Oral health is critical to our well-being and yet too many of us take it for granted. Despite decades worth of research linking oral health to systemic health, far too many people remain unaware of the importance in maintaining good oral health. A quick search on the internet reveals millions of articles discussing the link between gum disease and major chronic diseases such as cancer, stroke, heart disease, diabetes, pre-diabetes, arthritis, pre-term births etc. Gum disease is the most prevalent human infection with little progress being made.
No one would walk around with with chronically bleeding fingernails or pus-filled scabs on their arms, but because gums are hidden from view, most people will ignore their symptoms until it is too late and much damage has been done. Why is this? Studies have demonstrated the general unwillingness to address chronic gum disease when up to 70% of patients diagnosed with gum disease failed to get treatment due primarily to cost and fear of pain. (It can be assumed that 100% of those undiagnosed are not seeking treatment and this may represent about half of the population). Read more »
It has been known since the beginning of the last century that microorganisms can be killed by various combinations of dyes and light. Ancient Egyptian, Indian and Chinese civilizations used light to treat various diseases, including psoriasis, rickets, vitiligo and skin cancer. In 1901, Niels Finsen used light to treat smallpox and cutaneous tuberculosis and in 1903, he won the Nobel Prize for his work on phototherapy (Nature 2003, Dennis et al) However, the interest in antimicrobial Photodynamic Therapy (aPDT) was diminished concurrently with the introduction of antibiotics; it is only in recent years, with the emergence of antibiotic-resistant strains, such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus faecalis that a search for alternative treatments has stimulated a revival of interest on aPDT. It is an effective antibacterial therapy that involves the use of specific-wave light energy to activate a photosensitive compound (photosensitizer), which interacts with locally present molecular oxygen. APDT has the potential to be a powerful alternative to antibiotic therapy, particularly for the treatment of localized infections of the skin and the oral cavity. Microorganisms that are killed by this technique include bacteria, fungi, viruses, and protozoa. Read more »
Apparently poor dental health could be attributed to our modern diet, as today’s food tends to be a lot mushier than in ancient times. A recent conference, Evolution of Human Teeth and Jaws: Implications for Dentistry and Orthodontics in North Carolina put forward the suggestion that our diet is so radically different from our ancestors that numerous dental health problems, including cavities and crowded teeth are just about inevitable.
Their findings were based on studies of ancient teeth which tend to be well preserved. Archaeologists have been able to examine the teeth of not only our ancient ancestors, but also people who lived more recently, and who followed a hunter gatherer diet such as Kalahari Bushmen and the aboriginals. Around 13,000 years ago these hunter gatherers began to become farmers, and as a result food became much softer and didn’t need to be chewed so much. One of the effects is that the human jaw has become smaller, and more people suffer from overcrowding, and there is frequently little space for wisdom teeth to erupt.
If you let dental plaque and calculus buildup on your teeth, then you may not only be increasing your risk of developing periodontal disease, but also your risk of developing cancer. A new study published in the online British Medical Journal, Open, has linked dental plaque with a risk of premature death due to cancer. The longitudinal study looked at the connection between dental plaque and cancer mortality in Sweden.
The study followed 1,400 randomly selected adults from Stockholm over a period of 24 years, from 1985 to 2009. At the beginning of the monitoring period the adults were in their 30s and 40s, and were interviewed to assess their risk of developing cancer. Factors taken into account included whether or not they were smokers, and levels of affluence. In addition, their oral hygiene was assessed to discover current levels of gum disease and tooth loss, as well as levels of dental plaque and calculus.
The findings of two new studies were recently presented at the American Heart Association’s Scientific Sessions in Orlando, Florida and reinforce the links between periodontal disease and the risk for cardiovascular disease and strokes.
Researchers have found that patients who had their teeth professionally cleaned and scaled at regular intervals were at a reduced risk of heart attacks and strokes. The research was based on a nationwide study which took place over a seven-year period. Dr Emily Chen and Dr Hsin-Bang Leu examined data on 51,000 adults who had their teeth professionally cleaned on at least one occasion against a similar sized group who had never had their teeth professionally cleaned. Neither group had a history of heart attacks or strokes. The study showed those participants whose teeth were professionally cleaned at regular intervals had a 24% lower risk of heart attack and a 13% lower risk of stroke compared to those people who did not have their teeth professionally cleaned.
