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By: Dr. Wanda Nazario
Dental Services Administrator at MCS

When asking patients about their health and what they do to stay healthy, they don’t always include their oral health status. And while this may be the result of the patient’s notion that oral care is not part of an individual’s overall health, the American Dental Association (ADA) has established a close relationship between poor oral hygiene and certain conditions, including cardiovascular disease, diabetes, strokes, and even pregnancy complications. Therefore, it’s vital for the population to understand that taking care of one’s oral health to prevent periodontal disease is essential to enjoying good health.

The Importance of Oral Hygiene

Good oral hygiene ranges from brushing your teeth at least twice a day to flossing and eating well, while modifying behaviors such as smoking or chewing tobacco, which increase the risk of developing periodontal and other systemic diseases. Oral care also includes visiting the dentist regularly, or as recommended according to your treatment plan, and talking to your doctor about any changes or discomfort in your mouth or gums. This in turn will help doctors provide patients with timely treatments to maintain their oral and overall health.

The Connection Between Oral Hygiene and General Health

According to literature from the American Dental Association (ADA) and other organizations, there’s a close relationship between oral disease and general health. It is also a topic that’s continuously studied, as the specific causes are not fully understood – so much so that it’s recommended that when patients visit their dentist and are diagnosed with periodontal disease, they should also check with their doctor to see if they’ve had adequate screening for any cardiovascular risks. This is also the case with patients with uncontrolled glycemic levels, where doctors must ensure the patient is examined by a dentist to prevent other health-related complications, including the deterioration of oral health and the development of periodontal disease.

The American Dental Association, Spanish Neurological Society (Spanish acronym SEN), the Spanish Periodontology Society (Spanish acronym SEPA), and the American Diabetes Association have published studies and research on the risks of periodontal disease to other health conditions, along with recommendations for managing them at the dental clinic or doctor’s office:

• Strokes Because patients with periodontitis are 2.8 times more likely to have a stroke3, doctors are urged to talk to patients about integrating oral hygiene as part of a healthy lifestyle to improve health outcomes.2
• Alzheimer’s disease. Patients with periodontal disease are 1.7 times more likely to suffer from this type of dementia, and the risk may triple in those with more severe periodontal conditions. Studies also show that people with periodontitis perform poorly in neuropsychological cognitive function tests as well.
• Pregnancy. Given their hormonal changes, pregnant women may suffer from gingivitis (early-stage gum disease) which, according to the ADA, can eventually develop into periodontitis. Some symptoms during pregnancy, such as nausea and vomiting, can cause the loss of tooth enamel (tooth erosion), and could lead to the extraction of one or more teeth. Most dental treatments are safe for pregnant patients, so visiting the dentist and having a treatment plan, if necessary, should not put the pregnancy at risk.
• Heart attacks. A recent study by the University of Michigan revealed that patients who had suffered a heart attack and did not receive dental treatment had a greater number of hospitalization days compared with those who had received oral health treatments. Those who received treatment had fewer days of hospitalization and more follow-up visits.3 The study also suggests that patients at risk of a heart attack would benefit from having a stable periodontal condition.
• Diabetes. The relationship between oral health and diabetes is bidirectional. The American Diabetes Association has stated that patients with diabetes have an increased risk of developing gingivitis, and if not treated properly, could develop into periodontitis. People with diabetes are more likely to develop dry mouth, which promotes the accumulation of bacteria, increasing the risk of periodontal disease. In turn, diabetic patients with periodontitis are at greater risk of systemic complications due to the difficulty of controlling glycemic levels. However, experts say that proper oral care and regular checkups reduce the risk of complications.

The ADA continues to support and encourage research among dentists and other members of the multidisciplinary team to identify the appropriate treatments and other systemic diseases suspected of being associated with oral health.

Essential Teamwork and Education

The integration of a multidisciplinary team that provides patient services, including dental and medical services, is essential in achieving the best health outcomes for the patient. Likewise, educating people on daily oral hygiene habits at home and regular visits to the dentist are paramount to reducing risk factors and complications for these patients.

This goes hand in hand with technological advances that make dental procedures easier for patients to tolerate, thus making visits to the dentist more positive experiences. In addition, there are also a variety of articles and recommendations for oral care at home, which help make this care more accessible and ongoing.

Therefore, in order to have a healthier society, all members of the care team (including the patient) must work together to promote oral hygiene, with everyone responsible for educating the population on the benefits of optimal oral health, how easy it can be, and how it contributes to enjoying Complete Health.

References:

1. “Medical-Dental Integration Emphasizes Mouth-Body Connection.” American Dental Association, adanews.ada.org/ada-news/2022/october/medical-dental-integration-emphasizes-mouth-body-connection/ Accessed 13 July 2023.
2. Martínez, Carla Nieto. “Are Periodontitis, Stroke, and Alzheimer’s Disease Linked?” Medscape, 15 June 2023, www.medscape.com/viewarticle/993282?icd=login_success_email_match_norm
3. Romesh P. Nalliah DDS, et al. “Association between Periodontal Care and Hospitalization with Acute Myocardial Infarction.” The Journal of the American Dental Association, 20 Apr. 2022, www.sciencedirect.com/science/article/abs/pii/S0002817722000873
4. ADA News, ADA releases new clinical practice guideline on caries restorations. adanews.ada.org/ada-news/2023/june/ada-releases-new-clinical-practice-guideline-on-caries-restorations/
5. Pregnancy and Oral Health - the Journal of the American Dental Association, jada.ada.org/article/S0002-8177(21)00017-9/fulltext Accessed 13 July 2023.
6. “Oral Health.” Diabetes and Oral Health | ADA, diabetes.org/diabetes/keeping-your-mouth-healthy Accessed 13 July 2023.
7. Păunică I, Giurgiu M, Dumitriu AS, Păunică S, Pantea Stoian AM, Martu MA, Serafinceanu C. The Bidirectional Relationship between Periodontal Disease and Diabetes Mellitus-A Review. Diagnostics (Basel). 2023 Feb 11;13(4):681. doi: 10.3390/diagnostics13040681. PMID: 36832168; PMCID: PMC9954907.