Clean teeth and healthy gums certainly make for a bright smile. But maintaining good oral health is not only about appearances – it’s important for your overall health. In the past decade or so researchers have linked poor oral health to a number of diseases. It’s what is now being referred to as the body-mouth connection.
When you visit the dental hygienist, they are doing more than simply cleaning and polishing your teeth. “We look at your face, neck and jaw first to assess whether there have been any changes, then we look inside your mouth at your teeth, and also at the soft tissues – tongue, cheeks and gums,” explains Lauren Chapman, dental hygiene therapist at Cayman Dental.
One thing dental hygienists are looking for is signs of mouth cancer – there is now a tool that can screen for this - but they are also checking for swelling, bleeding or pocketing – a space between the teeth and the gum – which all indicate periodontal disease, or gum disease. Gum disease is very common: around 50% of adults over age 30 suffer from it, and the incidence increases with age. If left untreated it can have serious consequences both for the teeth and for other organs in the body.
What is Gum Disease?
Gum disease occurs when bacteria build up on the teeth and gums in the form of plaque. Regular brushing and flossing will remove plaque, but if left it hardens into tartar along the gum line, which can only be removed by a hygienist.
Acids in the plaque and tartar attack the enamel on the teeth and irritate the gums, leading to inflammation and bleeding. The early stages of gum disease – known as gingivitis – may be painless and therefore go unnoticed by the patient, Chapman notes, so regular dental hygiene appointments are important for early detection, when the condition is still reversible. If it is not treated, gingivitis can progress to periodontitis: gums recede, the bone that supports the teeth is lost, teeth then become loose and may even fall out.
Gums Health & Overall Health
It’s not only the risk of tooth loss that makes it so important to catch and treat gum disease early on. Numerous studies have found associations between gum disease and other systemic diseases such as diabetes, heart disease, respiratory disease and, more recently, Alzheimer’s and dementia.
The theory is that the mouth is the gateway through which most bacteria enter the body. In a healthy mouth, there are enough good bacteria to fight off the bad, but when gum disease is present, bad bacteria proliferate and can then enter the bloodstream and travel to other parts of the body.
Diabetes: The connection between oral health and diabetes is the one that has been known the longest, Chapman says, and it’s a bi-directional relationship. People with diabetes are more likely to have gum disease, as high blood sugar levels lead to oral bacteria multiplying. At the same time, gum disease may impair glycaemic control, exacerbating diabetes. It’s therefore essential that diabetic patients look out for and manage gum disease – particularly as periodontal treatment has been associated with improved glycaemic control.
Heart disease: People with gum disease are two to three times more likely to have a heart attack, stroke or other cardiovascular event than those with healthy gums. Several studies have found an association between the two conditions, and although no direct causal link has been established, it is thought that inflammation and bacteria in the gums may travel to the arteries causing them to narrow, or infection may reach the heart’s valves.
Respiratory disease: Various studies have confirmed a strong association between gum disease and respiratory diseases such as pneumonia, bronchitis, and emphysema, possibly as a result of bacteria multiplying in the mouth and moving into the respiratory tract. Poor periodontal health and oral care are particularly linked to an elevated risk of developing chronic obstructive pulmonary disease.
Alzheimer’s and dementia: Some studies have found that the bacteria that cause gum disease are also associated with the development of Alzheimer’s and other dementias. Others have linked gum disease with a faster cognitive decline in those diagnosed with dementia. Again, there is no clear causal link, but it is possible that better dental hygiene could help slow the progression of dementia.
A Good Oral Health Routine
Good oral hygiene clearly has numerous benefits. So what is a good routine to follow?
“Brush your teeth twice a day, for three minutes each time. Use a rechargeable electric toothbrush and pay attention to the gum line as well as the teeth,” Chapman advises. “You should also floss once a day to reach the surfaces that brushing doesn’t reach.”
Regular visits to a dental hygiene therapist are also an essential part of preventive dental health. For most, a visit will be scheduled every six months, but if there are oral health issues, more frequent appointments may be required. And, Chapman adds, it’s never too early for an oral hygiene appointment – as soon as a child has teeth, they should start to visit the dentist.
Although further research is required to establish the exact mechanisms that connect oral and overall health, taking good care of your teeth and gums, by brushing, flossing and seeing your hygienist regularly, can clearly help you live a healthier life.