Oral Health-Total Health: Know the Connection

Oral health and its relationship to total health underscore the need to educate consumers about the importance of quality preventive oral health care.

Research has identified periodontal (gum) disease as a risk factor for heart and lung disease, diabetes, premature, low birth weight babies and a number of other conditions. The 2000 Surgeon General's report, Oral Health in America, has called attention to this connection and states that, if left untreated, poor oral health is a "silent X-factor promoting the onset of life-threatening diseases which are responsible for the deaths of millions of Americans each year."

Periodontal Disease and General Health

The signs and symptoms of many potentially life-threatening diseases appear in the mouth first. Dental hygienists routinely screen for these signs and symptoms during regular oral health examinations and explain their observations to patients, urging them to follow up with a medical visit for a definitive diagnosis. When necessary, dental hygienists also provide therapy for the oral manifestations of systemic diseases.

Heart Disease

A major disease with an oral health connection is heart disease—the number one killer of men and women—claiming more victims than all forms of cancer and AIDS combined. In 2005, more than 80 million people had one or more forms of cardiovascular disease (CVD); almost 900,000 died in 2004 from CVD.(1) Numerous research studies have shown a connection between heart disease and key bacteria in periodontal disease. While research continues to explore this link, dental hygienists are instrumental in identifying the presence and extent of the periodontal infection and work with patients, both to treat existing periodontal problems and to prevent future complications.

Diabetes

Another disease that has an important relationship to periodontal disease is diabetes—a serious, costly, and increasingly common chronic disease that affects 23.6 million children and adults in the United States and contributes to more than 200,000 deaths a year. Periodontal disease has long been considered a major complication of diabetes.(2) Approximately 95 percent of Americans who have diabetes also have periodontal disease and research shows that people with periodontal disease have more difficulty controlling their blood sugar level. Severe periodontal disease also can increase the risk of developing diabetes. Almost one-third of people with diabetes have severe periodontal disease with loss of attachment of the gums to the teeth measuring 5 mm or more.(3) After a physician has made a conclusive diagnosis, it is critical that patients with diabetes receive professional oral health care regularly and follow a customized home-care routine to help keep their blood sugar levels in check.

Babies

Periodontal disease also has been linked to premature, low birth weight babies.(4) Studies have found that expectant mothers with periodontal disease are up to seven times more likely to deliver premature, low birth weight babies. Oral infection also has been implicated in respiratory ailments. Bacteria in periodontal disease can travel from the mouth to the lungs and lower respiratory system, where it can aggravate respiratory conditions, particularly in patients who already have other diseases.

Other Connections

A routine oral health exam also can uncover signs and symptoms of osteoporosis and low bone mass, conditions that affect 44 million Americans aged 50 and over; eating disorders, such as anorexia nervosa and bulimia, which can be detected by thin tooth enamel and a red mouth; and HIV, which often shows signs in the mouth first.

Oral Cancer

One of the most serious diseases found in the mouth is oral cancer. Often curable in its early stages, oral cancers are a major cause of death and disfigurement in the United States, according to the National Cancer Institute. Oral cancer is more common than leukemia, skin melanoma, Hodgkin's disease and cancers of the brain, liver, thyroid gland, stomach, ovaries, and cervix. If caught early, it can be treated successfully; however, if not, it can spread into other parts of the body and become difficult, if not impossible, to treat. The oral cancer screening constitutes one of the most important components of a routine dental hygiene and dental exam.

Approximately 80 percent of American adults have some form of periodontal disease and the majority of them do not realize they have it, because in its early stages, it is usually painless.(5) In view of the critical relationship of periodontal disease to overall health, and the staggering number of Americans who develop it, it is essential that the disease be prevented or detected early and treated aggressively.

ADHA is the largest national organization representing the professional interests of the more than 150,000 dental hygienists across the country. Dental hygienists are preventive oral health professionals, licensed in dental hygiene, who specialize in the prevention and treatment of oral diseases in order to protect total health.

1 American Heart Association. Cardiovascular Disease Statistics. Available at: http://www.americanheart.org/presenter.jhtml?identifier=4478. Accessed October 16, 2008.

2 American Diabetes Association. All about Diabetes. Available at: http://www.diabetes.org/about-diabetes.jsp. Accessed October 17, 2008.

3 National Diabetes Information Clearinghouse. National Diabetes Statistics. Available at: http://diabetes.niddk.nih.gov/dm/pubs/statistics/. Accessed October 16, 2008.

4 Romero BC, Chiquito CS, Elejalde LE, Bernardoni CB. Relationship between Periodontal Disease in Pregnant Women and the Nutritional Condition of Their Newborns. Journal of Periodontology. 2002;73:1177-1183.

5 National Institute of Dental and Craniofacial Research. Periodontal (Gum) Disease: Causes, Symptoms, and Treatments. National Institute of Dental and Craniofacial Research. Available at: http://www.nidcr.nih.gov/OralHealth/Topics/GumDiseases/PeriodontalGumDisease.htm. Accessed January 7, 2009.

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