Is it possible that maintaining oral hygiene can play an important role in initiating or developing or even recovering from a disease process? Well, yes, it is. Also, a disease process can manifest itself in initial stages within the mouth, which can play a great role for early diagnosis and hence better treatment of the disease.
Effects of poor oral hygiene are almost always easily ignored because they’re hidden in the mouth. Thus, maintaining oral health is quite important as it can be a window to the overall health. While poor oral health tends to promote systemic diseases and conditions, often it so happens that the first sign of a disease manifests in the oral cavity. Studies and surveys have shown that heart disease, clogged arteries, stroke and bacterial endocarditis can be caused by the bacteria from gum disease. If gum disease bacteria enter the bloodstream, it affects arteries or heart valves, resulting in heart related diseases.
Conversely, diseases and conditions can have an effect on oral health as well. For e.g., Blood disorders, gastrointestinal disorders such as Gastro Esophageal Reflux Disease (GERD), respiratory diseases and conditions can affect oral health. Medication including antihistamines, decongestants, painkillers, and antidepressants prescribed for other conditions may cause dry mouth. This in turn can increase risk of dental decay, oral yeast infections and other oral infections. People with weakened immune systems have heightened susceptibility in developing oral fungal and viral infections. Diseases that show oral manifestations could be HIV with one of the first signs of AIDS likely to appear in the mouth with severe gum infection. Nutrition deficiencies also have a part to play in causing serious effects on oral tissues.
How can oral health affect overall health?
Maintaining oral hygiene becomes quite important in cardiac patients. Quite often, when there is an immune response, it results in inflammation and narrowing of arteries. Thus while attempting to defend itself against the inflammation, the body deposits fat tissues along the walls of these blood vessels which contribute to clots and the hardening and narrowing of the arteries. This may lead to increase in blood pressure and cardiac complications. Bacteria in these fatty plaques are similar to those witnessed in the oral cavity. There is also a possibility of oral bacteria aggravating cardiac infections. This could occur when they get into the blood circulation reaching the heart. Hence analyzing the signs of poor oral hygiene, such as mobile teeth, missing teeth and periodontal disease can be quite effective in predicting heart disease just like testing cholesterol and triglycerides levels.
In pregnant women, gum disease may cause a preterm low weight infant with or without other health complications, but treating periodontal disease during pregnancy is considered late. This is because the infection may have already spread in the patient’s body, so it’s vital to maintain excellent oral health beforehand.
Poor maintenance of oral hygiene is connected to certain forms of cancers as well. It has proven to cause worsening of oral cancer and pancreatic cancer. This is because it helps in harboring infections in the area affected which will aid in further destruction of tissues. Also, according to some researchers, tumors seem to aggravate when capillaries dilate and tissue perfusion increases in inflammation.
According to many researchers, the mouth, as they say can very well serve as a reservoir for bacterial contamination of the lungs with subsequent development of lung conditions. Study has shown that bacteria from the oral disease can affect lungs too and if it enters the respiratory system through circulation, it may result in bacterial pneumonia and respiratory problems.
How do general disorders affect the oral cavity (mouth)?
Diabetic patients have a very high tendency of developing gum infections. Periodontitis is often also known to be as ‘the sixth complication of diabetes’. The reason for high rate of periodontitis occurrence in patients with poorly controlled diabetes is because of their compromised immune system. Hence, while diabetics can be more prone to oral infection, cavities, tooth loss, burning mouth syndrome and dry mouth, which again manifests into dental caries and salivary gland infections. Poor oral hygiene possibly makes it more difficult to control blood sugar level just as infection of the mouth can disrupt blood-sugar levels and make diabetes harder to control.
Women going through menopause very commonly experience a burning sensation of the mouth. Often there maybe redness of the gums with swelling, and dry mouth (xerostomia). This is quite normal yet unpleasant, and again the chances of occurrence can be minimized with good oral hygiene maintenance along with a positive lifestyle.
People infected with HIV have a risk of developing conditions like oral thrush (candidiasis), fever blisters, canker sores, hairy leukoplakia, oral warts, aphthous stomatitis, herpes simplex, and quite rarely, opportunistic oral tumors. These conditions have a higher occurrence because of the patient’s weak immune system and inability to successfully stave off these infections or conditions. People with HIV/AIDS may also experience dry mouth, which elevates the progress of tooth decay making chewing, swallowing and sometimes talking difficult. So how do we avoid these secondary conditions when we have a compromised immunity? The rationale for this is to take enough care by avoiding bacterial infections.
Another virus that invades the oral cavity is the Human Papilloma Virus (HPV). The virus is apparently associated with lesions that occur on sides of the tongue and lips. Unfortunately, these lesions are more difficult to treat than conditions found in patients infected with HIV. They can also be more prevalent or multiply quickly in AIDS patients.
Lifestyle factors in quite a number of people are known to hallmark in the occurrence of oral infections, apart from heart disease and diabetes. Some of the factors are smoking, anxiety, depression, stress, alcoholism and a sedentary lifestyle. Stress increases production of a hormone known as cortisol which plays a role in the deterioration of the gums, hence leading to poorer prognosis of the oral condition.
Another important factor causing oral manifestations that can be controlled is nutrition. Adequate nutrition influences the body’s disease fighting capability and helps maintain integrity of the tissues. Thus, compromised intake will favor the infections and retard disease healing. Bulimia is another condition where the stomach acid from repeated vomiting causes severe erosion of the hard tooth structure. This can cause hypersensitivity and weakening of the tooth.
Hence I hope to conclude with a clear idea about how oral health maintaining is important. A healthy mouth means more than just an attractive smile. Oral and overall heath are undoubtedly related, which makes oral hygiene maintenance one of the more important preventive measures. The mouth indicates many symptoms of body health and diseases. By physically examining your mouth it is possible to determine the status of general health, and even signs of smoking or drug abuse as well as diseases.
While the mouth’s relationship to the rest of the body will certainly be a matter of public health, patient awareness and the changing roles among caregivers, it will first and foremost be a matter of science. And, thus as the inter-relationship between the mouth and the rest of the body becomes clearer, we may just have to rethink the term ‘oral health’.
-Dr. Ritu B. Kulkarni