February 8, 2018
More than you might think.
Most people consider teeth and gums as separate from other aspects of personal health, yet they are more connected to serious health conditions that you might realize.
Good dental health is a reflection of good health overall. That is because the mouth is a gateway to the rest of our body. It is how we breathe and nourish our bodies. It is also a major source of contracting infection, from the air, or from what we eat.
A routine dental exam may reveal unknown problems with your bones, heart, blood sugar, or digestion because certain warning signs live inside your mouth. So, visiting the dentist regularly is not only good for your dental health, but your overall health too.
Tooth decay (cavities) are an infectious disease.
Bet you didn’t know that a cavity in your mouth is actually contagious.
While, it’s not airborne like the flu, the infection can certainly spread through your body, and even from person to person, like many other diseases. The spread of bacteria from mouth to mouth, is part of the reason why tooth decay (cavities) are the single most common chronic childhood disease.
Cavities are infections resulting from bacteria (most commonly ‘Streptococcus mutans’) feasting on the sugar and starches that remain after you've eaten. They release acids that eat away at a tooth's enamel, eventually weakening it and forming cavities. Left un-checked, the infection reaches the inside of the tooth (the pulp), where the blood vessels and nerves in the tissue also become infected and inflamed. Without treatment, the infection can spread to the gum's crevices (at the gumline and below it), causing more inflammation and swelling, which is why your gums may bleed when you brush your teeth. This can lead to periodontal (gum) disease and eventually loss of teeth.
In some cases, the infection can spread from the mouth to other parts of our body, and even become life threatening in severe cases. “Acute dental infections can be truly life threatening if left un-treated, and the risk becomes even worse when there are other chronic conditions present, such as diabetes,” says William G. Flick DDS, MPH, Clinical Professor, Oral Maxillofacial Surgery at UIC. “Many patients requiring surgery to address severe dental infections such as a facial infection or abscess are also poorly controlled diabetics.”
The good news is, tooth decay is mostly preventable.
To reduce the likelihood of tooth decay, we all know what we’re supposed to: brush and floss after meals, at least twice a day. Even drinking and swishing some water after a snack or sweetened drink can help. And – don’t forget to visit the dentist for regular check-ups.
The connection between oral health and overall health
Beyond brushing and flossing, it also helps to know how your mouth health is connected to your overall health.
There are many connections between oral disease and other chronic conditions that can have major consequences on your health. Periodontal (gum) disease in particular is associated with several, often serious, health problems. And it is more common than you might think. About half of adults in the U.S. has some form of gum disease.
Did you know?
Half of American adults suffer from periodontal (gum) disease.
Data from the Centers for Disease Control and Prevention show high prevalence of periodontal disease in the U.S. population.
Much of the connection starts with bacteria.
Your mouth is home to millions of bacteria – most of them harmless – but some cause our teeth to decay, and can spread to other parts of the body through the bloodstream. Periodontal disease causes your gums to become chronically infected, creating bacteria and inflammation, which can spread to other parts of the body. The deep pockets that form between the teeth and gums as part of the disease offer a favorable environment for proliferation of plaque bacteria and facilitate entry of bacteria into the bloodstream.
There is a growing body of evidence that periodontal (gum) disease is associated with negative health consequences related to a number of medical conditions such as type 2 diabetes (T2D); rheumatoid arthritis (RA); cerebral vascular disease (CVD); and adverse pregnancy outcomes.
So if you are suffering from diabetes, you could be at higher risk for periodontal (gum) disease. Likewise, the presence of periodontal disease may make it more difficult for you to manage blood sugar levels, which further complicates your diabetic condition.
Other health factors may also increase your risk of periodontal disease including smoking, substance abuse, inadequate nutrition, or even stress.
Fun facts about bacteria:
- There are an estimated 300 different species of bacteria living inside our mouths.
- A ten-second French kiss can spread as many as 80 million bacteria between mouths.
- There are more bacteria on a mobile phone than on a toilet seat.
- We have more than 30 trillion bacteria in our body at any given time.
- Bacteria are very tiny - only 1/500th of a human hair in width - but can cause big problems in our mouths.
(photo credit: 2006.National Escherichia, Shigella, Vibrio Reference Unit at CDC)
What you can learn about your health from a routine dental visit
A routine dental exam may reveal problems with your bones, heart, or digestion because certain warning signs live inside your mouth.
As part of a comprehensive oral healthy exam, a dentist may check several aspects of a patient’s overall health to see if indicators are out of normal ranges. These checks can range from a standard medical history questionnaire, to a blood pressure check, or an oral cancer screening.
