Systemic health and oral health
Dental professionals are aware of the links between systemic health and oral health. Many practitioners describe the mouth as ‘the gateway to the body’ as any disease in the mouth can mirror what is going on in the body and vice versa. Research is now available to show how some of the most commonly faced systemic health problems are connected with oral health.
There is a lot of evidence suggesting a link between cardiac and oral health. One recent study found a correlation between tooth loss and coronary heart disease.[i] Inflammation-causing oral bacteria can enter the bloodstream causing damage to blood vessels in the heart and brain over time.[ii]
As such, good oral hygiene is crucial to help minimise the risk of future heart problems. A study presented at the American Heart Associations’ Scientific Sessions meeting last year supports this. It demonstrated that brushing for less than two minutes, twice a day, can cause a three-fold increase in the risk of heart attack, heart failure or stroke.[iii]
There is a well-established relationship between blood glucose levels and oral health.[iv] People with diabetes have a three times higher risk of periodontitis.[v] However, if blood sugar is well-controlled there is no increased risk of periodontal disease compared to non-diabetics.[vi] To optimise the oral health of patients with diabetes, as well as aiming to ensure blood sugar is well controlled, it is important for these patients to have regular oral examinations and periodontal assessments. Checks for other oral conditions such as xerostomia are also beneficial.
There is some evidence to suggest that there is an association between oral health and rheumatoid arthritis – particularly tooth loss and severity of rheumatoid arthritis.[vii] It has also been proposed that the main bacteria responsible for gingival disease (P.gingivalis) can cause earlier onset and faster progression of rheumatoid arthritis. Similarly, there is a link between more serious periodontal problems and more serious arthritic symptoms.[viii]
Improving systemic health
Improving oral health can help patients reduce their risk of systemic health problems and make certain conditions more manageable. This means going back to basics and working towards “DELIVERING BETTER ORAL HEALTH”. Reviewing brushing techniques, recommending effective products and tailoring oral hygiene routines to individuals are all crucial. Talking to patients about their diet, lifestyle and other risk factors associated with systemic health conditions is important, for example, smoking and alcohol consumption.
As dental professionals know, some patients will develop periodontal disease even with good oral hygiene. Similarly, they will not automatically develop systemic diseases when gingival problems occur. The most important thing is therefore to work together. As a team, dental professionals and patients need close collaboration and have a shared responsibility to improve health and wellbeing.
[i] Batty GD, Jung KJ, Mok Y, Lee SJ, Back JH, Lee S, Jee SH. Oral health and later coronary heart disease: Cohort study of one million people. European Journal of Preventive Cardiology. 2018; 25(6); 598-605 DOI: 10.1177/2047487318759112
[iii] American Heart Association News. Bad tooth-brushing habits tied to higher heart risk. November 2018. [Accessed July 2019]
[iv] Taylor GW. Bidirectional interrelationships between diabetes and periodontal diseases: an epidemiologic perspective. Ann Periodontol. 2001; 6(1); 99–112.
[v] Preshaw PM, Alba AL, Herrera D, et al. Periodontitis and diabetes: a two-way relationship. Diabetologia. 2012;55(1):21–31. doi:10.1007/s00125-011-2342-y
[vi] Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet. 2005; 366(9499): 1809-1820