THE ORAL-SYSTEMIC LINK 1/3

The connection between oral health and systemic health is well-established and ever-evolving. One thing we know for certain; we are living longer, but with more chronic diseases and medication than ever before.

The latest statistics are alarming. Forty-seven percent of US adults who are age 30 or older – an estimated 64.7 million Americans – have either mild gum disease (8.7%), moderate gum disease (30%) or severe gum disease (8.5%). As the population ages, the prevalence rises with 70% of individuals over the age of 65 exhibiting some level of gum disease. And, since we are on statistics, by 2030, it is estimated that the number of people over 70 years of age will have doubled from 35 million to 71 million.

So, as we age, our risk of developing disease increases. Interestingly, there is also a direct correlation between the regions of the US with the greatest concentration of gum disease, and those that have a high incidence of cardiovascular disease and diabetes. Although a direct cause-and-effect link is still in the process of being established between gum disease (periodontitis) and other systemic diseases, inflammation is often a common denominator. And it is always important to remember that the mouth is the gateway to the rest of the body.

We used to think that if people didn’t brush their teeth well, or didn’t visit a dentist often, they would automatically get gum disease. However, there are patients who have poor home care who never develop gum disease, and there are also patients who have great home care, visit a dentist regularly, and continue to experience breakdown from gum disease – albeit at a slower rate than they would if they had poor habits.

We now know that managing gum disease and other chronic inflammatory diseases like cardiovascular disease, diabetes, respiratory disease and arthritis are more patient specific based on an individual’s “inflammatory mediators”. These are molecules released by immune cells and are largely responsible for individual responses to disease susceptibility and progression. This is why probiotics are likely to play a significant role in treatment of chronic inflammation in the future.

As we wait for research development for different ways to combat chronic inflammation, it is without dispute that people should do all they can to minimize inflammation in the mouth. The mouth is very accessible and with proper training, coaching and monitoring, a healthy mouth is better for your whole body.

Although some may say that the associations between gum and systemic diseases are statistical by nature, not causal, the data is fairly strong that there is a link between gum disease and cardiovascular disease – such as heart infarction and stroke.  This supports diagnosing and treating oral infections, including lifelong professional maintenance and good home care.

Remember – just because it doesn’t hurt doesn’t mean there isn’t a problem. More next week.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com