Oral health can be a contributing factor related to several common diseases and conditions. Here are some of the most common and important connections between your dental health and overall health.
Heart disease is the leading cause of death in the United States, with one out of every four deaths occurring because of it. Every year, 610,000 Americans die of heart disease, according to the Centers for Disease Control and Prevention (CDC).
Research suggests that heart disease, clogged arteries and stroke might be linked to the inflammation and infections that oral bacteria can cause. Some studies have also shown that bacteria in the mouth that are involved in the development of periodontal disease can move into the bloodstream and cause an elevation in C-reactive protein, a marker for inflammation in the blood vessels. These changes can, in turn, increase the risk of heart disease and stroke.
Why do dentists check blood pressure?
Blood flows to and from our mouth and the rest of the body. People who have certain heart conditions may be at higher risk of contracting disease from infections. Having high blood pressure can cause excessive bleeding in the gums even during brushing, as well as during treatment.
“Elevated blood pressure is one of the most significant public health problems being addressed in this country,” says William G. Flick DDS, MPH, Clinical Professor, Oral Maxillofacial Surgery at UIC.
“We use blood pressure checks to identify patients who may have undiagnosed hypertension, and then refer the patient for medical evaluation and treatment. We may also modify treatment, medications and local anesthetics to prevent adverse effects situations during dental treatment.”
Since tooth decay and periodontitis are forms of infectious disease, it is possible that blood can transport bacteria related to these conditions from the mouth to the heart and other parts of the body. For instance, Endocarditis, an infection of the inner lining of your heart, typically occurs when bacteria or other germs from another part of your body, such as your mouth, spread through your bloodstream and attach to damaged areas in your heart.
At UIC, dentists check blood pressure prior to treatments and during routine check-ups. We want to know the patient’s baseline blood pressure as part of their health evaluation. It’s important because we need to know if a high blood pressure condition may exist. Some dental treatments may cause an increase in blood pressure above normal range. For instance, certain local anesthetics may cause an elevation in blood pressure. That is why we check blood pressure, and ask the patient follow up questions if the measurement is higher than normal.
People with diabetes are at higher risk for developing infections for many diseases. Diabetes reduces the body's resistance to infection — putting the gums at risk. Research shows that people who have gum disease have a harder time controlling their blood sugar levels, and that regular periodontal care can improve diabetes control. While the causal relationship between diabetes and periodontitis is less clear, it is still important to understand how these conditions increase risk.
“We take time to educate our patients on the connections between oral and systemic health. A common example is the association between periodontal diseases and diabetes. We make sure our patients understand that they must also work to get blood sugar under control in order for their body to properly fend off the infections leading to periodontal disease. When diabetes is under control, periodontal disease is also more easily controlled. Likewise, people who have severe periodontal disease find it harder to control blood sugar levels.”
Aniruddh Narvekar, BDS
Clinical Assistant Professor
Diplomate, American Board of Periodontology
Nearly 50,000 Americans will be diagnosed with head & neck cancer this year, causing nearly 10,000 deaths, making it the sixth most common cancer in the world. There are more than 640,000 new cases of oral cancer diagnosed annually worldwide. Mortality from oral cancer is nearly twice as high in some minorities (especially black males) as it is in whites. Preventing high risk behaviors, that include cigarette, cigar or pipe smoking, use of smokeless tobacco, and excessive use of alcohol are critical in preventing oral cancers. Early detection is key to increasing the survival rate for these cancers.
“All of our new patient dental exams include an oral cancer evaluation. We check the tissues inside and outside the mouth visually and by touch to detect signs of possible cancerous or benign legions or tumors. In some cases, we may refer patients to our oral medicine & facial pain specialist department for further evaluation. We use a multidisciplinary approach to expertly diagnose and treat these oral mucosal diseases. The Oral Medicine & Facial Pain experts at UIC collaborate with all dental disciplines, including Periodontics, Endodontics, and Oral Surgery as well as a number of medical disciplines, including ENT, Dermatology, Oncology, Neurology, Hematology, Radiology, Surgery, and Psychiatry.”
Beth Miloro, DDS, MPH
Clinical Assistant Professor
The importance of saliva to our health
Staying hydrated, and drinking plenty of water is not only good for your whole body, it also helps to protect your mouth from oral disease.
Why? Because saliva washes away food and neutralizes acids produced by bacteria in the mouth. Acids do the most damage when you are very thirsty or have a dry mouth. When you’re dehydrated, you lack saliva and your teeth are more vulnerable to acid attacks.
