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The Mouth-Body Connection

It’s frequently said that the mouth is the gateway to the body. More and more, medical professionals have been discovering just how true this really is. This is referred to as the oral-systemic link.

Dentists are often the first to detect conditions such as Crohn’s disease, diabetes, or cancer because the early symptoms may first show up in the mouth. Going in the other direction, we’re learning more and more about how what happens in your mouth affects the health of the rest of your body. 

The brain has the blood-brain barrier which protects it from toxins in the blood. In our mouths, there is a barrier between our gums and teeth and the rest of our body as well. In the case of periodontal disease, this barrier can break down and may cause disease or other problems in the rest of the body. Previously, it was thought that bacteria were the main factor in this, but more recent research has been indicating that inflammation may play a bigger role.

While the details of this connection between oral health and the health of the rest of the body is still being explored, it’s becoming increasingly clear that treating the inflammation of periodontal disease can help with the treatment of other inflammatory conditions (and, in some cases, vice versa).

Diseases with oral connections

Some conditions with strong connections to oral health include:

  • Diabetes – Gum disease can make diabetes harder to control, and diabetes can exacerbate gum disease. We explore the topic in more detail on the linked page, here.
  • Heart disease and stroke – Conditions causing chronic inflammation, such as periodontal disease, have connections to the likelihood of heart disease and stroke. Read more about them on the page dedicated to the topic, here.
  • Respiratory disease – The bacteria that grow in the mouth can find their way into the lungs as well. Respiratory diseases, such as pneumonia, can be caused by the same bacteria responsible for periodontal disease.
  • Cancer – According to the American Academy of Periodontology, those with periodontal disease were more likely to develop cancer than those without: 
    • 54% more likely to develop pancreatic cancer
    • 49% more likely to develop kidney cancer
    • 30% more likely to develop blood cancers

Other diseases that may be caused or complicated by oral infections include:

  • IBS
  • Breast cancer
  • Prostate cancer
  • Weight gain
  • Alzheimer’s and dementia
  • Low birth weight and premature birth
  • Osteoporosis
  • Rheumatoid arthritis

Some diseases can influence your oral health, as well, such as osteoporosis. Osteoporosis can lead to bone loss in the jaw which, in turn, can result in tooth loss, as there is no longer sufficient bone to support the teeth. 

It’s critical to understand how important oral health truly is to our wellbeing, and to take it seriously in order to help prevent, or reduce the effects of other conditions. Periodontal disease, in particular, should be avoided or treated as soon as it is detected. According to the Center for Disease Control (CDC), over 47% of individuals, 30 years and older, have some form of periodontal disease, and this percentage only increases with age. For individuals 65 and older, 70% of them experience gum disease. The best way to prevent gum disease is through proper dental hygiene, which includes brushing and flossing twice per day, and scheduling routine visits to the dentist.

Below, we’ll go into more detail on the connections between periodontal disease and many of the health issues we’ve mentioned.

Diabetes is a disorder that happens when the body has a higher-than-normal amount of blood sugar, known as glucose. Ordinarily, the hormone insulin regulates this sugar level and helps the cells of your body use this blood sugar for energy. Diabetes is the condition where the body doesn’t produce enough insulin leading to too much sugar in the bloodstream.

Insulin isn’t the only factor, however. It’s been found that the kind of inflammation from periodontal disease can impact the body’s ability to manage glucose as well. So, those who have both diabetes and gum disease may find themselves having an even harder time managing their blood sugar levels than they would otherwise. Diabetes, and the high blood sugar levels that result, also make for an environment where gum infections can be more likely to happen.

Very strong links have been established between oral health and cardiovascular disease, but researchers are still trying to clarify whether or not there is a cause-and-effect relationship. Evidence appears to be indicating a strong connection between heart disease and chronic inflammation such as what is found in gum disease. This chronic inflammation is tied to the narrowing or blockages of blood vessels, which, in turn, can lead to a stroke or heart attack.

In an article examining a number of related studies, it was pointed out that having gum disease could increase a person’s chance of having heart disease by nearly 20%. Another study showed that those with gum disease have nearly double the risk of suffering a stroke than those with healthy gums.

These are significant risk factors and should be enough to drive home the importance of treating periodontal disease for the sake of overall health.

How is Breast Cancer connected to Gum Disease?

A study done by the Federal University of Santa Maria Dental School in Brazil found that women with periodontitis (gum disease) are 2-3x more likely to develop breast cancer. This is yet another way that the health of our mouths is tied to our overall well-being. In this instance, the researchers believe that breast cancer may be triggered due to systemic inflammation resulting from gum disease.

The study was based on 67 women who have been diagnosed with breast cancer and 134 controls from 2013 to 2015. It is important to remember that this study does not mean that gum disease causes breast cancer, but it is an important study as we continue to find new ways of fighting cancer and learning what may cause certain kinds to develop.

In the United States, for every 100,000 women, there are 124.9 new cases of breast cancer. Breast cancer continues to be studied, and a possible connection to dental health issues would be a new opportunity to learn and treat this form of cancer.

How is Esophageal Cancer connected to Gum Disease?

A 10-year study performed by NYU Langone Health’s Perlmutter Cancer Center has found that two types of bacteria that are present in individuals with gum disease can increase the chances of being affected by esophageal cancer.

The eighth most common type of cancer in the world, esophageal cancer can be highly fatal and is the sixth most common cause of cancer-related deaths. In the US, it affects around 1 in 125 men and 1 in 417 women. The American Cancer Society says that currently, only around 20% of those diagnosed with this form of cancer will live for more than five years following diagnosis.

