Our mouths are full of bacteria, various types of plaque, and biofilms. Oral health is an integral part of general health and is essential to the overall health and well being of man. When we have plaque in our mouth, it can play havoc with other parts of our bodies because of bacteria and the infection it can cause. It is the early identification of oral disease that may contribute to early diagnosis and treatment for a number of systemic factors. Which came first, the gum problems or the systemic problems? If bacteria, plaque, and biofilms live inside your mouth, who is to say these don’t invade the bloodstream through the oral cavity?
CURRENT VIEW OF RISK FACTORS AND PERIODONTAL DISEASES
Initially, the bacteria of periodontal disease and the progression of periodontal infections are clearly modified by local and systemic conditions called risk factors. The local factors include pre-existing disease as evidenced by bleeding from gums and plaque retention areas associated with defective restorations. Risk factors, which we know to be important, include diabetes mellitus, tobacco use, rheumatoid arthritis, peptic ulcers, respiratory disease, cardiovascular disease, asthma, allergies, cancer, obesity, certain medications, gender (with males having more disease), age (with more disease seen in the elderly), and hereditary factors. Inflammation causes a host response to deal with the infection. When inflammation continues to be present, it can contribute to a number of systemic diseases/conditions.
DIABETES Diabetes is an important link, because patients with this disease generally have increased susceptibilities to many types of infections. High blood sugar levels help bacteria grow, which can lead to periodontal disease. Many studies have shown a positive relationship between poor glycemic control and increased incidences of periodontitis. The future in medically treating these patients to manage diabetes needs to include a referral to the dental office for a dental/periodontal exam and possible treatment.
CARDIOVASCULAR DISEASE The body contains 40 billion blood vessels, which makes it simple for harmful inflammatory byproducts to remain anywhere inside arteries, feeding the heart and brain.5 An underlying inflammatory response may place an individual at high risk for both periodontal disease and atherosclerosis. An inflammatory process probably has sources that may include systemic inflammation and local infections,inflammation and a higher incidence of heart attack.
PRETERM LOW-BIRTH WEIGHT BABIES Bacterial infections that occur with periodontal disease are commonly observed in women of childbearing age. Premature labor is the consequence of an immune response to infections of the uterus in some women and their infants. Having a healthy mouth can lead to a healthy, full-term pregnancy.
Many of the anti anxiety /antidepressant, anti-hypertensive, anti-diabetic drugs can cause dryness of mouth and gums enlargement, which in return may not only cause decay, but can exacerbate gums disease.
RHEUMATOID ARTHRITIS AND OSTEOPOROSIS Rheumatoid arthritis is a disorder in which the body attacks its own healthy cells and tissues. People with rheumatoid arthritis are at increased risk for osteoporosis for many reasons and it can cause bone loss not only systemically, but also in the oral cavity.
There is an association between dental plaque, poor oral health, and respiratory diseases. Oral secretions are aspirated along with respiratory pathogens and may affect the adhesion of the organisms to the respiratory epithelium.
PEPTIC ULCERS Research has now shown that H. pylori strains having similar virulence markers are able to induce different types of gastric inflammation and injury. The entire genome microarray of H. pylori revealed distinctions in the ability of H. pylori strains to induce epithelial cell responses, which are related to inflammation.
TOBACCO USE This is one risk factor that is preventable. Tobacco use causes chronic systemic inflammation because of toxins found in the body and can stimulate platelets to clump together. The body will go into “high gear” to fight this, causing inflammation that can result in various medical conditions.
CANCER Cytokines include many types of proteins, which can cause inflammation not only in the mouth but throughout various parts of the body.cytokines have the ability to cause bone loss systemically and orally.