Healthy mouth, healthy body: The link between them may surprise you.
The condition of your mouth is closely tied to your overall
health. Find out how oral health is linked to diabetes, heart disease, cancer,
and more.
Taking care of your teeth isn't just about having a nice
smile and pleasant breath. Recent research has found a number of links between oral health
and overall health. While in many cases, the nature of this link
still isn't clear — researchers have yet to conclude whether the connections
are causal or correlative — what is certain is that the condition of your mouth
is closely tied to your overall physical health.
Oral Health and Diabetes
Doctors have known for years that type 2 diabetics have an
increased incidence of periodontitis, or gum disease. In July 2008 the
connection was further highlighted: Researchers at Columbia University's
Mailman School of Public Health followed 9,296 nondiabetic participants,
measuring their level of periodontic bacteria over the course of 20 years.
"We found that people who had higher levels of periodontal disease had a
twofold risk of developing type 2
diabetes over that time period compared to people with low
levels or no gum disease," explains Ryan Demmer, PhD, associate researcher
at the department of epidemiology at the Mailman School and the lead author.
While more research is needed before doctors can conclude that gum disease
actually leads to diabetes, there are already a few theories about why this
might be the case: One proposes that when infections in your mouth get bad
enough, they can lead to low-grade inflammation throughout your body, which in
turn wreaks havoc on your sugar-processing abilities. "There are all kinds
of inflammatory molecules," says Dr. Demmer, "and it's believed that
maybe some attach to insulin receptors and prevent the body's cells from using
the insulin to get glucose into the cell."
Oral Health and Heart Disease
As with diabetes, the connection between poor oral health
and cardiovascular conditions has been recognized — the two are often found
together — but it still hasn't been determined conclusively whether or not
there is a direct causal relationship between them. (One reason is that there
are a number of other potential risk factors — such as smoking and old age —
that can lead both to gum disease and heart disease.) However, in a 2005 study
funded by the NIH, 1,056 randomly selected participants with no prior heart
attacks or strokes were evaluated for levels of periodontal bacteria: After
removing the effects of the other risk factors of age, gender, and smoking, it
was found that there was an independent relationship between gum disease and
heart disease, says Moise Desvarieux, MD, PhD, associate professor of
epidemiology at the Mailman School and lead author of the study. One theory
about why this may occur, says Dr. Desvarieux, is that small amounts of
bacteria enter your bloodstream while you're chewing. "Bad" bacteria
from an infected mouth may lodge itself inside blood vessels, ultimately
causing dangerous blockages. Strengthening his theory is the fact that when
scientists have looked at atherosclerotic blood vessels, they have sometimes
found fragments of periodontal bacteria. Meanwhile, a study published in the New
England Journal of Medicine in 2007 established that aggressive
treatment of gum disease reduces the incidence of atherosclerosis within six
months.
Pregnancy Complications and Gum Disease
For many pregnant women, gum infections stem from the
fluctuating hormone levels that come with pregnancy, says Marsha Rubin, DDS,
practicing diplomat of special-care dentistry at New York-Presbyterian/Weill
Cornell, who sees many pregnant patients in her practice. Others neglect their
oral care during pregnancy, since they have much on their minds, she adds. But
that's a mistake: Scientists believe that gum disease or inflammation in the
mouth possibly triggers an increase in a chemical compound called
prostaglandin, which induces early labour. While this theory has not yet been
confirmed, a 2001 study found that pregnant women who develop gum disease
between weeks 21 and 24 are four to seven times more likely to give birth
before week 37. There is evidence that poor gum health in the extreme can lead
to low birth weight as well. A number of studies — including a 2007 study of
3,567 Turkish women and a 2007 study of 1,305 Brazilian women — found a
relationship between periodontal disease, preterm birth, and low birth weight.
Pneumonia and Gum Disease
There has been a link established between poor oral health and pneumonia,
though much of the research focuses on high-risk populations. A 2008 study of
elderly participants found that the number who developed pneumonia was 3.9
times higher in patients with periodontal infection than in those free from it.
"The lungs are very close to the mouth," says Rubin. "Even in a
healthy mouth there is lots of bacteria, but bacteria in a not-healthy mouth
can get aspirated into the lungs, causing pneumonia or aggravating COPD,
chronic obstructive pulmonary disorder." Several intervention studies
cited by the CDC show that an improvement in oral health can lead to a
reduction in respiratory infection.
Pancreatic Cancer and Gum Disease
A study published in 2007 in the Journal of the
National Cancer Institute surveyed 51,529 American men about their
health every two years between 1986 and 2002. Of the 216 participants who
developed pancreatic cancer, 67 of them also had periodontal disease.
Independent of the participants' smoking status, the study found that having a
history of periodontal disease was associated with an increased risk of
pancreatic cancer. This, according to the study, could be because of systemic
inflammation or increased levels of carcinogenic compounds produced in the
infected mouth. Interestingly, another viable theory about why gum disease may
cause type 2 diabetes points to damage to the pancreas as well. "With the
pancreatic cancer study, we thought it was very interesting that you have this
localized infection that has an impact on a systemic organ that is very
intimately tied to the pathophysiology of diabetes," says Dr. Desvarieux.
Reasons for why this might be are as yet unknown.
