A Kick In The Teeth
I recall vividly the first visit to my dentist Dr. Ferjančić, soon after we moved to Switzerland in the 80s. A very serious and dour man, he examined my mouth closely for several minutes and then leaned back to pronounce in German, “Either you will take your teeth to the grave, or your teeth will take you to your grave.” His words are engraved in my memory; however, I did not grasp the full implication of his dramatic proclamation until more recently.
I have a better understanding now of the clear connection between overall health and well-being and oral health. In the past couple of decades, scientists and medical professionals have accumulated a large body of evidence establishing a clear link to cardiovascular and other diseases.
My dentist for the past 12 years, Dr. Mira Godiwala – who, in contrast to my Swiss dentist has an excellent chair-side manner, and the knack of putting patients at ease even as she provides a clear assessment of their oral health – concurs. “Periodontal disease has been connected to heart issues for a very long time, and now there is scientific evidence that it’s related to Alzheimer’s too,” she told me during my last checkup when I mentioned my newly-acquired knowledge.
Oral Health Matters
A report released in 2000 by the US Surgeon General describes the importance of oral health extremely well: Oral health is much more than just healthy teeth; it also includes the health of many other anatomical structures such as the gums, bones, ligaments, muscles, glands, and nerves. In addition, oral health affects some of our most basic human functions, thereby shaping an individual’s self-image and sense of well-being. These are tissues whose functions we often take for granted, yet they represent the very essence of our humanity. They allow us to speak and smile; sigh and kiss; smell, taste, touch, chew, and swallow; cry out in pain; and convey a world of feelings and emotions through facial expressions. They also protect against microbial infections and environmental insults. Yet, a significant number of us do a very poor job caring for our teeth and gums and neglect oral hygiene.
Lying Through Your Teeth
Let’s be honest. Many of us do not take oral health as seriously as we do our overall health. We eat right, exercise, watch our weight, and practice stress relief; but we floss rarely, if at all. We also hate going to the dentist – even for regular, routine cleaning and checkups. We are afraid. The phrase ‘like pulling teeth’ is commonly used to describe something difficult to do. Some of us call our dentist only when we can no longer tolerate the pain we’re experiencing.
A recent survey shows that 73% of patients routinely lie to their dentists. According to that survey, the most common lies are about brushing twice a day, flossing regularly, eating healthy, and consuming sugary carbonated drinks. The reasons to lie are embarrassment over poor oral hygiene, fear of dental work, protection of self-image, and the cost of treatment. “Unfortunately, says Dr. Godiwala, “these patients ultimately hurt themselves. They do not understand the potentially far-reaching consequences on their overall health.”
Periodontal disease
The National Institute of Dental and Craniofacial Research describes Periodontal or gum disease as an infection of the tissues that hold your teeth in place. It’s typically caused by poor brushing and flossing habits that allow plaque—a sticky film of bacteria—to build up on the teeth and harden. It starts with swollen, red, and bleeding gums. If left untreated, it can spread to the bones surrounding the gums, making it painful to chew. In the worst cases, teeth may become loose or need to be removed.
In addition, as Dr. Godiwala reminded me, it can lead to other very serious and acute illnesses. “Our teeth physically support the oral skeleton and structures. The loss of teeth allows muscles to cave in resulting in the airway collapsing. This can lead to sleep apnea. Among other health conditions, gum disease in women has been linked to complications during pregnancy and low weight at child birth.”
Medical conditions and oral health
A 2009 report from the National Academy of Sciences summarizes the interdependence of medical conditions and oral health. Metabolic processes in diabetic patients can result in infections of the gums and bone that hold the teeth in place. Conversely, infections in the gum have been shown to exacerbate glycemic control in diabetic patients. There is considerable research-based evidence that links gum disease to heart disease, heart failure, high blood pressure, and an increased risk for strokes.
Dr. Godiwala adds, “just as systemic disease can be related to oral disease, some systemic conditions may first manifest in the mouth. Frequent ulcerations could be a sign, for example, of an immune disorder such as HIV. An early detection of cancer is another possible outcome, since dentists screen for oral cancer. This is yet another reason why regular checkups with a dentist are so important.”
Chronic inflammation, immune response, and oral bacteria
Studies show that chronic inflammation of the gums and oral cavity caused by poor oral hygiene increase levels of inflammatory markers in the bloodstream, thereby affecting the immune response of cells in other parts of our body. In addition, the mouth acts as a reservoir for pathogenic bacteria that can enter the bloodstream and affect the rest of our body, leading to various diseases.
Studies continue
Recent studies have established links between oral health and Alzheimer’s disease and other forms of dementia, obesity, rheumatoid arthritis, and several cancers. While strong relationships between oral health and systemic diseases have been established, other complicating factors in these studies make it difficult to show a clear causation. Dr. David Satcher, the US Surgeon General who commissioned the report in 2000, emphasized that “oral health is integral to general health. You cannot be healthy without oral health.”
It is time for all of us to heed Dr. Satcher’s warning. Are you among those who need to mend their ways and prioritize good oral health?
Photo by Lesly Juarez on Unsplash