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How Oral Health Affects the Rest of You

“Show me your teeth, and I will tell you who you are,” declared preeminent 18th-century naturalist George Cuvier. The guy was onto something.

During the past few years, periodontal researchers and physicians have amassed a trove of evidence showing that not only can the gums and teeth act as a barometer for how well the body is doing; they may directly affect the health of the heart, metabolism, brain, and even penis.

Hyperbole? OK, maybe. But look at the facts: The mouth is the body’s most common entry point for infection, yet doctors have almost universally ignored it, says Wenche S. Borgnakke, a University of Michigan periodontal health researcher and a dentist who for decades has urged M.D.’s to take the health of the mouth more seriously. “Almost every medical condition has some kind of manifestation in the mouth,” she says. “Yet until two or three years ago, medical schools basically taught that the body began at the tonsils.” It’s a sentiment echoed by Harvard endocrinologist William Hsu, another of the new breed of oral health investigators: “I call the mouth the ‘black hole’ of the body because it’s a mystery to most medical folks.”

For anyone who needs a refresher, here’s why oral health is so crucial: Every time you eat, food particles stick to your teeth. If you don’t brush and floss daily, the particles attract bacteria and form a slimy coating on teeth: plaque. With less than a week of inattention, that plaque calcifies into hard tartar, which won’t come off without a dentist’s scraping tool, and begins to lodge in the supporting gum structure. The gums become inflamed — that’s gingivitis, the first stage of periodontal disease, or PD — and little pockets open up between the teeth and the gums.

The collateral damage from neglecting your teeth and gums stacks up fast: Heart disease, stroke, diabetes, and possibly erectile dysfunction and Alz­heimer’s can all be connected to an unhealthy mouth.

In the case of heart disease, the oral bacterium triggers the release of inflammatory molecules called cytokines, which interfere with the ability of the heart vessels to relax and contract. (Pretty much the same thing happens in vessels in the brain and can result in a stroke.) Last year, a study published in Circulation found that patients with periodontal disease were 30 percent more likely to suffer a first heart attack than patients with a clean bill of health — and that’s after accounting for factors like smoking and education.

Here’s how we know that it’s the bacteria from the mouth causing problems: After coronary bypasses, researchers dissected clogged arteries removed from patients, and they found oral bacteria, Borgnakke says. Probably the best evidence that these bugs are up to no good comes from studies in which people have had the health of their mouths restored with nonsurgical periodontal therapy — the vigorous scraping away of plaque on the teeth and underneath the gumline that we get when we visit the dentist.

A raft of studies show that if you’ve got gum disease, you’re more likely to have or develop diabetes; the worse the gums, likely the worse the diabetes. In a small study last year, a British team tracked Alzheimer’s patients over six months and found that the group with gum disease suffered cognitive decline at six times the rate of the group without.

At the University of Michigan, preventive cardiologist Melvyn Rubenfire asks each of his patients whether they keep up with dental evaluations, and his patients getting valve or congenital heart operations have an exam and necessary periodontal therapy before surgery to minimize the chance of infection-related complications. Meanwhile, Hsu continues to push for new guidelines from the American Diabetes Association, urging that, if you’ve been diagnosed with diabetes, you should go to the dentist to treat any gum infection or inflammation. “When I see an unexplained rise in blood glucose in a patient,” he says, “I’ll ask, ‘When is the last time you had a dental cleaning?’ ”Hsu and Genco even teamed up for a study in which they asked dentists to test the blood sugar of patients with periodontal disease to catch diabetes early among patients.

Take this 2014 study in the American Journal of Preventive Medicine: Researchers looked at the dental and medical insurance records of several hundred thousand people who had, among other conditions, heart disease, stroke, and diabetes. If they’d had at least one routine teeth scraping, their medical costs, and their likelihood of being hospitalized dropped.

At a more philosophical level, Borgnakke argues, we need to start thinking of the mouth as an ecosystem of bacteria that can drive health and sickness, similar to how we now view the gut. “When the balance in the community of bacteria gets skewed, nasty bugs take over,” Borgnakke says. That can happen when you neglect good brushing and regular flossing — or your diet. In the mouth, saliva breaks down sweets and even starches into sugar, this coats your teeth and feeds toxic mouth germs. If the bacteria seep into the gums and then the bloodstream, Borgnakke dubs them “the Traveling Oral Microbiome.” Exactly where they land, fester, and drive up the risk of disease — be it the heart, brain, or penis — is a question of individual vulnerability or the location of your particular Achilles’ heel.

Pass that floss.


Source: How Oral Health Affects the Rest of You – Men’s Journal

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