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Glenn D. Braunstein, M.D. Headshot

Why Oral Health Leads to Overall Health

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You can tell a lot about people by their mouths. Beyond the personality and charisma that shines through a gleaming white smile, important clues to your overall health can be found in the details of your teeth, gums, and even tongue, which is why putting off that next visit to the dentist can be costly not only to your wallet, but also to your heart and other vital organs.

Recent studies suggest that two common items may be powerful weapons against heart disease and stroke: a toothbrush and dental floss. Research indicates that those plagued with plaque on their teeth also might have worries about plaque in their arteries. No, the two buildups aren't the same -- the oral kind is a sticky residue of bacteria, acid and food particles, while plaque in arteries is a mix of cholesterol, white blood cells, calcium and other substances. But plaque in your mouth can cause periodontal disease -- an infection that leads dentists to warn that you don't need to floss all your teeth, only the ones you want to keep.

Healthy Teeth, Healthy Heart?

Numerous epidemiological studies have shown an association between periodontal infections and heart disease, although it is not clear if periodontal disease causes an increased risk of heart disease, or if those with heart and vascular disease have an increased risk of periodontal infections. There are several theories on how periodontal disease can cause atherosclerosis that can lead to heart attacks or stroke. Bacteria from infected gums enter the bloodstream and may directly infect blood vessel walls, making them susceptible for plaque deposition. Additionally, white blood cells may ingest the bacteria, and the bacteria may interact with blood platelets, both of which may then be incorporated into an atherosclerotic plaque. Finally, bacterial products may stimulate the liver to release proinflammatory proteins that can inflame the vessel walls, as well as clotting factors that can lead to enhanced formation of blood clots in the damaged vessels. These factors restrict the blood flow, nutrients and oxygen that the heart and other vital organs, such as the brain, need to function.

Bacteria entering the bloodstream from the teeth and gums also is particularly dangerous to individuals with abnormal heart valves, as the bacteria may land there, multiply and further damage the valves, while concurrently breaking off portions of the bacterial colony that embolize to other organs causing damage and infections. This condition, called infective endocarditis, is the reason why patients with heart valve problems are advised to take antibiotics before dental procedures. Bacteria, which cause cavities, tooth decay and gum disease, also have been linked to diabetes, respiratory problems and premature births.

Diet Ties to Teeth

Not only can oral health offer a clue to heart health, but teeth also offer a tip-off to your weaknesses and vices -- cavities indicating excess sugar consumption, stains showing you're a smoker and even the calamitous and notorious tooth and gum rot caused by abuse of drugs, especially methamphetamines. Those choppers also offer early warnings of problems in your body. If your teeth seem to be cracking, crumbling, disintegrating or becoming almost clear, that can be a strong indicator of gastroesophageal reflux disease (also known as GERD and acid reflux disease). Teeth that show these issues in a younger adult can signal bulimia, because with the frequent vomiting associated with this disorder, stomach acid eventually begins to wear away tooth enamel. And it's only when some adults start to lose teeth that they become aware they're afflicted with osteoporosis. For diabetics, it's important to link the eyes, so to speak, with the teeth. Not only must they curtail fondness for excessive consumption of health-disrupting sweets, they also need to regularly brush and floss. That's because many studies have shown that diabetics -- who always need to be wary of infections of any kind -- are at risk for periodontitis, an inflammation and infection of the ligaments and bones that support the teeth.

Your best bet if you have any ailment or chronic condition is to check with your doctor to see if there are any side effects for your oral health so you can take preventative steps and work with your dentist, periodontist and other care givers. Trained dental and medical personnel, of course, examine the tongue, gums and other soft oral tissues as part of a check-up because these, too, not only can become inflamed, infected or diseased, like the teeth, they also can signal bigger woes affecting other parts or the whole body -- including sexually transmitted diseases and HIV-AIDS; cancer, heart and lung ailments; a compromised immune system; and osteoporosis. Bad breath, too, may provide a health warning sign and is a common reason people make the sometimes-dreaded visit for care for their teeth and mouth.

A Whiter, Brighter Smile

In appearance-obsessed spots like Los Angeles, of course, a beaming smile rules, and it seems as if nearly everyone has tried whitening strips; hydrogen peroxide-filled trays; whitening toothpaste, mouthwash and even floss. When something becomes a trend, though, it makes sense to look at it skeptically, including for its possible health implications. It doesn't appear for now that the quest to flash the whitest smile possible has an adverse effect on health. Aside from tooth sensitivity and gum irritation, use of peroxide on teeth so far has been shown to have no further side effects, even among adolescents. But because these types of products have been around and in this kind of use for only a relatively short amount of time, there is no research on long-term health effects of these products' continued use, although one study showed that there is no relationship between tooth whitening products and oral cancer.

Another method of teeth whitening, light-activated bleaching, at this point appears safe, but should be discussed with your dentist. A study in the Journal of the American Dental Association concluded that this process is safe when performed by dentists in their offices; those practitioners appeared to gain experience in knowing just how much to heat up the tooth enamel in the process. That said, the General Dental Council in the United Kingdom is pushing for more controls on who can light-bleach teeth, saying this type of whitening should be done by a dentist -- not just anyone who owns a booth at a local mall. As with anything that can affect your health, apply common sense and discuss any planned treatment with a medical professional to avoid later health problems.

The take-home lesson is that it's important to commit to good oral health, because it's vital and affects your entire wellbeing. So before you guzzle that soda, light up a cigarette or cigar or forgo flossing, think twice: you do want a gorgeous, healthy smile, to go with a healthy body, don't you?