A salivary gland dysfunction can lead to ‘dry mouth’, or very low levels of saliva. Saliva helps keep a balance in our mouths to help clean away cavity forming bacteria, from leftover food. Lack of saliva can be due to gland issues, medication, lack of hydration or other external factors.
The link between periodontal disease and your overall health
There are many factors that lead to or increase the risk of periodontal disease. Genetics, unhealthy diet, unhealthy habits such as smoking, and poor oral hygiene all play a part in creating the conditions that may lead to periodontal disease.
Genetics, and other health related factors also play a part in influencing how our bodies respond to the disease and treatment methods. For instance, research studies have identified an association between periodontitis, obesity and type 2 diabetes. And, we know that obesity is a risk factor for several chronic diseases, most notably hypertension, type 2 diabetes, dyslipidemia and coronary heart disease.
Here are some additional risk factors associated with oral disease:
Acidic diet and reflux: Increased acidity in the mouth can cause a lot of erosion in the teeth. Some people who have a lot of wear in their teeth may not realize it could be caused from an acid reflux condition, or just an acid heavy diet.
Autoimmune diseases: diseases such as Sjogrens syndrome can cause dry mouth, increasing the risk of cavities. Other autoimmune diseases may cause sores in the mouth, making it painful to brush and floss.
HIV/AIDS: Oral problems, such as painful mucosal lesions, are common in people who have HIV/AIDS.
Jaw pain / TMJ: Frequent headaches, ringing in the ear or teeth clenching may be a sign of TMJ or other head & neck conditions. Without intervention, these conditions could get much worse over time.
Osteoporosis: Osteoporosis — which causes bones to become weak and brittle — might be linked with periodontal bone loss and tooth loss. Drugs used to treat osteoporosis carry a small risk of damage to the bones of the jaw.
Skin health: For some conditions such as a cancerous legion, or maybe even a skin problem, we can refer the patient to an appropriate specialist either within the UI Health system, or to a provider of their choosing.
Smoking: Smoking is one of the most significant risk factors associated with the development of periodontal disease. Additionally, smoking can lower the chances for successful treatment.
What about medications?
There are hundreds of prescription and over-the-counter medications that can reduce the flow of saliva, which has a protective effect on the mouth.
Without enough saliva, the mouth is vulnerable to infections such as gum disease. And some medicines can cause abnormal overgrowth of the gum tissue, which makes it difficult to keep teeth and gums clean. Several common medications — including decongestants, antihistamines, painkillers, diuretics and antidepressants — can reduce saliva flow.
“We factor medication use into our treatment planning. For instance, we want to know if a medication may cause side effects such as dry mouth, which can lead to other complications. We can plan ahead and have some extra water on hand for patients who are experiencing a dry mouth condition and suggest treatment options that would help to control this issue. Another example might be knowing if a patient has been taking a medication that could lead to excessive bleeding or inflammation in their gums.”
Alexandra Rodriguez, DDS, MS
Clinical Assistant Professor
Will the dentist coordinate care with my primary physician?
If certain conditions are detected during a dental exam, UIC dentists may coordinate prescription of medications, or share medical records and x-rays with a patient’s primary care physician as requested. In some cases, we will not prescribe medications or perform certain treatments without the physician’s consent.
UIC dentists will also work with primary and specialty care providers who wish to refer their patients for our oral care services. For instance, if your regular doctor notices an irregular lump in your mouth or throat, they may refer you to one of our oral medicine / cancer specialists.
A healthy mouth means a lot more than not having cavities. And serious problems in your mouth, such as gum disease, may increase your risk of other serious health problems such as heart attack, stroke, diabetes and other chronic diseases.
What's in your mouth can reveal a lot more about your health that you might have thought.
Comprehensive Dental Care at UIC
Regular dental exams are important for detection and prevention of oral diseases. That is why we take a comprehensive approach at UIC. During the dental exam, we will ask you about any health problems you have or medications you are taking and discuss how they might affect your oral health. We verify stability of fillings or other restorations, and evaluate your risk of tooth decay, root decay, and gum or bone disease. We will evaluate your need for tooth restoration or tooth replacement, and check your bite and jaw for problems. During the dental exam, we will also look for signs of oral cancer in the mouth and throat areas. We may also take digital X-rays, or perform additional diagnostic procedures to develop a comprehensive treatment plan, which will be reviewed with you at the completion of the exam. Regular exams allow our dentists to keep your mouth in good shape and monitor conditions that may get worse or lead to problems elsewhere in your body. We can also share recommendations for good nutrition and oral hygiene, and provide counseling on special oral health care needs, such as tobacco cessation.
Ready to learn more about your oral health?
Schedule an appointment online with one of our dentists.
Take control of your oral health!