Good Oral Health = Good General Health
Recently the intimate relationship between oral health, general health and your dentist was highlighted recently when I was asked by a Cardiologist to clear a patient as free of dental infection prior to cardiac surgery.
The patient was suffering from endocarditis, that’s an infection of the lining of the heart often associated with a heart valve. Examining the patient and his X-ray, I found that he had Chronic Periodontitis (moderately advanced gum disease with bone destruction around his teeth) with signs including bleeding gums and moderate loss of bone supporting his teeth. In addition, a dental abscess of an upper molar tooth was found.
The cause of the endocarditis had been confirmed by laboratory investigations as a bacteria associated with the mouth. Dental surgery was provided removing the tooth and associated infection from the jaw and a full mouth clean of the teeth and root surfaces was performed and after a short healing period of a week, the patient was able to have his heart valve replacement carried out once dental infection and systemic infection had been eliminated.
Following the recent case of endocarditis to which I refer above I decided that I need to raise awareness in the general community of this relationship between oral health, general health and gum disease so that everyone, and in particular those with diabetes, coronary artery disease and other inflammatory diseases can become more aware of how important it is that they see their dentist or attend a dentist with special interest and training in gum disease for detailed dental and oral examinations with particular attention being paid to identifying gum disease in these people.
Recent Medical Research
New research published over the past 10-15 years demonstrates the close relationship that exists between dental health and general health. There is a very close inter-relationship between gum disease and the associated inflammatory markers (chemicals associated with inflammation that can be measured in the blood) and other conditions including diabetes, insulin-resistance, premature birth, low birth weight babies, stroke and coronary artery disease to name just a few.
For example, the positive correlation in the relationship between gum disease and both Coronary Artery Disease and Stroke was investigated in a group of males in the Normative Aging Study in Boston, USA. Gum disease increased the odds of coronary heart disease by a factor of 1.5 and stroke by 2.8 (Beck J et al J. Periodontol. 67(10 Suppl)., 1123-1137 (1996). This is a highly significant finding and therefore gum disease along with smoking can be seen to have a major influence on cardiac and general health.
Have I got Gum Disease?
Gum disease can be identified from the appearance of the gums with redness and swelling of the gum tissues, bleeding on thorough tooth brushing and a general appearance of poor dental hygiene with accumulations of plaque noticed at the gum margins and in between teeth.
Patients having gum disease often report bleeding gums when they brush and in more severe cases they even report finding blood left on food after biting into it.
What can I do about it?
A simple referral for a periodontal consultation to include an X-ray and an assessment of the health of the gums and the tissues surrounding their teeth may help in reaching an early diagnosis of Chronic Periodontitis, Aggressive Periodontitis or acute periodontal infection for a significant number of gum disease patients and in turn this may assist in improving the control of their systemic. Such an examination can be undertaken by your dentist, a periodontist or a dentist with a special interest or advanced training in the treatment of periodontal diseases.
An additional fact of interest is that while diabetes can make someone more prone to gum disease, the successful treatment of that gum disease will benefit the person by improving the diabetes and making their diabetic control better. This is a very important reason why patients suffering from diabetes should be checked regularly for signs or symptoms of gum disease.
Dry Mouth is Common
After another recent patient, I wanted to draw attention to the issue of multiple medications taken by patients and the adverse effect of a dry mouth that can be seen in many patients. This is referred to as “Xerostomia”.
Xerostomia is frequently implicated in an increase in dental caries (decay) and periodontitis (gum disease) because saliva plays a significant role in protecting the tissues of the mouth from both conditions. Both gum disease and “dry mouth-associated dental decay” manifest themselves most often in elderly people or in patients on long-term drug therapy.
The High-Risk Group
Older patients frequently already have gum recession resulting from past gum disease and ageing with areas of root surface exposed to the mouth devoid of the protective enamel seen on the crown of the tooth. This unprotected root dentine is then attacked by the acids produced by the “acidogenic bacteria” (acid-producing bacteria) found in dental plaque leading to severe and fast progressing root surface decay that then leads to dental pain, oral infection and tooth loss at an alarming rate.
There are large numbers of elderly patients residing in nursing homes across the country who still have some teeth and it is therefore so important that those people caring from them are aware that their oral hygiene can play such an important role in both maintaining their general medical health and in preventing a deterioration in their dental health. Sadly many older patients do not obtain the regular dental examinations they need and consequently, their oral health suffers as they progress in years. It is clear that the elderly patient with gum recession needs regular dental screening if they are to avoid suffering dental disease and suffer tooth loss. Such dental infection and tooth loss results in a reduction in their quality of life as they find eating more difficult, less enjoyable and their appearance too may be jeopardised.
Summary – My Hope!
I therefore hope that by raising these issues, periodontitis “gum disease” and xerostomia “dry mouth” that older patients and younger patients on long-term drug therapy will pay particular attention to their dental health and if they notice any bleeding from their gums after tooth brushing, they should seek dental examination and seek professional advice. If patients are taking multiple medications and feel that they may be suffering from a reduction in salivary flow, then this too should be discussed with their dentist as well as their GP. Simple measures can help significantly and regular sipping of water in addition to the use of Biotene can alleviate symptoms and make life more comfortable.
contact the friendly team at NQ Surgical Dentistry today on (07) 4725 1656 or call in to see us at 183 Kings Rd, Pimlico QLD 4812
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