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ORAL HEALTH LINKED TO GENERAL HEALTH

Problems in the mouth can signal trouble in other parts of the body.

Seal: Public Health Service - 1798 Links Between Oral and General Health
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 The Mouth as Early Warning System
Problems in the mouth can signal trouble in other parts of the body. AIDS and osteoporosis are examples.

bulletMouth lesions and other oral conditions may be the first sign of HIV infection, and are used to determine the stage of infection and to follow its progression to AIDS.

bulletStudies in post-menopausal women suggest that bone loss in the lower jaw may precede the skeletal bone loss seen in osteoporosis.

Saliva As a Diagnostic Tool
Saliva, like blood and urine, can be used to detect and measure many compounds in the body. Saliva collection has the advantage of being noninvasive. 

bulletMany medications as well as alcohol, nicotine, cocaine, opiates, and other drugs can be detected and measured in saliva. Hormones and environmental toxins can also be measured in saliva.

bulletSaliva can be used to detect antibodies against viruses such as HIV and hepatitis A and B, as well as antibodies against bacteria like Helicobacter pylori, which causes peptic ulcers.

bulletSaliva could potentially replace blood testing for diagnosis and monitoring of diseases such as diabetes, Parkinson’s disease, alcoholic cirrhosis, and many infectious diseases.

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The Mouth As Source of Infection
The human mouth is home to millions of microorganisms, most of them harmless. Under certain conditions, however, some can cause oral infections such as tooth decay or gum disease. 

Oral bacteria may also enter the bloodstream if normal protective barriers in the mouth are breached. This can happen as a result of dental treatment or even tooth brushing and flossing.

In people with healthy immune systems, the influx of oral bacteria into the bloodstream is harmless. If the immune system is weakened by disease or medical treatments, however, oral bacteria can cause infection in other parts of the body. Infective endocarditis and oral complications of cancer treatments are examples.

bulletInfective endocarditis results when oral bacteria enter the bloodstream and stick to the lining of diseased heart valves.

According to the results, long-term antibiotic medication would prevent myocardial infarcts in patients that do not have periodontitis, or related signs of inflammation such as disease-causing bacteria or antibodies to those bacteria. Periodontitis appears to be such a significant chronic infection that the effect of antibiotic treatment in preventing cardiovascular events is lost in patients that suffer from it. During one year of observation, patients with no signs of periodontitis were more likely to avoid new cardiovascular events. A total of 79% survived without a new cardiovascular event compared with 74% of patients without teeth and 66% of those with periodontitis.
The article Paju S, Pussinen PJ, Sinisalo J, Mattila K, Dogan B, Ahlberg J, Valtonen V, Nieminen MS, Asikainen S. Clarithromycin reduces recurrent cardiovascular events in patients without periodontitis is published online before print in the journal Atherosclerosis on the 4th of January  06 http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T12-4HYN57P-1&_user=10&_handle=V-WA-A-W-WWY-MsSWYWW-UUW-U-AABEVAZWBZ-AABZEEDUBZ-CDYWBDAYB-WWY-U&_fmt=summary&_coverDate=01%2F04%2F2006&_rdoc=8&_orig=browse&_srch=%23toc%234878%239999%23999999999%2399999&_cdi=4878&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=4fe8808ca115aea2ca1bcdd906008882

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Harsh cancer treatments that damage mouth tissues can open the door to debilitating oral infections as well as systemic infections resulting from the spread of oral microorganisms. Besides cancer patients, others at increased risk for general infections caused by oral bacteria include hospitalized patients unable to practice oral hygiene, patients taking medications that reduce saliva flow, and those taking antibiotics that alter the balance of microorganisms in the mouth.

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Oral Infections As Risk Factors
Recent studies point to associations between oral infections – primarily gum infections – and diabetes; heart disease; stroke; and preterm, low-weight births. To date, there is not enough evidence to conclude that oral infections cause these serious health problems. Research is under way to determine if the associations are causal or coincidental.

bulletGum infections have been called "the sixth complication of diabetes," because people with diabetes are more likely to have periodontal disease. Researchers are exploring a possible two-way connection between the conditions to see if treating gum disease improves diabetic control.

bulletRecent studies point to an increased risk of heart disease and stroke in people with gum infections; the risk increases with the severity of the oral infection. However, there is not yet enough evidence to establish oral infection as an independent risk factor for heart disease or stroke.

bulletSome studies have found that mothers of preterm, low birth weight infants tend to have more severe gum disease than mothers of normal birth weight babies. More research is needed to determine if gum infections do indeed contribute to babies being born too soon and too small.

For more information, contact:
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Centers for Disease Control and Prevention

Dental health is integral to total health

 

Stomatognathic? Even dentists can expand their vision of their roles in patient health. Dentistry is more than teeth and gums. Ongoing interaction between dentists and 'allied health disciplines' can include:

 

Dieticians and Nutritionists: Dietary management relates directly to dental decay, bone and gingival health maintenance. Edentulous patients benefit from meals which they are capable of eating and which provide needed nutrition.

 

Psychologists: Stress management plays a key role in addressing underlying etiologies of bruxism, clenching, myofascial pain and temporomandibular dysfunction.

 

Neurologists: Identifying referred pain patterns from teeth and orofacial musculature are areas of dentists' expertise and can save on more extensive and invasive diagnostics and therapies. Chronic periodontal infection has been linked to stroke.

 

Cardiologists: Chronic dental infection is implicated in heart disease and heart attack. Prevention strategies-linking cardiologists with dentists in ongoing collaborative cross-referrals-can reduce morbidity and increase quality of life.

 

Pharmacists: Over 400 drugs have the possibility of producing adverse oral health consequences. Counseling patients when they receive these drugs, dental morbidity can be reduced.

 

Pulmonologists: Chronic periodontal disease has significant links to pneumonia. Drugs prescribed by pulmonologists have devastating oral side effects which must be prevented by dental referral.

 

Pediatric physicians: Prenatal nutrition, fluoridation, post-natal bottle feeding, airway/allergy management, orthognathic monitoring, sealants, nutrition counseling, personal hygiene, are among the topics which cross-over between dentists and pediatric physicians. In the picture below: Decay (1) enters the central chamber of the tooth containing the nerve, producing infection between the primary molar roots (2) and at the root tip (3). Pathologic microorganisms involving tooth abscess may be spread through the blood stream to involve distant organs. SBE, sinusitis, tonsillitis, pneumonia, enterocolitis, inner ear infection and other systemic consequences can arise in a 'simple' dental infection.

Diabetologists: The initial discovery of diabetic conditions can and does occur in dental screening examination.  Infection of dental origin can contribute to diabetic morbidity as significantly as infection in any other part of the body. In advanced periodontal disease, for example, the total surface area of ulcerated tissue surrounding diseased teeth and bone is estimated to approach six square centimeters. Diabetes related periodontal disease is often overlooked because physicians are unaccustomed to screening for dental causes

Otolaryngology: Research1 reveals that a dental cause was found in 40.6% of the sinuses diagnosed with 'chronic maxillary sinusitis'. Etiology must be investigated to determine if sinusitis is of either rhinogenous or dental origin.

National Institute of Dental and Craniofacial Research

Many of the quotes throughout this website are taken from the Surgeon's General Oral Health in America 2000.

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PLEASE NOTE: The information contained herein is intended for educational purposes only.  It is not intended and should not be construed as the delivery of dental/medical care and is not a substitute for personal hands on dental/medical attention, diagnosis or treatment.  Persons requiring diagnosis, treatment, or with specific questions are urged to contact your family dental/health care provider for appropriate care.
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