Ann Clark RDH
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Ann Clark RDH
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Andra Mahoney, BS RDH
Oral Health: A Window to your Overall Health
Many people are realizing that there is a direct connection between oral health and total body health. It is finally being generally accepted that oral health and general health are to be interpreted as one entity, not separate as has been the view in the past. Dentists has been saying this for years, and finally science is proving them right! You cannot be healthy without good oral health.
“The mouth can act as a portal of entry for infection, ” says Salomon Amar, DMD, PhD, Professor and Director at the Center for Anti-Inflammatory Therapeutics at Boston University School of Dental Medicine. “Ongoing inflammation in your mouth can allow bacteria to enter the bloodstream, which may lead to more inflammation in other parts of your body, such as the heart.”
What conditions may be linked to oral health?
Your oral health might affect, be affected by, or contribute to various diseases and conditions, including:
Endocarditis. Endocarditis is an infection of the inner lining of your heart (endocardium). Endocarditis 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.
Cardiovascular disease. Some research suggests that heart disease, clogged arteries, and stroke might be linked to the inflammation and infections that oral bacteria can cause.
In 2005, the NIH funded a study on this topic. They randomly selected 1,056 participants with no prior heart attacks or strokes. All were evaluated for levels of periodontal bacteria. After removing the effects of the other risk factors of age, gender, and smoking, Moise Desvarieux, MD, PhD, Associate Professor of Epidemiology at the Mailman School and lead author of the study stated, “It was found that there was an independent relationship between gum disease and heart disease.” One theory about why this may occur is that small amounts of bacteria enter your bloodstream while you’re chewing. “Bad” bacteria from an infected mouth may lodge itself inside blood vessels, ultimately causing dangerous blockages. Strengthening his theory is the fact that when scientists have looked at atherosclerotic blood vessels, they have sometimes found fragments of periodontal bacteria. Meanwhile, a study published in the New England Journal of Medicine in 2007, established that aggressive treatment of gum disease reduces the incidence of atherosclerosis within six months.
It has been found that up to 91% of patients with heart disease have periodontitis. “The theory is that inflammation in the mouth causes inflammation in the blood vessels,” says Sally Cram, DDS, PC, Consumer Adviser for the American Dental Association. “This can increase the risk for heart attack in a number of ways. Inflamed blood vessels allow less blood to travel between the heart and the rest of the body, raising blood pressure. There’s also a greater risk that fatty plaque will break off the wall of a blood vessel and travel to the heart or the brain, causing a heart attack or stroke.”
Pregnancy and birth. Periodontitis has been linked to premature birth and low birth weight.
Scientists believe that gum disease or inflammation in the mouth possibly triggers an increase in a chemical compound called prostaglandin, which induces early labor. While this theory has not yet been confirmed, a 2001 study found that pregnant women who develop gum disease between weeks 21 and 24 of their pregnancy are four to seven times more likely to give birth before week 37. There is evidence that poor gum health in the extreme can lead to low birth weight as well.
Babies born too early or at a low birth weight often have significant health problems, including lung conditions, heart conditions, and learning disorders. While many factors can contribute to premature or low birth weight deliveries, infection and inflammation in general seem to interfere with a fetus’ development in the womb.
Though men have periodontitis more often than women do, hormonal changes during pregnancy can increase a woman’s risk. For the best chance of a healthy pregnancy, Pamela McClain, DDS, President of the American Academy of Periodontology, recommends a comprehensive periodontal exam, “If you’re pregnant or before you become pregnant, identify whether or not you’re at risk.”
Diabetes. Diabetes reduces the body’s resistance to infection which puts the gums at risk.
Gum disease appears to be more frequent and severe among people who have diabetes. Research shows that people who have gum disease have a harder time controlling their blood sugar levels. Researchers at Columbia University’s Mailman School of Public Health followed 9,296 non-diabetic participants, measuring their level of periodontic bacteria over the course of 20 years. “We found that people who had higher levels of periodontal disease had a two-fold risk of developing type 2 diabetes over that time period compared to people with low levels or no gum disease,” explains Ryan Demmer, PhD, Associate Researcher at the Department of Epidemiology at the Mailman School and the lead author. There are a few theories about why this might be the case. One proposes that when infections in your mouth get bad enough, it can lead to low-grade inflammation throughout your body, which in turn wreaks havoc on your sugar-processing abilities. “There are all kinds of inflammatory molecules,” says Dr. Demmer, “and it’s believed that maybe some attach to insulin receptors and prevent the body’s cells from using the insulin to get glucose into the cell.”
It has also been noted that inflammation that starts in the mouth seems to weaken the body’s ability to control blood sugar. People with diabetes have trouble processing sugar because of a lack of insulin, the hormone that converts sugar into energy. “Periodontal disease further complicates diabetes because the inflammation impairs the body’s ability to utilize insulin,” says Dr McClain. Diabetes and periodontitis have a two-way relationship. High blood sugar provides ideal conditions for infection to grow, including gum infections. Diabetes can also slow the healing process and lower resistance to infections, including oral infections. Fortunately you can use the gum disease-diabetes relationship to your favor: managing one can help bring the other under control.
