Oral hygiene and the impact of poor oral hygiene on the overall quality of health

Digestion, Heart, Stroke, General | June 9, 2014 | Author: The Super Pharmacist

dental, periodontal, gum disease, cancer, Stroke

Oral hygiene and the impact of poor oral hygiene on the overall quality of health

The health of your mouth and your body are closely related. Various oral conditions can lead to health problems and, conversely, health conditions can affect the oral cavity. The mouth is the gateway to the rest of the body. While your skin acts as a barrier against environmental toxins and infectious agents, your mouth has to do the same thing. Unfortunately, your oral cavity also has the responsibility of passing air for respiration and consuming food and beverages for nutrition. Your mouth does not have the same defences as your skin and is covered in mucous membranes. Thus, your oral cavity is more vulnerable than your skin. We discuss the importance of oral hygiene in maintaining the health of your entire body.

What is good oral hygiene?

The key to good oral hygiene is to make sure that your mouth is healthy enough to take on its responsibilities: moving food and air to the stomach and lungs, respectively. This means keeping your teeth, gums, and other surfaces inside of your mouth intact. One weak point in a mouth’s defenses is between the teeth and the gums. This space is where food tends to collect during chewing and it stays. Food particles in this space lead to gum disease, creating portal between your mouth and the bloodstream. Regular tooth brushing (twice a day for two minutes each time) and flossing are important keys to good oral hygiene. These processes help remove food particles and other cavity-causing substances. Using an oral irrigator may provide extra cleaning power. Fluoride is important because it kills bacteria and also strengthens enamel, the covering on the teeth. Dentists suggest that you use fluoride-containing toothpaste and a fluoride rinse. Good oral hygiene also includes routine dental visits. It is also important to replace your toothbrush every three months (perhaps when the season changes).

Cavities and your health

shutterstock_34438063One consequence of not brushing with fluoride containing toothpaste and flossing regularly is that cavities can develop. Cavities, also called dental caries, is a form of tooth decay in which the enamel of the tooth breaks down, creating a small hole. Dental caries (caries is singular) is one of the most common oral conditions that lead to systemic disease. For example, moderate to severe cavities can affect the growth and development of young children.1 Pain from dental caries can interfere with school— American children lose an estimated 50 million school hours annually because of dental problems.2 About one in four people in the United States above the age of 60 have lost all of their teeth—half of those people had lost it because of periodontal (gum) disease and the other half from dental caries.3

Dental abscesses

Cavities can lead to dental abscesses, which are pockets of infection in the gums. Dental abscesses are difficult to treat because antibiotics (taken either orally or intravenously) cannot penetrate into these pockets, so the bacterial infection persists. Dental abscesses need to be drained in order to fight the infection. If dental abscesses are not treated promptly and successfully, they can cause systemic infection (i.e., an infection of the blood). Not only can dental abscesses cause the loss of the affected tooth or teeth, but a blood infection can cause serious, and even deadly consequences.

Gum disease in pregnant women

Pregnant women who have periodontal disease (i.e., disease of the gums) are almost 8 times more likely to deliver a baby prematurely and at lower than normal birth weight.4,5 Perhaps surprisingly, pregnant women with certain bacteria accumulations in their mouths (e.g., Streptococcus mutans) are not only at greater risk for dental caries and gum disease, but they can transmit that risk to their newborn babies.6 Women who are pregnant or who are planning to become pregnant should maintain excellent oral hygiene and make an appointment with a dentist early in the pregnancy.

Dental disease and coronary heart disease

In one study of over 1000 veterans, there was a significant association between gum disease and coronary heart disease.7 The subsequent, larger studies have not always found the same connection.8 Nevertheless, periodontal disease is an independent risk factor for coronary heart disease.9 In other words, having gum diseases is a risk factor for heart disease, somewhat like having high blood pressure or high cholesterol. Conversely, people with coronary heart disease tend to have worse periodontal disease.10

Gum disease and kidney disease

Having periodontal disease may also be a risk factor for kidney disease. The bacteria that cause gum disease can cause inflammation in the mouth and in the blood. This inflammation is not only connected to coronary heart disease but also chronic kidney disease.11 In fact, there is a relationship between all three diseases. People who have coronary heart disease and are on kidney dialysis from chronic kidney disease are five times more likely to die from a cardiovascular problem if they have severe periodontal disease.12

Gum disease, tooth loss, and stroke

People who have periodontal disease resulting in less than 24 teeth (after tooth loss) have an increased risk of having a stroke.13 This is perhaps due to abnormalities in the carotid arteries, the large arteries that supply blood to the brain.14,15

Periodontal disease and cancer

In a study of nearly 50,000 men for almost 20 years, periodontal disease was associated with a small, but nonetheless significant increase in the risk of cancer.16 While the risk of cancer was higher in general, periodontal disease increased the risk of lung, kidney, and pancreatic cancers and cancers of the blood. This increased risk occurred in smokers and non-smokers alike.

