Periodontal health is the indicator in most cases!
THE MOUTH-BODY CONNECTION
Just as our eyes are often referred to as the mirrors of our souls, our mouths are often windows into our body's health. Infections, nutritional deficiencies, pregnancies and some diseases such as diabetes, heart disease and stroke often manifest themselves in our mouths as well as our bodies.
For Dennis Medeiros, 66, of New Bedford, his diagnosis of diabetes was soon followed by a diagnosis of periodontal disease.
"I have had diabetes for 22 years," says Medeiros. "During the first year or two my gums bled a lot. When I went to a dentist, I was diagnosed with periodontal disease which, I was told, was due to my diabetes and to the fact that I didn't take good care of my mouth. At that point, there was a lot of bone loss and an oral surgeon had to remove all of my upper teeth."
Diabetes is not the only systemic disease that can be detected in the mouth.
"There are a wide range of changes that can be detected in the oral cavity," says Kabani. "Fungal infections in the mouth may indicate sexually transmitted diseases. You may also
see evidence of vitamin
deficiencies on the tongue. The oral cavity is also known to present changes that may affect the presence of underlying systemic diseases such as HIV infections and gastrointestinal diseases."
Dentists are now aware that there are definite links between oral health and certain systemic diseases. Researchers debate how and why these links exist, but exist they do in the statistics of many current research studies.
"In the past 10 years, research has recognized that oral infections, especially gum disease, might actually affect the course of systemic diseases or be a contributing factor to them," says Dr. Neil Ringler, a Barnstable general dentist. "Cardiac disease, pneumonia, diabetes and low infant birth weight are examples of that. Patients who have immune diseases are even more susceptible to oral infection than the average population. If you have high levels of bacteria in your mouth, you are more likely to have higher levels of bacteria in your body which can be a factor in certain diseases.
"The relationship (of oral health to systemic diseases) is a work in progress," Ringler adds. "We know a lot about some disease links. With other conditions, we know that there is evidence of a relationship; we're just not sure what the mechanism is that causes it."
In the end, the humble toothbrush may be our mouth's best friend. It's inexpensive, user-friendly and probably already sitting beside the bathroom sink. That proverbial ounce of prevention today just may keep our mouths and bodies healthier tomorrow.
"As dentists, we try to keep our patients mouths as clean as possible," concludes Ringler. "And we always emphasize the importance of oral hygiene at home."
Dentists Can Help to Identify Patients at Risk of a Heart Attack
"Dentists are really proud of their profession and feel no need to encroach upon doctors' territory," says senior dental officer and professor Mats Jontell at the Sahlgrenska Academy. "However, we wanted to find out if we as a profession could identify patients at risk of cardiovascular disease."
The study involved 200 men and women over the age of 45 who did not have any known cardiovascular problems. During a routine visit to their normal dentists in Borås and Gothenburg they were also checked out for known risk factors for cardiovascular disease.
"These risk factors are not normally manifested in the mouth, which is why the dentists went beyond their normal check-up routine," says Jontell. "They also took the patients' blood pressure and checked total cholesterol and blood sugar levels."
The risk of a fatal cardiovascular disease was calculated using a software known as HeartScore. The dentists felt that twelve men had a ten per cent risk of developing a fatal cardiovascular disease over the next ten years and advised them to see their doctors. Six of the twelve were subsequently prescribed medication to lower their blood pressure.
"Dentists regularly see a very large percentage of the Swedish population, and if there is sufficient interest they could also screen for cardiovascular risk factors which, untreated, could lead to a heart attack or stroke," says Jontell.
Dentistry with body connection-
Oral health not only affects the way we chew, drink and swallow, it affects our sense of taste and smell. It is also an important component of our self-confidence, the way we smile and communicate with others.
Yet, sometimes we take good oral health for granted and don't appreciate the essential role it plays in our lives until something goes wrong, until we experience pain or discomfort.
How well we treat our teeth, gums and the entire oral cavity can make a profound difference in our long-term health and our sense of well-being.
ORAL CANCER
Lifestyle behaviors such as the use of tobacco and the excessive use of alcohol can dramatically increase the risk of oral cancer. The disease is, in the majority of cases, preventable when behavioral risks are avoided and, in its earliest stages, is often highly survivable.
In 1992, Louis Vieira, 71, of South Dartmouth thought he had a toothache. "The tooth had hurt before," he says. "It would stop hurting, then come back, go away and come back, until finally there was so much pain, I just wanted to have the tooth removed."
The source of Vieira's discomfort was not tooth decay, but a cancerous lump in the hard palate of his mouth.
"Initially there are no symptoms in oral cancer," says Dr. Sadru Kabani, co-director of the Center for Oral Pathology in Cambridge and former professor and chairman of the Department of Oral and Maxillofacial Pathology at Boston University's Henry M. Goldman School of Dental Medicine. "Symptoms arise only after the cancer grows in size and becomes infected with oral bacteria. That's when the patient realizes pain and visits a doctor. Early detection of oral cancer is the best strategy for improving (the odds of) survival," adds Kabani. "You want to catch it in its premalignant stages, before it has grown."
