General Health Connections
The mouth is a busy place. Did you know that there are more than 500 species of bacteria that can be present in the mouth? Until very recently, health professionals have not recognized the significance of this and most did not connect your oral health to your general health. Thankfully, a paradigm shift is occuring that acknowledges the fact that the mouth is one of the most important "gateways" to the body, with connections to your whole immune system, your blood system, heart disease, problems with pregnancy, and much more. We hope you will explore those connections on this website and do some of your own research as well.
In this part of our website, we hope to increase your knowledge and understanding of some of the ways your general health and oral health are intimately connected.
Firstly, it is important to understand that your body is a complex machine made of complex systems that all interrelate. No part of your body operates like an island. If you have health conditions that plague one system, there is a good chance that this will have a role in creating an imbalance in other systems. This is the case with your oral health too!
If you have diabetes, gastro-intestinal problems, smoke, take medication for high-blood pressure or suffer from immune system deficiencies, we will commonly see evidence of that in your mouth. The converse is true as well...... if you have poor oral health, it can greatly effect your general health.
Recently, much attention has been paid to the discovery that there is a link between gum disease and heart disease. There is also a demonstrated connection between poorly controlled Type II diabetes and gum disease. We know that there is a link between gum disease and pre-mature births as well. The mechanisms of these connections are not clear, but the list of systemic "links" is growing every year.
In the last half-century, dentists and physicians have thought that gum disease was a focused infection and that, as such, it was NOT a factor in your general health. More recent evidence, however, has indicated that patients with gum disease (periodontitis) have increased levels of blood components that are associated with the whole body's immune response.
Here are some terrific links to related subjects and healthful websites:
http://www.buffalo.edu/news/fast-execute.cgi/article-page.html?article=55910009
http://www.perio.org/consumer/mbc.osteoporosis.htm
http://jada.ada.org/cgi/reprint/133/suppl_1/14S.pdf
http://jada.ada.org/cgi/reprint/137/suppl_2/26S.pdf
http://stroke.ahajournals.org/cgi/content/abstract/34/9/2120
http://well.blogs.nytimes.com/2008/08/07/gum-disease-signals-diabetes-risk/
http://www.sciencedaily.com/releases/2008/08/080806184905.htm
Please refer to the sub-categories on the left side of this page for information of a more specific nature. We hope that whether you are a layperson or another healthcare provider, this part of our web site will help you to help yourself and others live longer, healthier lives.
Detection and prevention of periodontal disease in diabetes
Because the prevalence of both chronic periodontitis and diabetes increases with age, establishing a relationship between them in the older age groups in extremely difficult. Recent studies in which the age relationship of periodontal diseases show that periodontal diseases is more sever and more prevalent than in non-diabetics of comparable age. However, it is generally accepted that adults whose diabetes is well-controlled do not have more gingivitis or destructive periodontitis that non-diabetics.
Thrush
Diabetics have elevated glucose levels in oral fluids when blood glucose is high, and these glucose elevations can influence the microbial flora, the composition of bacterial plaque, and the mixture of organisms at the bottoms of the periodontal pockets. Elevated glucose levels may in particular encourage the growth of candida albicans, the causative agent in thrush, and oral C. albicans counts have been reported to be higher in diabetics than non-diabetics
Physiology
In addition to elevated glucose levels, other pathophysiological changes in diabetics may predispose the diabetic to periodontal disease. These changes include decreases in leukocyte chemotaxis, phagocytosis, and bactericidal activity, as well as decreased cellular immunity.
Other factors contributing to periodontal diseases in diabetics may be vascular changes, including statis in the microcirculation, and altered collagen metabolism.
Dental infections themselves may worsen the diabetic state. As in other infections, dental infections result in hyperglycemic, mobilization of fatty acids, and acidosis. Exacerbation of dental infections may undermine good control that has been achieved in diabetes, and initial control may be difficult or impossible in a newly diagnosed diabetic with active dental infection.
Oral Hygiene
Periodontitis can be arrested by treatment aimed at plaque and calculus removal and improved oral hygiene, all of which are directed towards eradicating pathogenic bacteria that causes periodontal diseases.
Detections and Monitoring
Dry mouth and thirst are classic symptoms of diabetes mellitus, and an increases incidence of thrush is considered a complication of diabetes.
Oral Hygiene
Bleeding gums may be a sign of infection, and diabetics who notice this or other unusual lesions in the mouth should see a dentist
If you are a health professional and want more information, you may be interested to know.....
People with chronic periodontal disease have increased serum levels of CRP, hyper-fibrinogenemia, moderate leukocytosis, as well as increased serum levels of IL-1 and IL-6 when compared with unaffected control populations (Kweider et al., 1993; Ebersole et al., 1997; Loos et al., 2000; Slade et al., 2000, 2003; Hutter et al., 2001). Furthermore, in periodontitis patients, elevated serum CRP is associated with high levels of infection with periodontal pathogens (Noack et al., 2001).
Support for the hypothesis that periodontitis-driven inflammatory responses are of significance for otherwise healthy individuals is at least three-fold: (i) Periodontitis has been associated with increased odds of cardiovascular events (Genco et al., 2002; Joshipura et al., 2003), of delivering pre-term low-birthweight babies (Offenbacher et al., 1996), and of having sub-optimal control of type II diabetes (Grossi and Genco, 1998); (ii) the strength of association between periodontitis or other chronic infections and cardiovascular events seems to be of similar magnitude (Danesh, 1999); and (iii) experimental pre-clinical models have indicated that chronic infection with periodontal pathogens leads to thickening of the carotid intima (Li et al., 2002) and to fetal growth restriction (Collins et al., 1994).
Independently of the underlying mechanism(s), systemic inflammation seems to be central for explaining the nature of the link between chronic infections and atherosclerosis (Ridker et al., 1997; Danesh, 1999; Ross, 1999; Libby et al., 2002; Pearson et al., 2003). Within this context, CRP represents an emerging and reliable marker of the acute phase response to infectious burdens and/or inflammation. As a consequence of its kinetics, it best describes the inflammatory status of the individual (de Maat and Kluft, 2001). CRP hepatic production is usually elicited by an inflammatory stimulus and mediated through a complex network of cytokines (mainly IL-6) (Ablij and Meinders, 2002). CRP has also assumed a significant role as a predictor for future coronary events in healthy populations (Blake and Ridker, 2002).