We know the basic rules of good dental hygiene: daily brushing, frequent flossing and regular visits to the dentist.
Apart from keeping cavities and other dental problems at bay, good dental hygiene could keep your heart healthy and prevent cancer, too.
“The presence of inflamed gum tissues is associated with poorer overall health,” says Dr David Paquette, professor and associate dean for education at Stony Brook University’s School of Dental Medicine in New York State, US.
“Patients with periodontal disease and diabetes have poorer glycaemic or blood sugar control. Likewise, patients with periodontal disease are at higher risk for developing atherosclerosis and cardiovascular disease.”
Paquette was among the international dental experts who spoke at the eighth biennial International Dental Exhibition and Meeting in Singapore this month. He describes studies which indicate there is a consistent and significant association between periodontal disease and future cardiovascular events, such as heart attacks, stroke, or atherosclerosis.
With atherosclerosis, the walls of blood vessels thicken, restricting blood flow and increasing blood pressure. It’s a major risk factor for heart disease, stroke and death.
Tender, red or swollen gums are indications of periodontal, or gum, disease. It is a chronic inflammatory condition that attacks the gum tissue and the bone supporting the teeth.
“The odds for periodontal disease and cardiovascular events or atherosclerosis are modest, but this is magnified by the high prevalence of periodontal disease in populations, where up to 50 per cent of the population may be affected,” he says.
“Other studies have isolated periodontal bacteria in atherosclerotic vessels and have implicated periodontal bacteria in triggering inflammatory events and atherosclerotic changes in vessels.”
A new study published last week in the European Journal of Preventive Cardiology – the largest of its kind, assessing dental disease in nearly 16,000 chronic coronary heart disease patients from 39 countries – identifies periodontal disorders such as tooth loss and gingivitis as potential risk markers for cardiovascular disease.
A lower prevalence of tooth loss is associated with lower levels of cardiovascular disease risk factors, including lower glucose levels, low-density lipoprotein cholesterol levels, systolic blood pressure, and waist circumference. Diabetes and smoking are also less prevalent among patients with more teeth.
In another study that appeared in the Journal of the American Heart Association in October, researchers at Columbia University reported that improving gum health slowed the progression of atherosclerosis.
They followed 420 adults over three years and found that even subtle changes to dental health had a clinically significant result on artery thickness. This highlights the importance of treating of periodontal disease.
Poor oral health has also been linked with oral human papillomavirus (HPV) infection, which causes about 40 per cent to 80 per cent of mouth cancers, according to a study in Cancer Prevention Research in August.
Researchers from University of Texas’ School of Public Health studied data from nearly 3,500 people in the US and found those who reported poor oral health had a 56 per cent higher prevalence of oral HPV infection.
Thanh Cong Bui, one of the researchers, says that because HPV needs wounds to enter and infect the mouth, poor oral health resulting in ulcers or inflammation might create an entry portal for HPV.
Infection with low-risk HPV types can cause benign tumours or mouth warts, while infection with high-risk HPV types can cause oropharyngeal cancers.
Another study published in February in The Journal of Virology links gum disease to another type of oral cancer known as Kaposi’s sarcoma. Products in the form of small fatty acids from two bacteria prevalent in gum disease were found in high levels in the saliva of people with periodontal disease.
The researchers say this discovery could lead to early saliva testing for the bacteria to monitor signs of cancer so it could be treated before it develops into a malignant form.
One bacteria implicated in the study – Porphyromonas gingivalis – also produces a protein which other studies have found triggers an immune response that leads to chronic inflammation that causes bone and cartilage destruction.
A pregnant woman’s dental health can also have an impact on her baby. Several studies indicate that women with gum disease may be at risk of giving birth prematurely or having a baby with a low birth weight.
These babies may be at risk from long-term health problems, such as respiratory problems, vision and hearing loss.
“Routine brushing and flossing, and seeing a periodontist, dentist, or dental hygienist for a comprehensive periodontal evaluation during pregnancy may decrease the chance of adverse pregnancy complications,” says Dr Nancy Newhouse, president of the American Academy of Periodontology.
Men should also take note. Researchers from Turkey’s Inonu University have found that men in their 30s with inflamed gums caused by severe periodontal disease were three times more likely to suffer from erection problems.