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Can Oral Health Be Linked To Your Chronic Diseases?

Written by

Deborah Freudenmann BHSc

Our oral health influences our physical and mental health, and believe it or not, vice versa.

A universal view of ones wellbeing must encompass all aspects of health, this includes oral health to be truly holistic. Research is advancing in the connections between certain chronic conditions and oral health, although it is often overlooked in conventional medicine. Perhaps this is due to the disjointed approach to treatment of symptoms without viewing the body as comprehensive whole.

The body provides a variety of different signs and symptoms that can indicate underlying chronic disease, when the mouth displays these it may come in the form of; bad breath, gingivitis (bleeding gums), cavities, dry mouth and periodontitis.

White Coating

A white coating on the tongue and/or on the inside of the cheeks can indicate oral thrush. This is indicative of an oral microbial imbalance and possibly, systemic candida.

Red Gums

Red gums, often diagnosed as gingivitis is a mild form of periodontal disease. Despite it being deemed as mild, it is still an issue that needs to be addressed as it is an inflammation of the gum which can exacerbate and cause implications for other body systems. There are many factors that can lead to red gums such as smoking, dry mouth, vitamin C deficiency, immune deficiency, bacterial or viral infections or even uncontrolled blood sugar levels.

Pale Gums

Pale gums occur due to atrophy of the mucosa surrounding the teeth, this can occur due to lowered estrogen levels in women and reduced blood flow (gingivostamatitis with menopausal women). it can also be caused by a bacterial or viral infections and anaemia.

Yellow Gums

Yellow tinged gums, as opposed to the above discussed pale colour can also be indicative of a more serious case of gingivitis. A yellow area on the gum (this colour can indicate pus), paired with pain that surrounds a tooth is a sign of infection such as an abscess.

Bleeding Gums

Bleeding gums can indicate systemic inflammation within the body, that there are deficiencies in vitamins present such as vitamin C, D and/or K, or that there is a hormonal imbalance. Bleeding gums may also be associated with certain conditions and diseases, and the drugs used to treat them.

Cavities

Oral dysbiosis can occur and lead to cavity formation through the process of eating and not maintaining oral hygiene. The bacteria attaches to the outer layer of the tooth and then begins to digest sugars from the food consumed. Prior to a cavity forming, plaque will form that protects the bacteria, almost like the biofilm layers that are used by bacteria within the digestive tract. This can eventually harden and further erode the layers of the tooth when it forms a hard layer of tarter which needs to be removed by a qualified dentist. Adequate oral health care can disrupt this process of plaques forming and leading to cavities eventually, and further supports the need for good oral hygiene and a healthy diet void of added sugar.

Dry Mouth

Dry mouth can indicate underlying blood sugar issues or diabetes, mouth breathing or snoring and sleep apnoea. It can also be caused by multiple autoimmune diseases, in particular Sjogren’s syndrome, nerve disorders, HIV/AIDS, radiation or chemotherapy, and certain medications.

A further look at some of the conditions and diseases related to poor oral health

Studies have linked cardiovascular disease and the loss of bone support in the jaw due to periodontal disease. This direct correlation was identified in a systemic review where the numbers of existing and new cases of coronary heart disease are significantly increased in periodontal disease.

It has been indicated that there is a link between oral hygiene and respiratory health, particularly for those at higher risk being the elderly. The evidence in a study showed that by improving oral hygiene and frequent professional oral health care, there was a reduction in the progression and occurrence of respiratory disease in elderly patients.

The relationship between periodontal health status and fatal and non-fatal stroke was examined. It was found that there was approximately a 17% increase in the risk for stroke among those with severe periodontal disease in comparison to those of healthy individuals.

An important link to consider with the increased risk of other chronic diseases and conditions due to viruses is the implications of Epstein-Barr Virus and cytomegalovirus and their correlation with periodontitis and poor oral health outcomes. Multiple studies have indicated that periodontitis is frequently present in those suffering from these chronic viruses, and that it is also more likely that those with deeper recession pockets within the gums carry the two discussed viruses as well.

