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by Flora Stay, DDS
The Missing Link
There is virtually no disease and ailment that is not affected by oral health. In our quest for health, the key body part that is most often neglected is the mouth. We’re in the midst of a wellness revolution—a radical understanding of the mouth as being the missing link to health. Keeping it in proper working order is crucial to being healthy.
Discussions about the link between oral health and general overall health have been written about in medical and dental literature for years. In 2000, the Surgeon General of the United States stated that the relationship between the two is indeed a powerful connection, not to be ignored.
In a recent study from Harvard University, research conducted on more than 51,000 male doctors found that men with a history of gum disease were at 64 percent higher risk of getting pancreatic cancer, compared to those with healthy mouths. Pancreatic cancer is a deadly disease; this powerful evidence from this study should be another wake-up call.
Studies have linked gum disease with heart disease, stroke, diabetes, respiratory disease and pregnancy problems. Most people believe gum disease is confined to the mouth and has no effect on any other part of the body. A little bad breath, some bleeding gums…no big deal. What people don’t realize is that severe gum disease does not solely affect the mouth, but the whole body.
Heart disease is the number one cause of death in the U.S. How could gum disease possibly have anything to do with heart disease? This was a question Bob asked me after his wife Susan died of a heart attack at the age of 52. Bob is a local police officer and a very likable person. He and Susan had two children, 19 and 21 years old. They had a lot to live for and looked forward to enjoying the rest of their lives together. By all indications, Susan was very healthy. She had just made an appointment to see me for a routine check up. I discovered she had moderate to severe periodontitis. This means her gum disease had advanced to a point where bone was destroyed, and abscess was forming around some of her gums surrounding the teeth. Unfortunately, because there was no pain involved, and it had affected mostly her back teeth, which were slightly loose, she didn’t even know she had gum disease. She attributed the slight looseness to menopause. She hadn’t seen a dentist for years because in her mind, there was no need. There was only one filling in her mouth, and when she last saw a dentist more than four years ago, he gave her a clean bill of health.
I explained to Susan the basic premise of gum disease, and she scheduled an appointment to start treatment. We received a phone call from Bob the following week. Susan had died from a heart attack while at the gym. To say the least, Bob was devastated. Could this have been prevented?
I encourage you to educate yourself about what I’m about to tell you. Study further and research sources, until you are totally convinced of this link between oral health and overall health. You will know more than even the highly health conscious individuals; they too have been ignoring this connection.
The body’s first response to injury is inflammation. This is how the body protects itself from such things as bacteria, virus, damaged cells, or irritants. A cascade of biological events take place as the immune system sends signals to release chemicals and white blood cells into the blood or affected tissues to protect your body from these foreign substances attacking the tissues. The release of these chemicals increases the blood flow to the tissues. Some of the chemicals may leak fluid into the tissues, resulting in swelling. With the gums, inflammation is characterized by:
• Redness
• Swelling
• Sometimes fever/chills
• Fatigue/loss of energy
• Headaches
• Some bleeding of the gums on brushing or flossing
When the cause of inflammation is not treated, whether it’s from bacteria, or other irritants, it becomes “chronic”. It gradually upsets the delicate balance of healthy tissues. When the initial stage of gum disease, called “gingivitis” is not treated, it becomes chronic and advances to the more severe form of “periodontitis.” The good news is inflammation is reversible. With chronic inflammation, as destruction of the tissues continues, there is ongoing damage and the bridge to health is no longer there.
Recent studies recognize that inflammation plays a central role in heart disease and stroke, and that controlling inflammation is critical to your health, no matter where that inflammation is located. C-reactive protein (CRP) is one of the proteins that increase during the existence of chronic inflammation. Testing for the presence and level of CRP, known as an inflammatory marker, may be the new way to assess cardiovascular disease risk and is now widely available. Other reports suggest that even low-grade inflammation, as in gingivitis (the beginning stage of gum disease), might contribute to or even cause atherosclerosis (fatty build-up and blockage in the arteries).
The conditions and diseases associated with an elevated CRP include:
- Heart disease/Atherosclerosis strokes
- Obesity
- Dental disease
- Blood sugar disorders
- Alzheimer’s
- Arthritis
- Cancer
- Smoking tobacco
- Aging
Studies have shown a positive association between coronary artery disease, called atherosclerosis, and elevated CRP.
Periodontal infection and inflammation may indeed cause high CRP levels. According to the American Academy of Periodontology, past studies examining the relationship between periodontal disease and CRP found that often, after standard non-surgical periodontal treatment, CRP levels decrease. The Journal of Periodontology reported that inflammatory effects from periodontal disease cause oral bacterial by-products to enter the bloodstream and trigger the liver to make proteins such as CRP that inflame arteries and promote blood clot formation.