The study by NYU Langone found that bacteria associated with periodontal (gum) disease can find their way into the upper digestive tract, and in the case of one of the types of bacteria in the study, tannerella forsythia, its presence may increase the chances of this kind of cancer by 21%.

It is important to note that while the bacteria involved demonstrates a link between gum disease and esophageal cancer, it has not yet been proven that periodontal disease directly causes this cancer. However, the connection should be reason enough to reinforce the importance of proper oral hygiene and the treatment of gum disease.

What is Osteoporosis?

Osteoporosis is a disease of the bones involving the reduction of bone mineral density and mass. These changes in bones can cause them to become more fragile and put them at greater risk of breaks or fractures.

Considered a “silent” illness because of the subtlety of or lack of any noticeable symptoms, many people who suffer from osteoporosis are not even aware that they have it until they break a bone. However, osteoporosis is the leading cause of bone fractures in older men and women.

How Is Osteoporosis Related to Oral Health?

When considering osteoporosis in the context of oral health, the potential connection to periodontal disease is that one that interests researchers. Periodontal disease, or gum disease, if left unchecked, can lead to the loss of the bone and connective tissues that hold teeth in place. Since both diseases can have an impact on bone, the interaction between the two is something that needs to be better understood.

Research is currently inconclusive when it comes to whether or not having osteoporosis can lead to an increase in the chances of developing gum disease, however, for those who are suffering from gum disease and osteoporosis, data indicates that there is a higher chance of seeing deterioration in the alveolar bone which hold teeth in place.

For this reason, it is a good idea to let your dentist know if you have osteoporosis, especially if you are currently being treated for, or at risk of developing gum disease, as the condition may cause periodontal disease to progress more quickly. 

What Are the Symptoms of Osteoporosis?

In the US, it’s estimated that about 54 million people have osteoporosis. Bone mineral density tests ordered by your healthcare provider are the typical way that the disease is diagnosed. There aren’t any overt symptoms to look for, which is why, for many, bone fractures are the most obvious indicator, however, some things to watch out for include:

  • Reduction in height
  • Change in posture
  • Reduction in lung capacity
  • Pain in the lower back.

How Can Osteoporosis Be Avoided?

Recommended steps to take to lower your chances of developing osteoporosis include:

  • Getting regular exercise
  • Eating a healthy diet rich in vitamin D and calcium
  • Avoiding smoking
  • Avoiding excessive alcohol use

It can’t be overstated how much the health of the body is connected to oral health. Research has found that gum health is even linked to sexual and reproductive health.

The plaque that develops as a biofilm in our mouths is made up of bacteria, including these:

  • Porphyromonas ginigvalis
  • Tannerela forsynthia
  • Prevotella intermedia
  • Aggregatibacter actinimucentemcomitans
  • Treponema denticola

Periodontal disease allows these pathogens, which originate in the mouth, to be introduced into the bloodstream. The presence of some of these types of bacteria in the bloodstream is where many of the links between oral health of various other ailments have been discovered. And it isn’t just the bacteria itself, but the resulting inflammatory response and waste products of the bacteria that can cause problems.

Pregnancy and Oral Health

In the case of pregnancy, it’s believed that these pathogens can cause negative outcomes such as low birth weight or premature birth. A few studies have suggested that women suffering from chronic periodontitis may be 4 to 7 times more likely to give birth prematurely.

Women who become pregnant should be aware that hormonal changes make them more susceptible to getting gum disease as well. Gum disease has been linked with preeclampsia, a condition that can damage internal organs such as the kidneys and liver of both the baby and the mother.

Fertility and Periodontal Disease

Along with the impacts on pregnancy, studies have found that gum disease can play a role in fertility, with both male and female fertility being impacted.

One study in Australia found that women with periodontal disease may require two more months to conceive than those without.

In men, the bacteria related to gum disease lead to low sperm count, and poor sperm motility.

There appears to be a connection with erectile dysfunction as well, with men who have gum disease being more likely to suffer from ED.

Respiratory disease can also be referred to as pulmonary disease or lung disorder. These are conditions that affect the lungs and have an impact on breathing. Some forms of respiratory disease may be caused by air pollution or tobacco smoking, while others are the result of infection.

How is respiratory disease connected with gum disease?

We normally think of periodontal disease as a localized infection of the gums and connective tissues in the mouth, but researchers are finding more evidence to link it to respiratory diseases, either playing a possible role in contraction of the illness or in increasing its severity.

Respiratory diseases with links to periodontal disease include:

  • Chronic obstructive pulmonary disease (COPD)
  • Pneumonia
  • Bronchitis
  • Emphysema

Gum disease and pneumonia

Pneumonia is a type of inflammation of the lungs caused by infection by bacteria, viruses, or fungus, though bacterial infections are the most common. The disease results from these infections making it to the lower part of the airway. 

In healthy people, the body has defense mechanisms that prevent bacteria from the mouth from being able to reach places far into the lungs, but there are instances where this can be impaired, such as malnutrition, diabetes, or smoking.

In an examination of patients with pneumonia undergoing care in an ICU, it was found that patients who had dental plaque upon their admission to the ICU, or within the first five days of their stay, were 10 times as likely to develop pneumonia as those who were plaque-free.

In a two-year study of nursing home patients, one group was given routine toothbrushing by a caregiver as well as weekly professional care for plaque and tartar. At the end of the study, it was found that the group receiving oral care had fewer cases of pneumonia (11% vs 19%) and lower instances of pneumonia-related mortality (8% vs 16%). 

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