off. In real life, biofilm is the sticky, colorless film that develops on teeth and is more commonly known as plaque. It is this complex reef-like substance that builds up over time, setting the stage for gum disease and potentially leading to life-threatening health problems.
Gum disease is also referred to as periodontal disease and encompasses the various stages of the disease, including gingivitis and periodontitis. Periodontal literally translates to "around the tooth". Interestingly, as the disease progresses it manages to burrow itself more completely around the affected tooth or teeth.
The beginning stage of gum disease is gingivitis, which occurs when plaque buildup begins to inflame the gums causing them to redden, swell and easily bleed. Typically there is little to no discomfort during this stage. Because of this, gingivitis is generally detected during a regular dentist visit. If diagnosed and treated, gingivitis is completely reversible.
If gingivitis is not treated, it can lead to periodontitis, which occurs when plaque spreads below the gumline. The bacteria associated with plaque produces toxins, which trigger further inflammation. Over time, this heightened inflammatory response will ultimately deteriorate the bones and tissue that support the affected teeth, eventually leading to tooth loss. Once periodontitis sets in, treatment is crucial to manage the inflammation and minimize damage.
It is estimated that 80% of all American adults have some form of gum disease. Smoking, genetics, stress, medications (including oral contraceptives, anti-depressants and certain heart medications), pregnancy, clenching or grinding your teeth, poor nutrition, diabetes and other systemic diseases have all been implicated as risk factors for the disease.
The link between gum disease and systemic disease is at the center of a number of on going studies. What we currently know is that definitive links do exists between gum disease and heart disease, diabetes and pregnancy complications. Currently researchers are examining the possibilities that either inflammation, bacteria or a combination of the two are at the heart of the link between gum disease and other health problems.
In the case of heart disease, doctors have long been aware that heart patients run the risk of developing a mitral valve infection after a routine teeth cleaning. Bacteria released during the cleaning process can enter the bloodstream and travel to the heart where an infection may occur. (For this reason, heart patients are generally prescribed antibiotics prior to dental work as a safeguard.) Now researchers are finding new links between oral health and heart health. In a study recently published in The New England Journal of Medicine, scientists found that treating severe gum disease can improve the function of blood vessel walls, thereby improving heart health. Researchers are now shifting their focus to determine if treating severe gum disease will result in fewer heart attacks, strokes and other cardiovascular problems.
Diabetics run a particularly high risk of gum disease, developing the disease at a rate 3 to 4 times higher than non-diabetics. The suspected culprit is the body's inflammatory response, which can have devastating effects on blood sugar control. Diabetics with untreated gum disease find it nearly impossible to manage their blood sugar levels and diabetes therapies often fail to work. However, with regular treatment for gum disease, blood sugar levels can generally be controlled effectively. Interestingly, the link between gum disease and diabetes doesn't always originate with an insulin problem. A study in the Journal of Periodontology recently reported that gum disease predisposed certain people to developing early signs of diabetes. Clearly a link between oral health and blood sugar control exists.
A study published earlier this year in the Journal of Periodontology revealed that bacteria normally found in inflamed gums has been found in the placentas of pregnant women with high blood pressure. Scientists had already suspected that a link between gum disease and pregnancy complications existed. This suspicion was further confirmed in a study conducted at the University of Chapel Hill. Steven Offenbacher, DDS, PhD who headed the study announced earlier this year, "Our findings indicate that periodontal disease progression during pregnancy contributes to preterm deliveries and especially very preterm deliveries (less than 32 weeks) which places the baby at high risk for neonatal problems and disability." While these findings may seem bleak, the good news is that pregnant women can safely receive treatment for gum disease during their pregnancy. Successful treatment could minimize infection and inflammation and reduce the risks to the unborn child.
The research continues on as scientists set forth to further understand the implications of oral health. While a greater understanding is essential to solving this puzzle, there are steps that you can take at home to take charge of your own health today. I recommend the following steps to all of my patients in order to maintain a healthy and beautiful smile:
* Make sure to brush after every meal and floss daily
* See your dentist every six months for an examination and annually for radiographs
* See your hygienist every four to six months for a thorough cleaning
* If you notice swelling, redness or bleeding in your gums, consult your dentist right away
* If you have been diagnosed with periodontal disease, follow and complete your treatment plan as described by your dentist, hygienist and periodontist.
Andy Rooney once said, "A smile is an inexpensive way to improve your looks." I believe that it may just be an easy way to improve your health, too!