HIV/AIDS. Oral problems, such as painful mucosal lesions, are common in people who have HIV/AIDS. Studies suggest that oral bacteria and the inflammation associated with periodontitis, a severe form of gum disease, might play a role in some diseases. Certain diseases, such HIV/AIDS, can lower the body’s resistance to infection, making oral health problems more severe.
Osteoporosis. Osteoporosis, which causes bones to become weak and brittle, might be linked with periodontal bone loss and tooth loss. Osteoporosis and periodontitis have an important thing in common, bone loss. Researchers are testing the theory that inflammation triggered by periodontitis could weaken bone in other parts of the body.
Alzheimer’s disease. Tooth loss before age 35 might be a risk factor for Alzheimer’s disease.
–Dementia: The bacteria from gingivitis may enter the brain through either nerve channels in the head or through the bloodstream, that might even lead to the development of Alzheimer’s disease.
Pneumonia. A 2008 study of elderly participants found that the number who developed pneumonia was 3.9 times higher in patients with periodontal infection than in those free from it. “The lungs are very close to the mouth,” says Marsha Rubin, DDS, practicing Diplomat of Special-care Dentistry at New York-Presbyterian/Weill Cornell. “Even in a healthy mouth there is lot of bacteria, but bacteria in a not-healthy mouth can get aspirated into the lungs, causing pneumonia or aggravating COPD, chronic obstructive pulmonary disorder.” Several intervention studies cited by the CDC show that an improvement in oral health can lead to a reduction in respiratory infection. Periodontal disease may make pneumonia and chronic obstructive pulmonary disorder worse, possibly by increasing the amount of bacteria in the lungs.
Pancreatic Cancer. A study published in 2007 in the Journal of the National Cancer Institute surveyed 51,529 American men about their health every two years between 1986 and 2002. Of the 216 participants who developed pancreatic cancer, 67 of them also had periodontal disease. Independent of the participants’ smoking status, the study found that having a history of periodontal disease was associated with an increased risk of pancreatic cancer. This, according to the study, could be because of systemic inflammation or increased levels of carcinogenic compounds produced in the infected mouth. Interestingly, another viable theory about why gum disease may cause type 2 diabetes points to damage to the pancreas as well. “With the pancreatic cancer study, we thought it was very interesting that you have this localized infection that has an impact on a systemic organ that is very intimately tied to the pathophysiology of diabetes,” says Dr. Desvarieux.
Cancer. Your dentist and hygienist should screen for oral cancer and other cancers of the head and neck, including skin cancer, cancer of the jaw bone, and thyroid cancer, during routine checkups. He or she feels for lumps or irregular tissue changes in your neck, head, cheeks and oral cavity, and thoroughly examines the soft tissues in your mouth, specifically looking for any sores or discolored tissues. Survival rates greatly increase the earlier oral cancer is discovered and treated. During your next dental visit, ask your dentist to do an oral cancer screening. See your dentist immediately if you observe:
Any sore that persists longer than two weeks
A swelling, growth, or lump anywhere in around the mouth or neck
White or red patches in the mouth or on the lips
Repeated bleeding from the mouth or throat
Difficulty swallowing or persistent hoarseness
Scientists aren’t sure of the exact cause of oral cancer. However, the carcinogens in tobacco products, alcohol and certain foods, HPV infections, as well as excessive exposure to the sun, have been found to increase the risk of developing oral cancer. Risk factors for oral cancer may also be genetically inherited. You can help prevent oral cancer by:
Not smoking or using spit tobacco
Limiting your alcohol intake
Eating plenty of fruits and vegetables
Also, periodic self-examinations can increase your chances of detecting oral cancer, so be sure to examine your face, cheeks, jaw and neck regularly for any changes or lumps.
Other conditions. Other conditions that might be linked to oral health include Sjogren’s syndrome, an immune system disorder that causes dry mouth, and eating disorders.
Because of these potential links, be sure to tell your dentist if you’re taking any medications or have had any changes in your overall health, especially if you’ve had any recent illnesses or you have a chronic condition, such as diabetes.
How can I protect my oral health?
To protect your oral health, practice good oral hygiene every day. For example:
Brush your teeth at least twice a day.
Eat a healthy diet and limit between-meal snacks.
Replace your toothbrush every three to four months or sooner if bristles are frayed.
Schedule regular dental checkups.
Also, contact your dentist as soon as an oral health problem arises. It is important to let your dentist know your full family medical history. If you have periodontal disease, make sure you see your dentist frequently and get it treated promptly, before it progresses to the point where you begin losing teeth or it starts to affect your overall health. Remember, taking care of your oral health is an investment in your overall health.
One thing is clear: the body and mouth are not separate. Your body can affect your mouth and likewise, your mouth can affect your body. Taking good care of your teeth and gums can really help you live well longer.
