If the eyes are the window to your soul, then the mouth should be the door to your heart. Not just because it is key to a loving kiss, a pretty smile and savoring a meal, but also because poor oral health can be the root cause of some serious health problems, including heart disease. Yet, many Americans, even those with good access to healthcare and insurance, don't give oral care the attention it deserves. We bypass brushing, forgo the floss and dodge the dentist until there is a problem. Some adults have such heighten dental anxiety they never set foot in a dentist's office.
But research is unearthing evidence that says that skipping mouth care is a dangerous strategy because what begins quietly at the gum line can later set off a chain of events that can lead to heart attack, memory loss, stroke and miscarriage. And of all the measures we know of that can avert a potentially life-threatening disease, oral care is probably one the most effortless activities one can do.
What Gives at the Gums?
Teeth are hard calcified structures firmly anchored in the sockets of soft fleshy gum tissue called gingiva that covers the ridge of bone in the jaw.
Within a few hours of brushing a soft film of plaque begins to coat the surface of teeth. At first the plaque is easily removed and you can scrape it off without much effort using a toothbrush. Within a day however, plaque begins to absorb hardening minerals from saliva. And in a couple of weeks, it turns into cement-like calcified tartar that can only be removed with a dental tool. It collects on and between teeth and in the gum pockets.
The mouth is also home to bacteria, even a healthy mouth. There's just no way around it. And bacteria love plaque because it is a particularly cozy environment in which to grow. As soon as plaque begins to build, bacteria colonize like mad. They feast on and ferment sugars and starches from food, which then produces tooth-damaging acid that can cause enamel erosion, decay and cavities.
If the plaque and tartar aren't removed, the bacteria set up camp in the periodontal area between teeth and at the gum line. At first, the calcifications and colonization causes mild gingivitis, swelling and bleeding of gums. But as more bacteria take hold in plaque- and tartar-laden gums, gingivitis can advance to full-blown periodontitis. Eventually the pus-filled, inflamed tissue pulls away from the tooth, bone is compromised and exposed, and the tooth can no longer stay anchored in the mouth.
Symptoms of periodontal disease
- Red, swollen or receding gums (may look like teeth are getting longer)
- Pain, tenderness or sensitivity
- Loose teeth
- Pus or sores in gums
- Unexplained bad breath
- Change in bite or fit of dentures
Although bleeding while brushing, flossing or eating is a chief symptom of periodontal disease, symptoms can be mild or absent.
Consequences of Periodontal Disease
Periodontal disease not only impacts your quality of life, cosmetically, nutritionally and socially, but also your overall health. Behind the scenes, the body's immune system is bombarded with signals that a bacterial infection is underway. So it brings out all the guns to deal with the invasion by marshalling germ-fighting cells and chemicals. But the problem with persistent inflammatory diseases like periodontal disease is the assault can be relentless and the body doesn't get a chance to recuperate. It is in a defensive state all the time. Herein lies the problem.
The theory holds that the high load of inflammatory chemicals and leakage of bacteria into the bloodstream can wreak havoc elsewhere in the body. The onslaught of bacteria, immune cells and inflammatory markers, such as C-reactive protein and other cytokines, may directly or indirectly influence or injure tissue to cause or worsen some common chronic diseases. Researchers are finding that they may make blood vessels more favorable for the build-up of fatty deposits, and affect insulin resistance, blood clot formation and brain cell activity. Bacteria from the mouth can travel to colonize tissue elsewhere in the body.
Conditions linked to periodontal disease include:
- Heart disease and heart attack
- Memory loss, dementia and Alzheimer's disease
- Miscarriage, preeclampsia and preterm birth
- Pneumonia and other lung diseases
- Cancer of the blood, pancreas, tongue, lung and kidney
No one can say with certainty that periodontal disease causes or exacerbates any of these conditions, or whether treating periodontal disease will prevent them, but taking care of your teeth and gums is a good policy, one that can prevent gum disease, cavities, tooth loss, pain and money.
Getting on Your Mouth's Good Side
Performing oral care correctly and routinely is important for everyone to help stave off cavities and periodontal diseases. Some people however are predisposed to bad gums even when they practice good oral care.
Major risk factors for periodontal disease include:
- Genetic susceptibility (30% of the population)
- Medications (oral contraceptives, antidepressants, blood pressure drugs, chemotherapy)
- Autoimmune diseases (Rheumatoid arthritis, Crohn's disease, lupus)
- Poor diet
- Genetic diseases (Down's syndrome)
- Immunocompromising viruses (HIV, herpes)
It is particularly important to be evaluated for periodontal disease if you are planning to become pregnant or beginning cancer therapy or other treatment that might compromise the immune system.
Oral care tips:
- Brush all surfaces of teeth for at least 2 minutes once in the morning and before bedtime
- Replace toothbrushes as soon as they become worn (many now have a color indicator signaling when it’s time for a new one)
- Floss between teeth and down along the gum line of each tooth
- Use a rubber-tipped gum stimulator or interdental cleaner daily
- Visit the dentist and get a full exam and professional cleaning by a dental hygienist 2 times a year or more depending on your propensity for periodontal disease
- Have your dentist measure the depth of your gum pockets and have periodic X-rays to determine the health of gums, teeth and bone
- If you have dental anxiety, know that there are many new strategies that prevent the pain and quell anxiety prior to any oral procedures as well as specialized clinics for the super anxious
- Avoid sticky foods and frequent snacking to decrease acid load
- Don’t smoke or chew tobacco (also increases risk or oral cancer)