Dental Hygiene: It Is Important In Preventing Other Diseases
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Max Sherman-man339@gmail.com
I am fortunate to have most of my teeth despite my advantaged age and I credit that to quarterly visits with my dentist, persistent dental hygiene including flossing, healthy diet, genetics and luck.
I even remember my first dentist, one who avoided using anesthetics, and someone whose painful visits I learned to dread throughout my childhood. It was also my good fortune to have a parent who enabled me to wear braces to correct an inauspicious and glaring overbite. Fortunately, braces corrected that deformity before I entered high school. The cost back then was $300 and my mother paid that sum with $10 monthly payments and no interest. The charge even included a retainer I was fitted for, and wore for a year when I returned from the service 10 years later.
I may not have realized back then but since learned how dental health affected other parts of my body.
Diseases
A recent article in the New York Times listed a number of diseases for which there is moderate to strong evidence that periodontal disease (around the teeth) may be a contributing factor, including diabetes and insulin resistance, certain cancers, Alzheimer’s disease, gastrointestinal disease and cardiovascular disease as well as respiratory tract infection and adverse pregnancy outcomes. Good oral health lowers the risk of heart problems and people with diabetes may even be able to lower blood sugar overtime, according to the Centers for Disease Control and Prevention. The Center calls periodontal disease a worldwide pandemic, causing disability, speech impairment, low self-esteem and a reduced quality of life.
The presence of periodontal pathogens and their metabolic byproducts in the mouth may in fact modulate the immune response beyond the oral cavity, thus promoting the development of systemic conditions.
A review article in the Biomedical Journal deemed periodontal disease as one of the most common inflammatory diseases in adults. In 2010, 3.9 billion people worldwide were reported to have periodontal disease, with the prevalence of mild periodontitis being 35%. As the global population ages, periodontal disease has become a significant public health concern and a mounting burden on the healthcare system.
Cause And Effect
It remains to be established whether specific periodontal pathogens stimulate development of the systemic disease, or if the systemic disease causes the abundance of periodontal pathogens to change. If the pathogens cause non-oral disease, then they would represent obvious targets for therapeutic intervention.
But as a minimum, according to a recent paper in the Biomedical Journal, the presence of pathogenic pathogens could be used as diagnostic markers to predict susceptibility to non-oral disease. Periodontal pathogens could promote development of non-oral disease directly or indirectly. For example, about 30 abundant species in the oral cavity, mainly gram negative anaerobic bacteria, are known to produce endotoxins, which directly contribute to systemic disease. Migration of oral pathogens to the blood stream could also occur in some cases, such as following surgical procedures.
Bacterial accumulation on the teeth due to poor dental hygiene and/or environmental factors induces a host inflammatory response, which may result in periodontitis and bone loss but could also be harmful to the host systemically. All of the above are powerful reasons to visit your dentist at least twice a year.
Dental Plaque
And Pathogens
The most common Gram negative bacteria in the oral cavity include Treponema, Bacteroides, Porphyromonas, Fusobacterium, Actinobacillus and Eikenella. There are likely many more, as many as 500 to 700. The bacteria are present in saliva, on gum tissue and other inner surfaces of the oral cavity and concentrated in dental plaque.
Dental plaque is an organized biofilm of microorganisms that are either attached to the tooth surface or to other microorganisms in a way that allows them to survive and resist host defense mechanisms or antibiotics. Sugar metabolism by the dental plaque biofilms lead to the production of organic acids, which demineralize the tooth surface.
There is another reason to visit the dentist and have the plaque removed. If not, tissue trauma, flossing, or even chewing food may induce breakage of blood vessels in close proximity to the plaque, which can introduce bacteria into the systemic blood stream.
American Dental Association Suggestions
The ADA does not have a set schedule for checkups: Some people need to visit the dentist once or twice a year, while others, like myself, may require more trips. Most agree though, that you must go.
There may not be pain with periodontal diseases which are usually caused by an infection of the gums and the bones supporting the teeth and affect nearly half of adults 30 years of age and older, potentially leading to tooth and bone loss.
Other suggestions include flossing, using an interdental brush to clean hidden places where bacteria grow, and brushing your teeth at least twice a day with the brush held against the gumline at a 45 degree angle. Both electric and manual tooth brushes work.
Max Sherman is a medical writer and pharmacist retired from the medical device industry. His new book “Science Snippets” is available from Amazon and other book sellers. It contains a number of previously published columns. He can be reached by email at maxsherman339@gmail.com.