Individuals with diabetes are more likely to have periodontal disease than those without diabetes. This may be because diabetics are more susceptible to infection anywhere in the body, and possibly due to previous or current dietary influence for those with type 2 diabetes that is poorly managed. Periodontal disease is often considered the ‘sixth complication’ of diabetes so it needs to be considered greatly in the treatment of those with diabetes. Of great concern, the presence of periodontal disease may make it more difficult for diabetics to control their blood sugar as severe periodontal disease can increase blood sugar levels.

Whilst there is a strong link between chronic kidney disease and poor oral health, the outcomes of improving oral health to see if this approach reduces the complications of chronic kidney disease is yet to be shown. Changes in the mouth of those with chronic kidney disease may contribute to increased health complications and death rates due to inflammation, infections, protein-energy wasting, and complications from hardening of the arteries.

A recent study has shown that patients with poor oral hygiene are more likely to have H. pylori, both on their teeth, and within their stomach. This study indicates that the mouth may be another area within the body for H. pylori to proliferate, and potentially a source of transmission or reinfection. This highlights the need to address oral health and oral hygiene to effectively treat this bacteria that is a common issue.

In dementia patients with impaired memory and delayed processing, it has been shown that there is an increased risk of poor oral health and periodontal disease. Individuals with dementia are predisposed to dental conditions due to reduced saliva (potentially from the medications used to manage the disease), a change in diet due to reduced ability to consume a varied diet and reduced dental care due to progressively reduced individual care abilities. Positive outcomes for oral health may be achieved simply by better management and understanding of this condition.
It has been shown that there is a relationship between upper body obesity and periodontal disease in adults, this could be assumed to be dietary linked and is largely addressable with dietary and lifestyle change.
Headaches, jaw disorders, premature tooth wear and cracking as well as damage to previously treated cavities is an issues associated with anxiety. This can be avoided through addressing anxiety holistically and reducing the way in which it manifests in the mouth.
Periodontal disease and the use of daily mouthwash which often contains alcohol (the problematic ingredient in this instance) may be independent causes of cancers of the head, neck, and oesophagus, studies have previously suggested. This highlights the need for a more holistic approach to oral health and the reduction in use and recommendation of such products.

Oral health is a common link…Inflammation from plaques may trigger an autoimmune response within the body.


Hashimoto Disease

Periodontitis is often found in individuals with Hashimoto’s disease. An article highlights the link between adverse outcomes for oral health and both hypothyroidism and hyperthyroidism. Having Hashimoto’s and unmanaged oral health can be linked to burning mouth syndrome, Sjogrens syndrome, systemic lupus and maxillary and mandibular osteoporosis.

Rheumatoid Arthritis

Rheumatoid arthritis can be a debilitating and painful condition which may lead to reduced ability to physically brush the teeth, in some instances, the jaw may even be implicated in the condition. A common link with the above discussed autoimmune conditions is Sjogrens syndrome, RA is no different and patients with this disease are also at higher risk of Sjogrens syndrome.

The unique hormone balance of a women’s unique hormonal profile makes them more susceptible to oral health issues and inflammation caused by periodontal disease. It is important that good oral health and hygiene is a matter of self care priority for women.

It is well known and studied that infection with bacteria from periodontal disease in the mouth may impact the health of a pregnant woman which can lead to low birth-weight and premature labour. This significant correlation was first shown in a 1996 study and to date, the consensus of available findings from a number of studies strongly supports this original finding. Pre-eclampsia, which is high blood pressure in pregnancy, is one of the significant problems in pregnancy and complicates 8 – 10% of pregnancies. It can adversely impact the unborn baby as well as the mother, and may result in premature birth and risk of intervention. It should be highlighted that an association between periodontal disease and pre-eclampsia have also been found.

What should healthy gums look like?

