We have to take the mouth and body as one. The funny part about education as medical professionals is that we go through school as either a doctor or a dentist. But the body isn’t separated that way. It’s not separated at all! It’s all connected. Along with my private practice, I also work on staff at a local hospital. I am frequently called in to evaluate patients who are in need of cardiovascular surgery. The vast majority of these patients have infections in their mouths they didn’t know about. Dental disease, more often than not, is completely painless. When I perform these hospital evaluations, I routinely discover abscessed teeth and periodontal disease that produced no signs or symptoms at all!
The American Heart Association recently circulated a comprehensive statement that included studies that examined the relationship between cardiovascular disease and periodontal disease. In another study, researchers took DNA samples of the plaque masses built up in the patients’ arteries and veins and found that 78 percent of the masses had dental pathogens associated with abscessed teeth, and 35 percent carried pathogens related to periodontal disease. The plaque found in both the body and the mouth also raises a chicken- and-egg paradox: Was the plaque there first in your arteries, before moving into your mouth? Or did the plaque originate in your mouth, before moving into your arteries?
Everything comes down to systemic inflammation. The word systemic, in medicine, is used to describe that which affects the whole body, including multiple organ systems. And, yes, this includes your gums. The word inflammation refers to a process that occurs when your body is fighting against something that is harming it. The result is the release of chemicals designed to kick your immune system into gear. If the cause of inflammation is resolved, then the body stops production of these chemicals. If the cause is not resolved, as is the case with plaque and periodontal disease in your mouth, these chemicals will linger. The longer these chemicals continue floating around in your bloodstream and tissues, the more likely they are to cause the breakdown of other systems in your body. These include your heart, arteries, joints, reproductive organs, endocrine systems, and central nervous system. The severity of your inflammatory response to the plaque and bacteria in your mouth has a lot to do with your diet, your lifestyle, and your predisposed health conditions, which are governed by your genetics.
Simply cleaning your gums improves the overall health of your mouth and your body by decreasing systemic inflammation. You may not have heard the term adult prophylaxis, but you’re most likely familiar with its colloquial name, “dental cleaning.” The meaning of the word prophylaxis is “to prevent,” and routine cleanings should be done every six months to protect your teeth from disease and decay.
Keep in mind that the best way to treat periodontal disease (frequently referred to as periodontitis) is prevention. It’s essential that you maintain a habit of brushing and flossing your teeth twice a day to prevent the buildup of bacteria. If enough dental plaque builds up on your teeth, bacteria can eventually inflame your gum tissue to cause gingivitis, which is characterized by a puffy, red appearance in the gums and bleeding when brushing or flossing. Gingivitis can be reversed by removing the plaque, but if left untreated, it can progress to periodontitis—an infection of the gums. Patients who show signs of periodontitis have “pockets” around their teeth from where the body’s response to bacteria has destroyed the supporting tissue and bone.
Don’t forget that under your gums are your roots and the sup- porting bones. Deep inside these supporting structures lies a vast network of arteries and nerves that provide nutrients and sensation to the teeth and gums. These structures are not visible without radiographs! Just like you, I try to avoid excess radiation whenever possible. But when a doctor has reason to suspect a problem, I take the darn X-ray. The same is true in dentistry. If a dentist has reason to suspect periodontal bone loss or an abscessed tooth, a radiograph should be taken to evaluate the situation. Would you want bacteria from periodontal disease or a dental abscess floating around in your bloodstream clogging up your arteries, joints, and brain? No way, kemosabe! What if you had a root canal a few years ago that wasn’t completely successful and bacteria was living up inside your jawbone, and you didn’t know about it? Every time you chew, you are pumping bacteria into the jawbone like a piston in a car engine, flushing bacteria throughout your entire body. Personally, I find this quite disturbing.