The last decade has brought a renewed interest in oral health. Not as much interest in how oral health affects your teeth, but how it affects your body. The science and research that is coming from the medical side of health is connecting inflammation and infection in your mouth to serious diseases such as heart disease, diabetes, risks associated with pregnancy, and most diseases that have an inflammatory component or vascular system connection.
In other words, that “little bit of bleeding” when you brush or that gum tissue that stays red or recedes, may have much more of an impact on your overall health than your teeth.
It all seems to center on inflammation and the health risks that are associated with chronic inflammation in the body. It is actually inflammation that triggers the plaque formation on the artery wall. While we were all taught that cholesterol is a great indicator of vascular health, inflammation is now widely regarded as the primary initiator of plaque formation.
Your dental hygienist should no longer be just a teeth cleaner. That profession is moving towards becoming gingival (periodontal) therapists with a goal of keeping inflammation at bay as opposed to just cleaning surfaces. Because gingival inflammation, and infection, is caused by specific bacteria, simply cleaning your teeth often does nothing to stop disease progression. It might make the surfaces feel better, but does nothing to stop the subclinical disease process.
So, when you hear that oral health is related to heart health, it’s not simply keeping the teeth clean. It’s much more about controlling the microbiology that can initiate inflammation.
Think about this. In most health care situations you are seeking therapy. You want a problem addressed or you want a problem detected so it can be treated as early as possible or prevented. For example, your regular MD appointments center on immediate needs, finding perhaps unknown health problems, or preventing health problems. We don’t go see them to be cleaned. The healing arts are built around therapy not hygiene.
Don’t get me wrong, hygiene is important. But statistics tell us that oral health infections, specifically those gum tissue related are severely underdiagnosed and under discussed. That bleeding, inflamed gum tissue, which is skin, is somehow OK in the mouth as opposed if it were somewhere else in, or on, the body.
According to a 2012 study done by the Centers for Disease Control, 1 out of 2 Americans over age 30 have periodontal (gum) disease. Periodontal disease affects not just the gum tissue, but the actual bone of the upper and lower jaws. It is a more advanced form of gum disease that could have been prevented. This study by the CDC was the most comprehensive survey of periodontal health ever conducted in the United States. So, 50% of adults over age 30 have an advanced form of gum disease. That number increases to 70% of adults over age 65
The most interesting thing about periodontal disease is the only way it advances in severity is from lack of intervention. It all starts with gingival inflammation (gingivitis) and is often painless and very subtle in its progression.
The key is early intervention, as with any health care model.
According to a recent manifesto on Periodontal Disease and General Health that was done by the European Federation of Periodontology and the American Academy of Periodontology begins by stating that “ periodontal disease should be acknowledged as a major public health issue, that all dental and medical professionals should be provided with relevant treatment guidelines”. That periodontal disease “is independently associated with cardiovascular diseases and adverse pregnancy outcomes, and is a chronic inflammatory disease with potentially negative consequences for general health”.
Both the CDC study and the EFP manifesto can easily be found online.
The bottom line is that your dental team should be as focused on your general health as they are your dental health. Your dental hygienist should be more of a therapist as opposed to a cleaner, and taking blood pressure, properly evaluating health histories, and working with other physicians and health care specialists is where dentistry is going.