Want to learn more? Visit us at
Ann Clark, RDH
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Lindsay Whitlock RDH
ORAL PIERCINGS THROUGH THE AGES:
EFFECTS OF ORAL PIERCINGS:
WHAT YOU SHOULD DO IF YOU ALREADY HAVE AN ORAL PIERCING?:
American Dental Association. Oral Health Topics: Tongue Piercing and Tongue Splitting. Amended. October 2004. Retrieved 30 April 2013. http://www.ada.org/2750.aspx?currentTab=2 Body piercing Statistics. (2012). Retrieved from http://www.statisticbrain.com/body-piercingstatistics Chimenos-Küstner.E. (2003). Appearance and culture: oral pathology associated with certain “fashions” (tattoos, piercings, etc.). retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12730654
Ford CA, Bearman PS, Moody J JAMA. Foregone health care among adolescents.1999 Dec 15; 282(23):2227-34. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360944/
Francesco Inchingolo, Marco Tatullo, Fabio M. Abenavoli, Massimo Marrelli, Alessio D. Inchingolo, Antonio Palladino,Angelo M. Inchingolo, and Gianna Dipalma. Oral Piercing and Oral Diseases: A Short Time Retrospective Study. Published 2011 October 18. Retrieved 30 April 2013. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3204433/
Kelly Soderlund, ADA News staff. Fewer adults visiting the dentist. Updated 13 March 2013. Retrieved 30 April 2013. http://www.ada.org/news/8366.aspx
Oral Piercings. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360944/
The Perils of Oral Piercing Retrieved from http://www.rdhmag.com/articles/print/volume- 26/issue-3/feature/the-perils-of-oral-piercing.html
Wilkins, E. M. 2011. Clinical Practice of the Dental Hygienist. Philidelphia: Lippincott Williams & Wilkins.
It’s no secret that at least everyone has gotten a few canker sores in their lifetime. Have you ever had that period of time where you just cannot seem to get rid of a canker sore? Or you just keep getting them? Well, as I’ve mentioned in my previous blog, I was an orthodontic patient for 3 years. If you’ve ever had braces, you know the drill with the canker sores. Your braces just love to cut you, and canker sores just LOVE to appear everywhere they possibly can. I was so annoyed with my mouth, that I tried every possible way I could to get rid of them. Allow me to walk you through my journey of canker sore relief.
To start, canker sores are small lesions that develop on the soft tissues in your mouth, or at the base of your gums. You can have 2 different types of canker sores; simple, or complex. Simple canker sores may appear three or four times a year and last up to a week. Complex canker sores are less common than simple, and occur more often in people who have previously had them. Unlike cold sores, canker sores are not contagious. A lot of people confuse canker sores with cold sores when in reality, they are very different. The exact cause of a canker sore is unknown, while some say that it could be caused b stress, or injury to your tissue in your mouth. So for example, if you were a cheek biter and lip biter like I was, canker sores will come very easily to your mouth. The constant chewing damages the tissue, leaving room for canker sores to “grow.”
When I was younger, I remember getting the occasional canker sore here and there, nothing big. I would wait for a few days, they would go away. But, when I had my braces put on, it was like I was getting a new canker sore every other day! It was awful. I wasn’t just getting them on my gums, or cheeks, but I was also getting them on my tongue. I tried everything. I went to Walgreens and got every canker sore cream they owned. Nothing would ever help me. I tried everything from orajel, to canker care. It would relieve them, and make them smaller, but I would feel like they would never heel, or new ones would always be sprouting different places in my mouth. I finally made the trip to my dentist after I couldn’t stand them anymore. This was when I had braces, so it’s really hard to clean the gum tissue around my braces. And it was also really hard for me to clean the food out of my teeth really well, which was also part of the problem. When I would eat acidic food, it would stay in my teeth, and because my cheeks would always be damaged due to the braces, it would result in canker sores…everywhere. Well, I started to change my diet, be more thorough with my cleaning, and floss. What do you know? My canker sores started becoming less and less! It was amazing, I was so happy. Doing a really detailed job on cleaning my teeth have now become a habit I never intend to break.
My canker sore journey doesn’t end there, even after my braces were off, I continued to get canker sores. I was furious! I marched right back to Walgreens and started from square 1. All of those creams and gels still did nothing for me. I didn’t want to go to my doctor again, knowing he would just tell me the same thing again. I decided to take matters into my own hands. I started to Google things, and tried all of these ridiculous home remedies….until I found one remedy that was no longer ridiculous. Are you ready for it? Warm salt water. Who knew? It worked miracles. I would swish warm salt water in my mouth twice a day, and within one day, I was feeling the canker sores go down, and I had little pain, and I was able to eat salty things again. After about 3 days of warm salt water, my mouth was canker sore free. I was one happy lady. It just blew my mind that the simplest of things helped me so much. This is what I recommend to everyone out there suffering from canker sores. The salt helps fight the infection and the pain, and inflammation, whereas the warm water helps ease the pain.
Every time I feel a canker sore coming on, I grab that salt water, and gargle and I’m feeling better the next day. It is the only thing I trust when it comes to my canker sores! I recommend it to everyone who has the same problem as I do.