Up until recently it has been a bit of a mystery as to how common oral bacteria such as P. gingivalis, A. actinomycetemcomitans, and T. fosythia, were able to wreak such havoc in the mouth. Scientists have pondered for years how exactly they were able to trigger periodontitis, despite being present in relatively low numbers in the sub gingival crevice. Now researchers have discovered that the common oral bacteria P. gingivalisis able to reprogram the immune cells that normally protect the sub gingival crevice, into creating conditions it finds more favourable.
The reprogrammed immune cells effectively persuade more immune cells to follow their lead, prompting the usually benign bacterial residents of the sub gingival crevice to rise up and defend their realm, which in turn leads to inflammation of the supportive structures of the tooth. Prior to this research it had often been thought that P. gingivalis was directly responsible for the infection, but it now seems likely that it just sits back to watch the destruction unfold, waiting to feed off the nutrients generated by the inflammation.
George Hajishengallis, D.D.S., Ph.D., a researcher at the University of Louisville School of Dentistry was a co-lead author on the study which was supported by the National Institute of Dental and Craniofacial Research, and has commented that this research is important as it is the first documented case of a keystone species being discovered in microbiology. The term keystone species was first invented in the late 1960s and is a species which is present in low numbers but which is able to exert a disproportionate influence on its environment. P. gingivalis, a common oral bacteria, would seem to be a perfect example as it is able to change the microbial environment creating conditions favourable for periodontitis to develop.
New research conducted by Queen Mary University of London has given an interesting insight into the way normal bacteria affect the development of gum disease, and could lead to new preventative measures being developed through manipulating these bacteria to help protect the gums.
The study was conducted on mice living in two separate test conditions. One set of mice had normal bacteria in their mouths, while the other mice were raised to be free from bacteria. Small amounts of Porphyromonas gingivalis, a bacteria commonly found in the oral cavity, was introduced to both sets of mice. The mice with normal bacteria in their mouths subsequently developed periodontal bone loss, while those who had previously had bacteria free mouths remained free of the disease.
Scientists found that the presence of P. gingivalis stimulated the growth of normal bacteria, which had a major effect on the inflammatory and immune system of the mice. It appears that even a small amount of P. gingivalis can have an almost disproportionate influence on the severity of gum disease that develops. It now seems that periodontal disease develops when P. gingivalis interacts with existing bacteria, and that these existing bacteria are needed for this to occur. Read more »
There is substantial evidence to support the link between gum disease and serious health conditions, such as heart attack, stroke and rheumatoid arthritis. Now, the mainstream media is taking on this issue too. In the below interview, Dr. Oz discusses how brushing your teeth daily may help prevent you from developing a heart attack.
Dr. Oz’s interview only reiterates what research has long suggested – your oral health is important to your overall health. Studies conducted in Great Britain, Canada, United States, Germany and Sweden have found people suffering from periodontitis have between a 25% and 100% increased risk of suffering from heart attacks. Other clinical studies suggest a link between periodontitis and the development of strokes. In this video, Dr. Oz discusses how bacteria from the mouth can enter the bloodstream, triggering the clumping of platelets that form blood clots, and increasing your risk of thrombosis. These blood clots can either block blood vessels supplying the heart, creating the right conditions for a heart attack, or they can block the arteries supplying blood to the brain, increasing the risk of a stroke. Periodontal disease has also been linked to other serious conditions, such as rheumatoid arthritis. Treatment for this disease has been found to not only improve oral health but to also have a beneficial effect on rheumatoid arthritis.
A report by the World Health Organisation on a global overview of oral health found that in spite of improvements, problems still persisted both in developed and developing countries, and were particularly prevalent amongst underprivileged groups.
Although preventative and curative oral healthcare is available here in North America, not everyone has sufficient coverage. Certain groups, such as the elderly or disabled, do not necessarily have access to affordable dental care. The problem is the shortage of oral health personnel. The majority of oral health services are offered from regional or central hospitals, and the lack of resources means little attention is given to preventative and restorative dental care.
The global prevalence of periodontal disease plays a significant role in oral disease, yet most oral healthcare providers and the general public fail to give it the attention it deserves. The purpose of the WHO report was to put the incidence of periodontal disease into perspective globally, as well as looking at strategies to prevent and control this disease. Read more »
We have long ago heard that gum disease may be linked to heart disease, but now due to recent discoveries made at the University of Rochester, there is even more evidence to shed light on why and how our oral health may affect the heart.