Beyond the Toothbrush: Oral Hygiene and Health

Maintaining healthy teeth and gums is the essence of good oral hygiene.  Brush twice a day, floss once a day, and see the dentist every six months: sounds like a sound plan.  Most people know how good oral hygiene is relevant to teeth and gums. Cavities, root canals, plaque, and gum disease are all familiar words associated with a sick mouth.  But healthy teeth and gums or rather unhealthy teeth and gums can impact the body far beyond the mouth.

Dentists rarely chat with patients about cardiovascular disease, stroke, pneumonia, diabetes, or preterm birth.  What about longevity?  Do dentists tell patients that caring for teeth could lead to a longer, healthier life?  There has been a lot of research linking poor oral hygiene with the aforementioned diseases and linking good oral hygiene to longevity.  If prevention of a heart attack or stroke could begin in a dentist chair or with floss in hand, who would choose to forego such simple preventative measures?  Fear and lack of pain or symptoms are often the instigators of apathy when teeth are concerned.  Many people have a real and intense fear of sitting in a dentist chair.  It is easy to neglect things that don’t scream out for attention.  But silently, poor oral hygiene can have devastating consequences not only in the mouth, but also to overall health.

Bacteria are present in all mouths, but are kept within normal limits by brushing, flossing, and seeing the dentist regularly.  When bacteria are not removed from the mouth and food particles are left behind to feed and help the bacteria proliferate, these bacteria can cause inflammation and infection.  Inflammation and infection in the mouth can be introduced systemically through bleeding gums and can cause inflammatory responses in blood vessels, the heart, the lungs, and elsewhere.  The final effect is an increased risk of diseases, such as cardiovascular disease, stroke, pneumonia, and low birth weight

Cardiovascular disease can be promoted when oral bacteria are introduced into the bloodstream which can induce platelet aggregation and the formation of clots in the arteries of the heart.  When clots form in blood vessels, they can block the flow of blood to a part of the heart.  When heart muscle is deprived of oxygen which is carried by blood, a heart attack is eminent.  If bacteria infect the lining of the heart or heart valves, a very serious condition called infective endocarditis (infection of the lining of the heart or heart valves) can result.  Infective endocarditis can cause poor heart valve function, an abnormal heart beat, heart failure, stroke or kidney failure.  These inflammatory responses are most harmful to people with a history of any of the following: prosthetic heart valves, heart transplant, previous endocarditis or congenital heart disease.

The same inflammatory processes that affect the heart can also affect arteries in other organs of the body increasing the risk of blockages or aneurysms (dilated blood vessels).  Blockages and aneurysms that affect the brain can cause a stroke if the blockage is severe or if the aneurysm bursts.

Lungs can also fall victim to infectious bacteria harbored in oral secretions.  If aspirated into the lungs, certain bacteria can colonize there and cause bacterial pneumonia.  People at a high risk of developing bacterial pneumonia transmitted from oral bacteria have one or more of the following circumstances: chronic lung disease, advanced age, intubation, mechanical ventilation, a smoking history, a long hospital stay, and residence at a long term care facility

Oral infection has also been shown to contribute to low birth weight in babies of infected moms.  Pregnancy, in general, poses a higher risk for oral infection.  Changes in hormones during pregnancy can promote inflammation of the gums.  This inflammation can be transmitted through the blood via bleeding gums to the environment in which a growing fetus lives.  Infection in this environment can interfere with normal growth and cause premature birth and/or low birth weight.

Other conditions and activities that promote gum disease are diabetes, smoking, chewing tobacco, bulemia, eating or drinking foods high in acid and sugar, and having dental devices, such as dentures or retainers that can trap food and bacteria on the teeth and gums.  A person with any of the preceding circumstances should be aware of the risk of dental disease and take special preventative measures in caring for teeth and gums or dental devices.

Loss of self esteem is another risk to the health and well being of a person with poor oral hygiene.  Bacteria in the mouth cause bad breath, which can be chronic when tooth decay is untreated.  Tooth and gum disease can also lead to broken teeth and or loss of teeth.  This can be devastating to self esteem.  Poor self esteem can have negative effects on the health and well being of the mind and body.

The health of the mouth is to some extent a reflection of general health of the body.  Good oral hygiene starts with a toothbrush.  But beyond the toothbrush, flossing, having regular dental cleanings and exams, and becoming educated about personal risk factors of dental disease are essential to the prevention of a sick mouth and a sick body.