In case you’re still not convinced, a major study by the U.S. Department of Veterans Affairs found that men with severe periodontal bone loss had 150 percent greater risk of heart disease. In addition, the third National Health and Nutrition Examination Survey found those with severe periodontal disease were nine times more likely to have a heart attack. An even larger study, the Arteriosclerosis Risk in Communities study, reports that patients with gum disease have a 1.5 fold increased rate of heart disease.
There is indeed good news, however. Inflammation from the gums can be easily seen even by you, just by looking for the signs listed above. The development of inflammation starts with the lack of proper daily routine of brushing and flossing, not getting regular dental check ups, among other factors, such as poor diet and stress. Plaque, that sticky film of bacteria and food debris that coats your teeth when you wake up in the morning, builds up on the teeth within six hours after brushing. If not removed every 24 hours, it starts to harden and cause damage. The process causes inflammation, which then activates further destruction, in terms of the fibers and bone that hold your teeth and gums in place. The result is not a pretty picture. Gums separate from their snug attachment to the teeth, allowing more bacteria to hide and destroy tissue. Loose teeth and bad breath are the more visible signs.
The solution is simple: learn how to use proper tools to remove the plaque and maintain healthy gum tissue. How do you do that? Below are simple instructions for the road to a healthy, beautiful smile.
Plaque is the culprit. Bacteria in plaque excrete acids that leech out calcium from tooth enamel (called demineralization). This compound of calcium and acid combines with oxygen to form calcium phosphate. This deposit of calcium phosphate (tartar) is insoluble. Once it bonds to the tooth, regular brushing with toothpaste cannot remove it. The tartar becomes a source or irritation to the gums.
Does it matter which toothpaste or mouthwash you use?
Yes!
Toothpaste: Keep it simple. You don’t need botanicals or synthetic ingredients, which may have medicinal properties, such as antifungal or antibiotic actions. Supplements have no place in toothpaste either, since the effective percentage cannot be accommodated in the formula. Supplements are very important for oral health, but should be taken orally and not in toothpaste or mouthwash.
- Use toothpaste with calcium pyrophosphate. Calcium pyrophosphate is soluble and will help dissolve any destructive calcium phosphate that has not yet bonded to the tooth enamel and turned to tartar, therefore preventing its build up.
- Use toothpaste with baking soda that safely will help neutralize acids. The more acidic the oral environment, the more likely that harmful bacteria will thrive and multiply.
- Use toothpaste with xylitol. Studies have shown xylitol to be effective for cavity prevention.
- DO NOT use toothpaste with sodium lauryl sulfate. This is a harsh detergent and can cause drying of the tissues and allergies. Sodium lauryl sarcosinate is a mild cleanser. Look for this ingredient.
- DO NOT use toothpaste with artificial sweeteners, colors, propylene glycol, sodium benzoate, aluminum or chloride. Chloride dioxide and similar ingredients are all derived from bleach and are harsh and toxic.
Mouthwash: Keep it simple. You don’t need alcohol, natural botanicals or synthetic ingredients that claim to cure gum disease or bad breath. Baking soda and xylitol along with proper brushing and flossing methods are the best-proven methods to prevent gum disease. It’s ok to use a therapeutic mouth rinse recommended by your dentist during gum treatment. These are not meant to be used on going, but only during therapy.
Whether natural, or synthetic, therapeutic mouth rinses or mouthwashes (same thing), or toothpaste should only be used during therapy. If toothpaste or mouthwash with medicinal properties is used daily, it may have an effect on your immune system or build a resistance to certain bacteria.
Your daily seven steps to a healthy mouth: In the morning and bedtime:
- Rinse with mouthwash
- Floss thoroughly, making sure you clean under the gums. If you don’t know how to do this properly, ask your dentist or hygienist to teach you. Proper flossing makes a big difference and it can be tricky until you get the hang of it.
- Brush your teeth and gums thoroughly, but gently. Daily build up of plaque is soft and easy to remove, as long as you clean every side of every tooth. This should take at least three minutes.
- Clean your tongue with a tongue cleaner. Many bacteria hide in the cracks and crevices of the tongue. This is a major contributor to bad breath.
- Rinse with water.
- Rinse with the mouthwash.
- Keep it simple, keep it simple, and keep it simple, with the products you use and your routine. Drink lots of water, eat balanced, healthy foods, exercise and follow the instructions above along with regular check ups with your dentist, and inflammation from the mouth will be one thing you won’t have to deal with.
Flora Stay, D.D.S. For over twenty years Dr. Stay has helped thousands of individuals realize the importance of oral medicine to general health. As an author, university professor, with her own successful practice, her passion has been to educate the consumer.
Recognized as an experienced communicator in television, radio and print. She has had a weekly column in a Southern California newspaper for many years and has hosted her own radio show.
Dr. Stay is the president of Grace Products Inc., and has developed a line of oral health care products (http://www.cleure.com) that have been university tested and proven to be superior in quality and effectiveness. This has allowed her to not only educate the consumer on oral health, but provide the optimum tools needed to help prevent oral disease.
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