What food we put into our mouth clearly has an impact on our health and risk of developing disease, however the mouth is also strongly linked to the health in the rest of our body in a different way. Oral hygiene is important for a whole host of reasons including gum health. Periodontal (gum) disease causes a low level chronic inflammation all around the human body and causes raised inflammatory markers which can be measured in the blood.
This widespread inflammation or metaflammation is associated with chronic diseases such as heart attacks, strokes, and Alzheimer’s disease.
As discussed in previous blogs, chronic diseases are responsible for 74% of all deaths globally - the leading killer being cardiovascular disease which includes heart attacks and strokes. These diseases are a result of genetics (which we cannot change) as well as environmental and lifestyle factors (which we can change). By getting sufficient physical activity, having a healthy diet, and avoiding tobacco and excessive alcohol, we can decrease the risk of developing the chronic diseases of ageing.
Another lifestyle risk factor is oral hygiene. Maintaining good oral health is important for the removal of dental plaque, avoidance of tooth decay and prevention of periodontal (gum) diseases.
Gum disease typically starts to develop when people are in their 40s and its frequency increases with age. It is a chronic inflammatory disease in which the gums and all the structures supporting the teeth become progressively destroyed. Healthy gums are pink, firm and teeth well supported. However in the absence of consistent oral hygiene practices, the gums may begin to inflame - gingivitis - and eventually begin to separate from the tooth causing increased deterioration of the tooth’s support system (the various stages of periodontitis). These bacteria then enter the bloodstream and may initiate an uncontrolled inflammatory response.
Gum disease is also recognised as a risk factor for the world’s number one killer - cardiovascular disease. One of the main causes of cardiovascular disease is the narrowing of arteries by plaque build up - atherosclerosis.
In fact treatment for gum disease improves cardiovascular disease markers such as decreased blood pressure. Individuals with gum disease are also at increased risk for poor blood sugar control and have a significantly higher risk of developing type 2 diabetes.
This low grade systemic inflammation also plays a role in neurodegenerative diseases such as Alzheimer’s disease. It is thought that these oral bacteria enter the blood stream, breach the blood brain barrier and enter the brain contributing to the onset and progression of cognitive decline associated with Alzheimer’s. One of the most common bacteria causing gum disease has, in fact, been found in the brains of patients diagnosed with Alzheimer’s disease.
Studies have also shown that pregnant women with gum disease have a higher risk of negative outcomes with their babies with a lower birth weight and more pre-term births when compared to pregnant women with healthy gums. In women with gum disease, oral bacteria gain access to the maternal circulation and placenta and even penetrate the placental barrier to enter the baby’s circulation.
Oral health and hygiene is clearly linked to our general health. While the relationship between the two is complex and not yet fully understood, low grade systemic inflammation seems to be the prevailing occurrence linking gum disease to a variety of systemic conditions. Ensuring that our teeth, especially the tooth-gum margin and between the teeth, is kept clean and healthy is important in the prevention the chronic diseases associated with ageing.
Having good oral hygiene involves:
brushing your teeth thoroughly with a soft-bristled toothbrush at least twice a day
using a fluoride toothpaste
flossing your teeth once day
brushing your tongue
visiting your dentist regularly