Experts Link Poor Oral Health To Heart Attack, Stroke, Dementia

By Danielle Barron

New conclusions have emerged indicating that bad oral health like gum disease and oral bacteria may influence inflammation, chronic illness and long-term health.

The body of evidence for our oral health having a direct and indirect impact on our overall health is growing steadily. Far from being just a vital component of a nice smile, scientific research increasingly demonstrates that the health of our teeth is linked to the development of a wide range of health conditions.

“I always say, show me a patient’s mouth, and I’ll be able to tell you a lot about that patient’s health systemically, because we know there’s links between dental disease, and lots of different diseases, and there’s more and more solid literature coming out on that every day,” says Morgan O’Gara of Blackrock Dental in Co Dublin.

A number of studies highlight the correlation of certain oral pathogens to the prevalence of systemic diseases, says Sarah Flannery, the principal dentist at Azure Dental Clinic, also in Blackrock, Co Dublin.

“Periodontal disease or gum disease is an inflammatory condition of the gums and bone that support the teeth,” she explains. “It is caused by certain bacteria that cause the inflammatory response in the gums, but some of these bacteria are also found in other systemic conditions in the body.”

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Warning signs to look out for include persistent bad breath and changes in gums such as swelling, bleeding or receding.

While cardiovascular diseases such as atherosclerosis and hypertension, as well as diabetes, have widely been associated with periodontal disease, other conditions such as Alzheimer’s disease, COPD [Chronic obstructive pulmonary disease], pneumonia, some cancers, rheumatoid arthritis and chronic kidney disease are now also being linked to these bacteria.

The literature invariably shows that people who report poor oral health have higher risks of developing chronic conditions and even higher rates of all-cause mortality in later life.

One study published last year in the journal Neurology® Open Access, an official journal of the American Academy of Neurology, found that having both gum disease and tooth decay is linked to an 86 per cent increased risk of stroke compared to having a healthy mouth.

Several studies have also illustrated a possible link between chronic oral infections and neurodegeneration, accelerating the progression of Alzheimer’s disease.

In 2020, NIA scientists analysed long-term data from more than 6,000 older adults and found that those with signs of gum disease and mouth infections were more likely to develop Alzheimer’s disease or a related dementia than those without.

A 2021 study also found that older adults with tooth loss have a higher risk of cognitive impairment and dementia – this risk increases with each missing tooth.

“There is very strong literature out there in relation to dental health and cardiovascular health,” says O’Gara, who says he is extremely conscious of the overall health of his patients.

“When it comes to the link between oral health and dementia, there are a lot of very promising studies, and while it’s early days, there seems to be a lot of correlation there and it’s certainly an area I will be keeping a close eye on.”

The possible link between oral health and cancer is also being extensively studied. An observational study by Harvard University researchers determined that people with a history of periodontal disease were 43 per cent more likely to develop oesophageal cancer and 52 per cent more likely to develop gastric (stomach) cancer compared with people whose gums were healthier, with this risk even higher in those with gum disease severe enough to cause tooth loss.

“We now know that periodontal disease is associated with systemic inflammation in the body due to increased activity of these bacteria,” Flannery says. Unsurprisingly, studies are showing that treatment and elimination of the bacteria causing poor oral health can have a positive systemic influence on the health of the entire body.

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“It is thought that these bacteria enter the bloodstream from the oral cavity and trigger an inflammatory response elsewhere in the body,” she says. “Restoring oral health not only impacts the patient from a dental perspective, but also from an entirely systemic point of view.”

Both O’Gara and Flannery note that the dental hygienists in their respective practices are almost always fully booked, pointing to an enhanced awareness of the deeper importance of good oral hygiene and gum health.

“We see people coming preventively, as they now know the importance of gum health; they don’t want periodontal disease, nor do they want the potential implications of it.”

Flannery notes that her practice now employs a relatively new technique for the treatment of periodontal disease called guided biofilm therapy, or GBT.

“This is a non-invasive hygiene treatment that gently removes plaque, stains and tartar,” she explains. “It uses a warm, high precision spray of water, air and fine powder to clean above and below the gums,” she says, adding that it is perfect for patients with gum issues or sensitivity or maintenance after bonding, Invisalign or composite veneers. Results last up to nine months.

But while visits to the hygienist are key – every six months, say both dentists – maintaining gum health means building good brushing and flossing habits at home.

“Proper daily care removes plaque and bacteria, preventing inflammation and gum disease,” O’Gara says.

Brushing and flossing (or using interdental brushes) twice daily isn’t just good for your teeth, it could be playing a part in keeping your whole system – brain and body – healthy too, along with sensible anti-inflammatory measures: quit smoking, manage stress, and eat a nutrient-rich diet with plenty of fruits, vegetables, and whole grains and Omega-3 fatty acids.

– Irish Times