To accomplish that goal Kabani suggests that "the oral cavity be examined meticulously by a dentist every six months. People should also do self-examinations at home by looking at their tongue and mouth with a mirror to note any changes that seem unusual. Changes that suggest oral cancer show up in four different ways," he says, "a red or white patch, a lump or a non-healing ulcer."
"I didn't take very good care of my mouth," recalls Vieira now, "and I smoked five or six cigars a day for about 30 years. I also drank an average of six beers a week during that same time period."
The probability exists that, in combination, that brew of lifestyle behaviors was the recipe for Vieira's oral cancer. The American Cancer Society says 90 percent of patients with oral cancers use tobacco and 75 percent to 80 percent of them drink alcohol frequently.
"Prolonged alcohol and tobacco use can cause cellular changes in the mouth which can lead to cancer," says Dr. Richard Bravman, a Hyannis oral surgeon. "When we find lesions (changes in the structure of tissue due to injury or disease) that look suspicious and biopsy them immediately, we have an opportunity to remove tissue while it is still precancerous and before the tissue fully degenerates into actual cancer. Even if it's a very localized area of cancer, it can most often be treated very successfully."
Chewing tobacco and mechanical trauma can be just as harmful as cigarettes and cigars.
"I see a tremendous number of precancerous lesions that are due to smokeless tobacco," cautions Bravman. "Mechanical trauma can also cause worrisome lesions. If there is an area of tissue that is becoming red or white because it is chronically irritated with, for example, a sharp filling, it could eventually become a significant lesion."
Vieira underwent surgery and radiation to eradicate the tumor and has not had a recurrence of the disease since. But he is one of the lucky ones. The American Dental Association says that, on average, only about 50 percent of patients diagnosed with the disease will survive more than five years. The association goes on to estimate that 35,000 new cases of oral or pharyngeal (the cavity between the mouth and the esophagus) cancer will be diagnosed this year and that about 7,500 people will die of the disease.
PERIODONTAL DISEASE AND CAVITIES
Tobacco users are also at increased risk of periodontal disease. Genetics, stress, various medications and systemic diseases, puberty, pregnancy and menopause are risk factors as well.
In many cases, the disease can be controlled by regular professional cleanings and daily brushing and flossing. Yet, periodontal disease is common. Perio.Org states that "periodontal disease, a chronic inflammatory disease that destroys bone and gum tissues that support the teeth, affects nearly 75 percent of Americans and is the major cause of adult tooth loss."
Gum tissue should fit snugly around teeth like a turtleneck. When periodontal disease is present, pockets form around the teeth. As these pockets become deeper they provide space for bacteria to inhabit. Bacteria are microscopic, busy little invaders that can accumulate and advance under the gum tissue to form even deeper pockets that collect more and more bacteria. This process ultimately results in bone and tissue loss.
"Dentists should routinely check for inflammation of the gums around the teeth. A full series of mouth X-rays should also be taken every five years," says Dr. Ralph Pollack, a Dartmouth periodontist. "Every adult patient who has large fillings in their teeth should have X-rays done every three years because these people are more prone to infection in the roots of the teeth."
The main culprits in the formation of dental decay (cavities) are food products that contain carbohydrates (sugars and starches). Bacteria that live in the mouth digest these foods and turn them into acids. The acids and bacteria combine with saliva to form plaque, a sticky, colorless film that clings to teeth and eventually erodes the enamel on their surface. This process can cause holes or cavities in teeth.
Brushing teeth and flossing are the workhorses of oral hygiene. Their job is to keep the mouth clean and healthy. "Flossing and brushing twice daily greatly reduces the possibility of both gum infection and the forming of new dental cavities," says Pollack.
Medical researchers have known for years now that there's a definite link between dental problems(i.e. gingivitis) and persons' risk for a heart disease. Evidence is mounting, however, that information gleaned from a routine panoramic dental X-rays - wide angle frontal images --taken to establish the baseline condition of teeth and surrounding bone-- may serve as an accurate early-warning system of risk of dying from heart attack or stroke. According to researchers at the University of Buffalo School of Dental medicine, a study of 818 teeth and jaw x-rays of Pima Indians in Arizona found that those who had a build-up of calcified plaque in the carotid arteries were twice as likely to die from heart attack or stroke. Normally, calcified plaque is present in only about 3 percent of the general population. An earlier study of 2,700 dental patients showed calcium deposits on each side of the carotid arteries can be spotted in x-rays of the teeth and jaw bone. It makes sense that the dental x-rays would see the carotid artery --which carries blood from the heart to the brain and back-- so dentists should be aware that it is screening tool for cardiovascular disease. If they see signs of calcification in dental x-rays, they tell the patient to see his or her doctor ASAP. BOTTOM LINE: Don’t wait and try to save your money. Your life and your health is much more precious, not only to you but to those who love you. Dentistry is one of the key aspects in subject of your health.
