“Oral-systemic” is the connection between your oral health and your entire health system. Poor oral health has been linked is to conditions such as Covid-19, diabetes, heart disease, stroke, pneumonia and Alzheimer’s.  Specifically, high-risk oral bacteria that enters the bloodstream through the gums from periodontal disease can adversely impact overall health. Conversely, a healthy mouth can help overall health.

Periodontal (gum) disease is an inflammatory disease around the roots of teeth caused by bacteria.  It is estimated that around 70% of adults have some degree of periodontal disease. This high-risk bacteria gets into the bloodstream and can be inhaled into the airway.  The results of this oral-systemic link can contribute to susceptibility and worsening of other diseases like Covid-19, diabetes, heart disease, Alzheimer’s and pneumonia.

The Covid-19 link shows a relationship between periodontal disease and bad Covid-19 outcomes. The relationship is inflammation. Oral inflammation is not limited to the mouth; it activates chronic systemic inflammation which challenges the body’s immune system. The Covid-19 virus enters cells and elicits an immune response which can lead to a cascade of inflammation throughout the body, effecting many organs which can lead to death. The risk of serious complications from Covid-19 is significantly higher in patients with moderate to severe periodontal disease when compared to patients with no periodontal disease.

The bacteria that cause periodontal disease can also be inhaled into the airway leading to respiratory disease.  Research in nursing home patients demonstrated that regular tooth and gum cleaning lead to fewer cases of pneumonia and these patients were less likely to die from the infection.

The latest research suggest that the bacteria that cause periodontal disease may pay a role in Alzheimer’s disease and dementia.  Periodontal bacteria have been found in high levels in the brains of Alzheimer’s patients. Bacteria in the mouth that cause inflammation can also be found in remote areas of the body including crossing the blood-brain barrier.  This leads to the formation of amyloid plaque around nerve cells disrupting brain activity as seen in Alzheimer’s disease.

Patients with diabetes are more susceptible to periodontal disease. Proper periodontal care can have beneficial effects on the glycemic control and lessen diabetic complications.  Research shows that people with periodontal disease have more difficulty controlling their blood sugar, and 95% of Americans who have diabetes also have periodontal disease.

People who have periodontal disease are nearly twice as likely to suffer from heart disease or stroke. The bacteria that cause periodontal disease get into the blood stream causing blood vessel inflammation and damage; tiny clots, heart attacks and stoke may follow.

Many of the risk factors for systemic diseases are also the risk factors for chronic inflammatory periodontal disease.  Managing the common risk factors that affect oral and systemic diseases can help better manage the inflammatory driven systemic conditions.  Behavior management including cessation of smoking, weight control, healthy diet and supplements, as well as proper oral hygiene and regular visits to the dentist all contribute to an overall healthier body.

Dr. Robert A. Gallegos is a Fellow in the Academy of General Dentistry, visiting faculty at Spear Education, alumnus of Pankey Institute, Qualified Invisalign provider, member of the American Academy of Cosmetic Dentistry, the American Academy of Dental Sleep Medicine and the American Dental Association.  Dr. Gallegos practices dentistry in Middleburg, VA.  www.MiddleburgSmiles.com.

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