Summary
There is increasing concern about the connection between Oral Health and systemic diseases. That the mouth in general, and the tongue in particular, is a mirror to diseases elsewhere has been known since the times of Susrutha and Charaka. People who maintain poor oral hygiene could be at higher risk of cardiovascular, and other diseases.
What are Oral Health issues?
The mouth has important body-parts like teeth, gums and tongue, which are all critical for initiating the process digestion of food. The mouth is also vulnerable to various diseases. The list is long- cavities (basically tooth decay), periodontal Disease (PD), gingivitis, oral cancer, gum disease, enamel erosion, bad breath, root infection, sensitive teeth, receding gums and cracked or broken teeth.
Risk factors for poor oral health include poor oral hygiene, tobacco use and abuse, age, diabetes mellitus and serious health issues which make people indifferent to oral health.
What is the connection between the two?
In recent times, doctors around the world have reported increasing instances of people suffering from oral health issues as well as CVD. This has triggered various studies conducted by leading medical institutions of the world such as National Institutes of Health, a US Govt body.
There are intuitive risks to at least the cardiovascular and respiratory systems from poor oral hygiene and dental disease:
- There are risk factors that are common to both conditions – such as diabetes mellitus, cigarette smoking (or tobacco use in other forms), and advancing age. So older diabetics who smoke tobacco could have both CVD and oral health issues.
- Oral health issues are more common in developing countries where access to high-quality healthcare is poor. So, people who ignore oral health may also ignore other heath promoting habits.
- Atherosclerosis is the number one risk factor for CVD. Plaque deposits in the blood vessels of the heart narrow the arteries, thereby reducing blood-flow inside the heart, and to various parts of the body. Atherosclerosis has a very strong inflammatory component Chronic inflammation elsewhere can provoke inflammation in the cardiovascular system.
How do bad gums and teeth lead to infection and inflammation elsewhere ?
- The bacteria that cause infections of the gums and conditions like gingivitis and periodontitis can travel through the blood, to any part of the body. This particularly happens after dental procedures like drilling and extraction. When they reach the heart, they attach themselves to any damaged part of the heart and cause inflammation. This results in endocarditis, where the inner lining of the heart gets infected by these bacteria. Endocarditis is a very dangerous infection that leads to formation of infected clumps of cells called vegetations that adhere to the heart valves and severely damage them. They can break up, travel through blood, reach any organ including the brain and set up life / limb threatening infections
- Inflammation is a huge risk factor for atherosclerosis. In turn, atherosclerosis increases the risk of CVD, tiny blood clots, myocardial infarction (heart attack) and stroke.
- Oral bacteria can easily travel through body fluids to the airways and the lungs. The latter can evolve into aspiration pneumonia and lung abscess
- Some of the bacteria that causes PD and gingivitis are known to increase the risk of various conditions such as rheumatoid arthritis and pancreatic cancer. It is also known to induce platelet coagulation (blood clots), penetrate the carotid and coronary endothelial cells, increase the possibility of what is called macrophage infiltration and , endothelial dysfunction. All these help in the progression of atherosclerosis which in turn raises the risk of CVD.
Outlook
So, what should one do about this possible connection between oral health and CVD?
One should give high importance to oral health. Not just CVD, you will be happy to know that good oral health issues decrease the risk of several conditions, ailments and illnesses in the body.
- It is important that people of all age groups get regular dental checkups – once a year for people below 50 years of age, and twice a year for those over 50 years. Cavities must be filled-up immediately and scaling or removal of plaque deposits must be done once a year.
- Smokers should quit, or at-least reduce smoking as much as possible. Tobacco consumption in all other forms (hookah, beedi, pipe, cheroot, cigar and tobacco-chewing) must be completely avoided.
- Consumption of sweets, confectionaries, sweetened beverages and drinks must be avoided as much as possible. These are rich in added sugar which increases the risk of tooth decay and gum issues.
- Alcohol consumption must be limited as regular consumption can weaken the immune system which leads to higher rate of bacterial infection (in the mouth or elsewhere).
- Consuming food, beverages and water in unhygienic places must be completely avoided as this increases the risk of infection by bacteria, viruses and parasites.
- Every one, irrespective of their age and general health must get an annual health checkup which includes heart-health checkup.
- It is important to be in touch with your family doctor and have any small or major health concern discussed. One should be alert and notice any changes in the body as these can signal that something is wrong.
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.
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