The Oral-Systemic Connection
I recently read an article by Richard H. Nagelberg, a dentist in Philadelphia, that I thought did a great job of very briefly summarizing some of the evidence connecting oral health to total body health. As health research technology continues to progress, we begin to see more and more connections between oral health and other health conditions including respiratory infections, diabetes, adverse pregnancy, cardiovascular disease, and hypertension. It is important for the general dentist and their patients to understand that there is not a single connection, but rather, links for a variety of organ systems and disease entities.
Respiratory infections- the connection between respiratory infection and inhaled oral pathogens is well established. Uncontrolled pathogenic bacteria in your mouth can easily lead to respiratory infection.
Diabetes- there is a 2 way relationship between diabetes and gum disease. That is, poorly controlled diabetes worsens gum disease, and gum disesase worsens diabetes. Poor glycemic control due to an increase in insulin resistance from the infectious and inflammatory components of gum disease has been abundantly researched and demonstrated.
Pregnancy- Connection between gum disease and adverse pregnancy has had ups and downs. Some studies show a relationship between gum disease and preterm, low-birth-weight infants, while some do not.
Cardiovascular disease- There seems to be a strong relationship between gum disease and cardiovascular disease. Recent studies have shown a number of different mechanisms by which an association may exist. One, for example, shows that gum disease causes an increase in levels of CRP and Lp-PLA-2 ,which are proteins that are proven to be significant markers for cardiovascular disease.
Hypertension- Studies have demonstrated a relationship between the amount of oral bacteria and hypertension. DNA studies have shown the presence of oral bacteria in coronary blood vessel walls. Research also shows that the same inflammatory mediators are released in response to periodontal disease, rheumatoid arthritis, cardiovascular disease, and adverse pregnancy
As dentists and dental patients, it is important that we not separate the oral cavity from the rest of the body. We know that conditions in the oral cavity can affect many different areas of the body, and vice versa. Maintenance of a healthy body includes maintenance of a healthy mouth and healthy smile!
Reference article: Nagelberg, Richard H. “The Oral-Systemic Connection.” Dental Economics, June 2011.