Healthy gums are pink and fit firmly around the teeth and do not recede. If, as previously discussed, the gums are displaying signs of inflammation or infection, periodontitis or another gum disease may be at play and it is essential to address these. 
The best approach with periodontitis (as with many conditions) is the prevention of it occurring in the first place. 

How Ozone therapy impacts your oral microbiome…

Ozonized water on oral wounds showed an acceleration of wound healing and earlier wound closing than patients who did not receive ozone treatment.

Ozone can be used in a preventative care routine for root caries. Trials have shown that non-cavitary root caries can be reversed and arrested of progression which eliminates the need for removal. 

Lichen planus is an inflammatory condition that affects the mucous membranes in the mouth. Application of gaseous ozone has been proven to be effective in increasing wound healing after a high-dose radiotherapy. 

Gingivitis and periodontitis are common inflammatory diseases of the gums. They are a major source of teeth loss due to infection. Ozonated water, and gaseous ozone is effective in addition to a thin layer of ozonated oil which can be applied daily to decrease chances of infection. 

Ozone can kill the bacteria, fungi, and viruses within the mouth and diminish halitosis.

Ozone administration was proved to be an effective method to treat osteonecrosis of the jaw post-surgery, especially for patients who had a lesion greater than 2.5 cm.

When ozone therapy and laser application therapy were paired, a study showed that there were significant lower pain levels following an oral surgery.

Ozonated water can be helpful in reducing infections caused by the oral microorganisms that exist in dental plaque.

Ozone is being used to disinfect roots after removing the nerves and blood vessels. Studies have shown that ozone can disinfect the canals and leave them clean for a year.

Ozone therapy has been shown to be more effective than medication for treating temporomandibular joint-related pain. 

Want more information? 

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In addition to the 3 non-negotiable recommendations of regular teeth brushing, flossing or water pik use, and ozone therapy….

Mindfulness and awareness of dietary impact is crucial to oral health. High acidity foods and foods that are high in sugar can be detrimental to the enamel of the teeth and also the discussed oral microbiome, paving way for inflammatory oral conditions and cavities. Fruit juices and sugary drinks are an issue for not only oral health, but many other functions within the body.

Oil pulling is an Ayruvedic remedy which involves swishing approximately one tablespoon of sesame oil in the mouth. Coconut oil may also be used as it has natural antimicrobial properties. This should be done for 5-20 minutes upon rising as this is how long it takes to break down the biofilm around the bacteria present in the mouth. It is imperative to ensure the oil is expelled in the trash so as not to clog drains, and due to the toxic bacteria in the oil after oil pulling, it is essential not to swallow it.

Seeking support from a dentist, fortunately, there are many dentists who practice holistically who are supportive of maintaining oral health without the use of toxic products. It is advisable to get regular checkups to ensure good oral health.

Toothpaste choices…

There are so many toothpastes on the market, and oddly enough, many contain sugar which poses drastic and counter productive issues for our oral microbiome. In addition to this additive, (mainly for taste purposes), there are also inclusions of problematic ingredients further posing issues to our health such as fluoride, sodium laurel sulfate, carrageenan, titanium dioxide, hydrated silica, “natural flavours” and triclosan. The availability of different brands will vary from country to country, it is recommended that the avoidance of the above ingredients be adhered to at a minimum, and opt for a natural option where possible.

Want to find a safe product or check out the safety of it’s ingredients.. then check out the website below. 

A Final Word On Oral Health

There is a clear link between poor dental health and hygiene, and the exacerbation of certain conditions and in the reverse as well, uncontrolled conditions causing dental issues. It goes to show the intrinsically linked way that our body functions, and how crucial it is to ensure that each part is functioning optimally to avoid the cascade of events that can occur that lead to discomfort and poor health.

References

Mutneja, P. et al. Menopause and the oral cavity. Indian Journal of Endocrinology & Metabolism.2012.

