AmeriPlan Health Awareness: Oral Health: The Mouth-Body Connection

WebMD Feature
By Joanne Barker
Reviewed by Steve Drescher, DDS

Oral Care That You Should be Aware Of

Years ago, a physician who suspected heart disease would probably not refer the patient to a gum specialist. The same went for diabetes, pregnancy, or just about any other medical condition. Times have changed. The past 5 to 10 years have seen ballooning interest in possible links between mouth health and body health.

“Physicians are taking a more holistic approach to their patients’ overall health,” says Sally Cram, DDS, PC, consumer advisor for the American Dental Association. And for good reason. In one recent study, people with serious gum disease were 40% more likely to have a chronic condition on top of it.

In this article, WebMD answers two questions about the mouth-body connection. Why can the health of your mouth affect your whole body? And why are simple habits like daily brushing and flossing more important than you might think?

Your Mouth, the Gateway to Your Body
To understand how the mouth can affect the body, it helps to understand what can go wrong in the first place. Bacteria that builds up on teeth make gums prone to infection. The immune system moves in to attack the infection and the gums become inflamed. The inflammation continues unless the infection is brought under control.

Over time, inflammation and the chemicals it releases eat away at the gums and bone structure that hold teeth in place. The result is severe gum disease, known as periodontitis. Inflammation can also cause problems in the rest of the body.

Oral Health and Diabetes
The working relationship between diabetes and periodontitis may be the strongest of all the connections between the mouth and body. Inflammation that starts in the mouth seems to weaken the body’s ability to control blood sugar. People with diabetes have trouble processing sugar because of a lack of insulin, the hormone that converts sugar into energy.

“Periodontal disease further complicates diabetes because the inflammation impairs the body’s ability to utilize insulin,” says Pamela McClain, DDS, president of the American Academy of Periodontology. To further complicate matters, diabetes and periodontitis have a two-way relationship. High blood sugar provides ideal conditions for infection to grow, including gum infections. Fortunately you can use the gum disease-diabetes relationship to your favor: managing one can help bring the other under control.

Oral Health and Heart Disease
Though the reasons are not fully understood, it’s clear that gum disease and heart disease often go hand in hand. Up to 91% of patients with heart disease have periodontitis, compared to 66% of people with no heart disease. The two conditions have several risk factors in common, such as smoking, unhealthy diet, and excess weight. And some suspect that periodontitis has a direct role in raising the risk for heart disease as well.

“The theory is that inflammation in the mouth causes inflammation in the blood vessels,” says Cram. This can increase the risk for heart attack in a number of ways. Inflamed blood vessels allow less blood to travel between the heart and the rest of the body, raising blood pressure. “There’s also a greater risk that fatty plaque will break off the wall of a blood vessel and travel to the heart or the brain, causing a heart attack or stroke,” Cram explains.

Oral Health and Pregnancy
Babies born too early or at a low birth weight often have significant health problems, including lung conditions, heart conditions, and learning disorders. While many factors can contribute to premature or low birth weight deliveries, researchers are looking at the possible role of gum disease. Infection and inflammation in general seem to interfere with a fetus’ development in the womb.

Though men have periodontitis more often than women do, hormonal changes during pregnancy can increase a woman’s risk. For the best chance of a healthy pregnancy, McClain recommends a comprehensive periodontal exam “if you’re pregnant or before you become pregnant to identify whether or not you’re at risk.”

Oral Health and Osteoporosis
Osteoporosis and periodontitis have an important thing in common, bone loss. The link between the two, however, is controversial. Cram points out that osteoporosis affects the long bones in the arms and legs, whereas gum disease attacks the jawbone. Others point to the fact that osteoporosis mainly affects women, whereas periodontitis is more common among men.

Though a link has not been well established, some studies have found that women with osteoporosis have gum disease more often than those who do not. Researchers are testing the theory that inflammation triggered by periodontitis could weaken bone in other parts of the body.

Oral Health and Smoking
Not smoking is one of the most important things you can do for your mouth and your body. According to the CDC, a smoker’s risk of severe gum disease is three times higher than someone who does not smoke.

“Nicotine in cigarettes causes blood vessels to constrict,” McClain tells WebMD. This interferes with your gums’ ability to fight infection. Not only that, smoking interferes with treatment — gum surgeries tend to be more complicated and recovery more difficult.

Oral Health and Other Conditions
The impact of oral health on the body is a relatively new area of study. Some other mouth-body connections under current investigation include:

Rheumatoid Arthritis. Treating periodontal disease has been shown to reduce pain caused by rheumatoid arthritis.
Lung Conditions. Periodontal disease may make pneumonia and chronic obstructive pulmonary disease worse, possibly by increasing the amount of bacteria in the lungs.
Obesity. Two studies have linked obesity to gum disease. It appears that periodontitis progresses more quickly in the presence of higher body fat.

The Bottom Line on Oral Health
One thing is clear: the body and mouth are not separate. “Your body can affect your mouth and likewise, your mouth can affect your body,” says McClain. “Taking good care of your teeth and gums can really help you live well longer.” This means brushing twice a day, flossing once a day, and going for regular dental cleanings and check-ups.

Cram stresses the importance of letting your dentist know your full family medical history. And, she adds, “if you have periodontal disease, make sure you see your dentist frequently and get it treated promptly, before it progresses to the point where you begin losing teeth or it starts to affect your overall health.”