While the saying “Don’t look a gift horse in the mouth” is a piece of thankfulness advice, it also makes a point about how teeth have long been used as a gauge of age and health.
Cavities, root canals, and crowns are the most common consequences of poor oral health for most people. However, scientists have discovered that its effects go well beyond the mouth, contributing to a variety of systemic disorders and conditions.
Poor oral health was labeled a “hidden epidemic” by US Surgeon General David Satcher twenty years ago, owing to its pervasiveness and wide-ranging consequences.
Since then, over 700 research have looked into the complex ecosystem of bacteria that dwells in the mouth and how it causes gum disease if left unchecked.
Chronic inflammation caused by periodontitis, a severe form of periodontal disease, has also been related to diabetes.
Heart disease, diabetes, and possible links to Alzheimer’s disease and cancer are among the major, life-threatening illnesses.
The molecular processes and immunological feedback loops that support these relationships are now being revealed by scientists.
a better distinction between oral and overall health The ramifications are numerous.
According to the CDC, nearly half of persons over 30 have periodontal disease.
To grasp the serious dangers that come with this illness, it’s essential to start with a simple example: the mouth microbiota.
IN YOUR MOUTH, THE JUNGLE
Because we eat, drink, talk, and breathe via our mouths, it is home to a diverse colony of bacteria, the second-largest in the body after the gut.
“This community is like a miniature city,” says Jeanie Suvan, associate editor of the International Journal of Dental Hygiene, referring to the 700-plus species that coexist.
Together, these bacteria form plaque, which is a strong, sticky biofilm that adheres to teeth and soft tissues and colonizes an area the size of your hand.
Purnima Kumar, a periodontist and microbial ecologist at Ohio State University, says, “These bacteria are familiar to our immune system.”
“Some of us get them as babies before we ever have teeth.” The majority are benign or even beneficial, while a dozen or so are pathogenic.
Under normal circumstances, the presence of healthy bacteria keeps the bad bacteria in control.
The oral microbiota, like any ecosystem, requires balance.
When that balance is disrupted, problems develop. Changes in the oral ecology, according to Suvan, might lead to biofilm formation.
Imperfect care (even in a few hard-to-reach locations), missed dental cleaning appointments, smoking, or even changes in hormone levels or medications could all contribute to this.
Biofilms can form beneath the gum line as they accumulate. In that anaerobic atmosphere,
Porphymonas gingivalis, the bacteria that cause periodontal disease (gum disease), and other deadly bacteria multiply like an invasive species.
Toxins are secreted by them, which tear down tissue. Inflamed gums may bleed soon after the usual tooth cleaning.
Jan Potempa, a scientist at the University of Louisville School of Dentistry, explains that this prompts immune systems to attack, and inflammation is where the issues begin.
He compares it to a war, with waves of immune cells combating bacterial invaders, such as neutrophils, macrophages, and lymphocytes.
However, because viruses are tough to eradicate, immune cells release signaling molecules known as cytokines, which recruit more soldiers to the fight.
Meanwhile, substances released by the body as part of the immune response inflict collateral damage, similar to what happens when a city is bombed.
These chemicals cause deep pockets in the gums, allowing bacteria to colonize new territory.
It becomes a “freewheeling, self-perpetuating cycle,” as Kumar describes it. In the absence of treatment,
This long-term infection develops into full-blown periodontitis, which affects the gum tissue and the ligaments that hold the teeth in place. The bone is also obliterated.
Teeth become loose, move, or fall out with time. Periodontitis is now the leading cause of tooth loss in adults, and it is one of the world’s most common chronic inflammatory disorders.
More than 700 million people are affected. It could potentially be a sign of something far more serious.
FROM THE MOUTH TO THE BODILY BODILY BODILY BODILY BOD
Scientists have discovered that pathogenic germs can travel into the circulation if periodontitis has taken hold.
DNA from oral pathogens and live mouth bacteria has been found in the heart, brain, joints, liver, and lungs, fetal tissue, and even malignant tumors in animal investigations.
New systemic struggles are sparked by the invasion. According to Thomas Van Dyke, a professor of oral medicine at Harvard University and vice president of clinical and translational research at the Forsyth Institute, the body doesn’t want them there, so it sends an influx of lymphocytes and macrophages. Chronic inflammation can result as a result of this.
“Where the production of cytokines pulls them almost like a beacon of light,” Kumar explains, oral pathogens are driven to sites of persistent inflammation.
One of such beacons is the heart, notably arteries clogged by a plaque: cholesterol and fat.
According to Kumar, the introduction of additional infections “starts another chain of events…a hyper-amped response and increased plaque buildup.”
This may increase your chance of heart failure, but it’s also possible that it won’t. A ten-year study indicated that thorough dental hygiene did reduce that risk.
Oral health, or the lack thereof, has been related to other disorders linked to inflammation.
A unique two-way association between type 2 diabetes and gum disease has been discovered after 40 years of research.
Diabetics have a far higher risk of periodontitis than the general population.
Because the proinflammatory cytokines that combat gum infection can create insulin resistance, the onset is frequently early and severe, and blood sugar levels become difficult to control.
Gum disease appears to increase the chance of premature birth among pregnant women, according to studies.
Endocarditis, a potentially fatal heart valve infection caused by oral bacteria, is also a known cause of rheumatoid arthritis aggravation.
A link to Alzheimer’s disease has lately been investigated by scientists. In the brain, P. gingivalis and other oral infections have been discovered.
While autopsies of Alzheimer’s patients revealed them trapped in the disease’s characteristic amyloid plaques.
If oral infections have any effect on brain health, the mechanism by which they do so is unknown.
However, in recent animal research, P. gingivalis was found to affect neuron function, learning, and memory. There is still much work to be done.
PREVENTING THE BATTLE FROM BEGINNING
Gum disease can go unnoticed for years while advancing slowly but steadily.
It may not be unpleasant, unlike other infections, with only minor chewing discomfort.
The only true indication may be a small amount of blood in the sink after brushing, which is frequently overlooked. “Would you consider it normal if you were bleeding from somewhere else?” Suvan wonders.
While it’s possible to injure your gums by brushing or flossing too forcefully or biting into a hard pizza crust, bleeding, swollen, red gums aren’t typical.
It is, however, a pretty common occurrence. This affects between 60 and 80 percent of adults in the United States at some point.
Potempa advises that if you’re bleeding, you should see your dentist right once to avoid more injury.
Gingivitis is straightforward to cure with deep cleaning if caught early, and it can be avoided with excellent home care.
Periodontitis, on the other hand, is a far more dangerous condition. A below-the-gumline root planing operation can remove buried plaque and lessen the depth of ulcerated pockets, allowing them to be cleaned at home.
A periodontist may also be able to help loose teeth regain their attachment.
Brushing, flossing, rinsing, and visiting a dental expert for cleanings are just a few of the practices that Suvan recommends for preventing this infection cascade.
Despite tight surgical practices that make visits safe, many patients have missed dental appointments due to the current Covid-19 outbreak.
This emphasizes the importance of watchful home care even more.
A healthy mouth is crucial for a variety of reasons, including the ability to speak, eat what we want, and smile.
However, we now understand that it is even more vital. Kumar claims that “having a healthy mouth is crucial to having a healthy body.”