Grubbs, V. et al. The Association Between Periodontal Disease and Kidney Function Decline in African Americans: The Jackson Heart Study. Journal of Periodontology. 2015.
Wentz, I. Periodontitis, a trigger for Hashimoto’s? Thyroidpharmacist.com. February 13, 2020.
Chandna, S., & Bathla, M. (2011). Oral manifestations of thyroid disorders and its management. Indian journal of endocrinology and metabolism, 15(Suppl 2), S113–S116.
De Filippis F, Vitaglione P, Cuomo R, Berni Canani R, Ercolini D. Dietary Interventions to Modulate the Gut Microbiome—How Far Away Are We From Precision Medicine. Inflammatory Bowel Diseases. 2018 Apr 13.

U.S. Department of Health & Human Services. Diabetes, gum disease, & other dental problems.National Institute of Diabetes and Digestive and Kidney Diseases Health Information page. September, 2014.

Mayo Clinic staff. Gingivitis. Patient Care & Health Information: Diseases & Conditions. August, 2017.

Huizen J. What causes pale gums? Medical News Today. May, 2018.

Gao, L., et al. Oral microbiomes: more and more importance in oral cavity and whole body.Protein & Cell. May, 2018.

U.S. National Library of Medicine. Bleeding gums. MedlinePlus. Accessed March 9, 2020.

Nakajima, M. et al. Oral Administration of P. gingivalis Induces Dysbiosis of Gut Microbiota and Impaired Barrier Function Leading to Dissemination of Enterobacteria to the Liver. PLOS ONE.July, 2015.

Dietrich, T. et al. Association between serum concentrations of 25-hydroxyvitamin D and gingival inflammation. American Journal of Clinical Nutrition. September 2005.

U.S. National Library of Medicine. Salivary Gland Disorders. MedlinePlus. Accessed March 9, 2020.
Layeghifard M, Hwang DM, Guttman DS. Disentangling Interactions in the Microbiome: A Network Perspective. Trends in Microbiology. 2017 Mar;25(3):217–28.

Valdez-Jimenez, L. et al. Effects of the fluoride on the central nervous system. Neurologia. June, 2011.

Luke, J. Fluoride deposition in the aged human pineal gland. Caries Research. March-April, 2001.

Ramin, C., et al. Night shift work at specific age ranges and chronic disease risk factors.Occupational and Environmental Medicine. 2015.

National Academy of Sciences. Fluoride in Drinking Water: A Scientific Review of EPA’s Standards. The National Academies Press. 2006.

Galetti, P. M. & Joyet, G. Effect of fluorine on thyroidal iodine metabolism in hyperthyroidism. The Journal of Clinical Endocrinology and Metabolism. October 1958.

Follin-Arbelet, B. & Moum, B. Fluoride: a risk factor for inflammatory bowel disease?Scandinavian Journal of Gastroenterology. September 2016.

Scott, J. My No-Soap, No-Shampoo, Bacteria-Rich Hygiene Experiment. New York Times Magazine. May 22, 2014.
Bruce-Keller AJ, Salbaum JM, Berthoud H-R. Harnessing Gut Microbes for Mental Health: Getting From Here to There. Biological Psychiatry. 2018 Feb;83(3):214–23.

Martino, J. V., & et al. The Role of Carrageenan and Carboxymethylcellulose in the Development of Intestinal Inflammation. Frontiers in Pediatrics. 2017.

Tobacman, J. K. Review of harmful gastrointestinal effects of carrageenan in animal experiments.Environmental Health Perspectives. October 2001.

Skocaj, M. Titanium dioxide in our everyday life; is it safe? Radiology & Oncology. December, 2011.

American Dental Association. Dry Mouth Symptoms – American Dental Association.MouthHealthy.org. Accessed April 10, 2020.

Abou Neel, E. A., et al. Demineralization–remineralization dynamics in teeth and bone.International Journal of Nanomedicine. 2016.
Suh, Y., Patel, S., Kaitlyn, R., Gandhi, J., Joshi, G., Smith, N. L., & Khan, S. A. (2019). Clinical utility of ozone therapy in dental and oral medicine. Medical gas research, 9(3), 163–167.

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