There's much more to oral and dental health than you might be aware of which goes way beyond reducing the risks of tooth decay. Your oral health is a window into the status of your overall health and poor dental health is linked with poor health in general.
In this article, we discuss this link and suggest some steps you might like to consider in order to keep your mouth and teeth in good health.
Dental health and overall health
People with poor oral health are much more likely to succumb to other illnesses for example:
- People with periodontal disease, a form of gum disease, are much more likely to have diabetes, cardiovascular disease, metabolic syndrome, and Alzheimer’s disease.
- People with periodontal disease have an increased risk of giving birth to babies of low birth weight, suffer respiratory diseases, be obese, have rheumatoid arthritis; renal disease, cancer and inflammatory bowel disease.
- People who have fewer teeth are more likely to get dementia, certain types of cancer, and die of heart disease.
- People who are vulnerable are affected more – for example, of those with mental health problems, trauma and housing instability, 46.3% report poor or fair oral health.
- Periodontitis is the most common inflammatory disease, affecting nearly half of adults in the United Kingdom and 60% of those over 65 years.
Understanding the link
It’s not clear whether dental infection has a part to play in causing these conditions since correlation does not equal causation. It may be that the association is through some other factor which may influence both oral health such as smoking, poor diet and stress; things that affect the poor and disadvantaged disproportionately.
In a 2019 study of dentists’ understanding of the link between dental health and overall health, 97% believed that more patients would seek oral care if they were made aware of the links.
Recently, DNA from oral bacteria (mainly Porphyromonas gingivalis and its toxins) have been found in the tissues of people with chronic diseases such as Alzheimers’ disease and atherosclerosis. In another paper, 100% of patients with cardiovascular disease had Porphyromonas gingivalis colonising their arteries.
One possible theory is that infection may spread from the mouth to other areas of the body including the brain, leading to activation of the innate immune system and chronic inflammation. Overall, it is an extremely complex system and no one mechanism is likely to provide the complete explanation.
How to notice periodontal disease
Periodontal disease is not only very common, it can often go unnoticed. It affects the gums and bones supporting the teeth (periodontal tissue) which become red, swollen and bleed. Periodontal disease is caused by a bacterium Porphyromonas gingivalis. Infection below the gums is protected by a biofilm (plaque) where it can sit shielded and slowly and silently cause damage over years.
In the early stages, the disease is called gingivitis. As it progresses, chronic inflammation causes the gums to pull away from the teeth, leading to loosening, loss of bone and teeth. Often, it’s accompanied by bad breath (also known as halitosis). These infectious bacteria also occur in low levels in healthy people (25% of the population) without obvious disease. It progresses to disease only in certain conditions and genetic susceptibility and lifestyle factors play an important part.
Contributing factors to poor oral health
Factors that influence poor oral health include chronic stress, poor diet including lack of nutrients, smoking, other environmental agents and poor dental hygiene. Genetic susceptibility also plays a part in your risk of dental issues.
For most people, good dental health can be maintained and gum disease can be prevented with good oral hygiene and simple lifestyle changes that focus on eliminating the contributing factor.
Simple ways to brush up on your dental health
- If you smoke – quit
Clinical studies tend to suggest that smokers have a higher risk of periodontal disease than non-smokers. A 2007 study found that edentulism, or tooth loss, was 8% higher among smokers than those who’d never smoked.
- Avoid sugar in food and drinks which can feed bad bacteria
Certain diets might predispose people to higher rates of infection. For example, sugar in the diet allows bullish bacterial strains to thrive at the expense of their more helpful bacterial neighbours.
Chronic stress is depleting and leads to persistently raised stress hormones levels e.g. cortisol and adrenaline. Several studies indicate that chronic stress adversely affects various health behaviours. In a 2010 study into how exam stress affects oral health, students had higher rates of plaque and gingivitis when compared with controls.
- Eat a nutrient rich diet
A Japanese trial concluded that tooth loss was linked to poorer nutrition. Intake of key nutrients like vitamins A, C, dairy products and green-yellow vegetables was lower among those with fewer teeth. These people were also found to consume more confectionary products.
- Good dental hygiene
Following a rigid dental hygiene routine is key to preventing and removing build-up of plaque. Brush twice or more daily with toothpaste.
- Reduce alcohol intake
Alcohol, especially mixed with fizzy drinks, can lead to increased levels of acid in the mouth, which may cause tooth erosion.
- Visit the dentist for regular for check-ups
Going to your dentist or oral health professional once or twice per year for regular check-ups is an important part of keeping your teeth and gums in good health and to notice and deal with problems early. The examination includes; checking the current state of your oral health, cleaning if necessary and advice on cleaning techniques.
To floss or not to floss?
Although traditionally recommended by dentists, the importance of flossing for dental health is still up for debate. However, there is some evidence to show that regular flossing may reduce your risk of periodontitis.
On the other side of the coin, bleeding due to overly rigorous cleaning techniques can provide a route for infection to enter into the blood stream. A sensible approach might be to avoid overly rigorous brushing and if you notice persistent bleeding, get some expert help from your dentist.
According to a recent study, it was noted that using floss, in addition to toothbrushing, may reduce gingivitis in the short and medium term. It’s unclear if it reduces plaque. Using an interdental brush, in addition to a toothbrush, may reduce gingivitis and plaque in the short term. The evidence is low to very low‐certainty. The effects observed may not be clinically important.
Keep smiling: take control of your dental health
There are compelling reasons to pay attention to dental hygiene, not only to enjoy better dental health but to reduce the reduce the many risks associated with periodontal disease and dental infection. This could lower your odds of developing an array of distressing, often painful, dental conditions and possibly some rather more serious chronic illnesses. Being more aware of the risks means that you’re better placed to take action.
Practising good oral hygiene is key – by removing the offending dental plaque that harbours the potentially harmful bacteria, as well as getting expert help when necessary.
A nutrient-rich diet is also key – by providing the body with all its necessary ingredients. This should include minimising dietary sugar and reducing alcohol consumption as well as smoking cessation, twice-daily brushing and regular check-ups with the dentist.
If you decide to make a change you can use your Evergreen Life app and retake the dental health check to monitor your progress. We’re with you every step of your wellness journey, providing personalised questionnaires and self-help strategies so you can achieve the health you want.