Acute necrotising ulcerative gingivitis (ANUG)

Acute necrotising ulcerative gingivitis, also called trench mouth, is an infection of the gums that is not contagious. It is more common in people with immunosuppressive diseases like HIV/AIDS or those undergoing cancer treatment, but can also occur in people with poor oral hygiene, malnutrition, and diabetes. ANUG can rather rapidly lead to a serious infection of the jawbone, head, and neck, if left untreated. This can lead to facial disfigurement.

Dental disease and heart valve abnormalities

People who have problems with one or more of their heart valves (e.g. those with a heart murmur or mitral valve prolapse) need to pay particular attention to their oral hygiene. Gum disease increases the risk for bacteria to enter the bloodstream. In people who have abnormal heart valves, bacteria can land on the heart valve and grow causing a condition known as endocarditis. Endocarditis is often life-threatening because the bacteria can further damage the heart valves and heart muscle as the infection progresses.

References

  1. Acs G, Lodolini G, Kaminsky S, Cisneros GJ. Effect of nursing caries on body weight in a pediatric population. Pediatr Dent. Sep-Oct 1992;14(5):302-305.

  2. Gift HC, Reisine ST, Larach DC. The social impact of dental problems and visits. Am J Public Health. Dec 1992;82(12):1663-1668.
  3. Beltran-Aguilar ED, Barker LK, Canto MT, et al. Surveillance for dental caries, dental sealants, tooth retention, edentulism, and enamel fluorosis--United States, 1988-1994 and 1999-2002. MMWR Surveill Summ. Aug 26 2005;54(3):1-43.
  4. Offenbacher S, Katz V, Fertik G, et al. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol. Oct 1996;67(10 Suppl):1103-1113. doi:10.1902/jop.1996.67.10s.1103
  5. Dasanayake AP. Poor periodontal health of the pregnant woman as a risk factor for low birth weight. Ann Periodontol. Jul 1998;3(1):206-212. doi:10.1902/annals.1998.3.1.206
  6. McGhee JR, Michalek SM. Immunobiology of dental caries: microbial aspects and local immunity. Annu Rev Microbiol. 1981;35:595-638. doi:10.1146/annurev.mi.35.100181.003115
  7. Beck J, Garcia R, Heiss G, Vokonas PS, Offenbacher S. Periodontal disease and cardiovascular disease. J Periodontol. Oct 1996;67(10 Suppl):1123-1137. doi:10.1902/jop.1996.67.10s.1123
  8. Hujoel PP, Drangsholt M, Spiekerman C, DeRouen TA. Periodontal disease and coronary heart disease risk. JAMA. Sep 20 2000;284(11):1406-1410.
  9. Humphrey LL, Fu R, Buckley DI, Freeman M, Helfand M. Periodontal disease and coronary heart disease incidence: a systematic review and meta-analysis. J Gen Intern Med. Dec 2008;23(12):2079-2086. doi:10.1007/s11606-008-0787-6
  10. Machuca G, Segura-Egea JJ, Jimenez-Beato G, Lacalle JR, Bullon P. Clinical indicators of periodontal disease in patients with coronary heart disease: a 10 years longitudinal study. Med Oral Patol Oral Cir Bucal. Jul 2012;17(4):e569-574.
  11. Fisher MA, Borgnakke WS, Taylor GW. Periodontal disease as a risk marker in coronary heart disease and chronic kidney disease. Curr Opin Nephrol Hypertens. Nov 2010;19(6):519-526. doi:10.1097/MNH.0b013e32833eda38
  12. Kshirsagar AV, Craig RG, Moss KL, et al. Periodontal disease adversely affects the survival of patients with end-stage renal disease. Kidney Int. Apr 2009;75(7):746-751. doi:10.1038/ki.2008.660
  13. Joshipura KJ, Hung HC, Rimm EB, Willett WC, Ascherio A. Periodontal disease, tooth loss, and incidence of ischemic stroke. Stroke. Jan 2003;34(1):47-52.
  14. Carallo C, De Franceschi MS, Tripolino C, et al. Common carotid and brachial artery hemodynamic alterations in periodontal disease. J Clin Periodontol. May 2013;40(5):431-436. doi:10.1111/jcpe.12099
  15. Uyar IS, Sahin V, Akpinar MB, et al. Does oral hygiene trigger carotid artery intima-media thickness? Heart Surg Forum. Aug 1 2013;16(4):E232-236. doi:10.1532/hsf98.20121137
  16. Michaud DS, Liu Y, Meyer M, Giovannucci E, Joshipura K. Periodontal disease, tooth loss, and cancer risk in male health professionals: a prospective cohort study. Lancet Oncol. Jun 2008;9(6):550-558. doi:10.1016/s1470-2045(08)70106-2

 

 

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