We, dentists have the power to change the world by leading post COVID world. A complete health dentist can save billions in health
As we all know, our mouth is a gateway to our body. Anything happening in our mouth has a direct impact on the rest of the body. Be it any tooth or gum infection, missing teeth or broken-down teeth, they all have consequences that affect our body if left untreated.
In this era of holistic dentistry (Complete Health Dentistry) our main focus is on the prevention of oral diseases which can have a negative impact on our body in the form of many debilitating or life-threatening conditions.
Unfortunately, our oral health is ignored by most and many of us don’t take oral hygiene seriously. When we feel discomfort in our teeth, we ignore it at that time and again till it evolves to excruciating pain. By that time, the tooth is no longer restorable. This is the conventional norm of dealing with dental problems in our society. Smaller problems that could be dealt with minimally invasive treatment are ignored.
If we have a wound on our finger, we don’t plan on getting our finger amputated. In fact, we do whatever we can to promote healing. Then why be prejudiced against the oral cavity? Just because you cannot see it? The total area of your gums is the size of the palm of your hand. If you had an open wound that big would you choose to ignore it!? Of course not!
This is where we step in. To inculcate in our patients, the essence of good oral health and its monumental significance to general body health.
Our body responds to infection with inflammation in an attempt to heal it. As mentioned previously, total area of our gums is about the size of palm of hand and if it stays infected for a long period of time, the body utilizes most of its healing resources. There comes a tipping point where the body can’t cope up with infection. The infection can make our body suffer from a host of different inflammatory diseases. For example, heart attacks, stroke, diabetes, rheumatoid arthritis, Alzheimer’s disease, kidney disease, pancreatic and various other types of cancers.
Heart Attacks
Some of the oral bacteria present in gum disease have been found to be involved in thickening of blood vessels leading to heart attacks, high blood pressure and strokes.
40% of acute heart attacks in America have been found to be triggered by oral infections. Smoking increases the risk of heart attack by 60 times but the risk of heart attack from gum disease increases up to 200 times. C-reactive protein (CRP) is an inflammatory marker; its level increases in gum disease. The combination of gum disease with increased level of CRP is associated with higher chronic heart diseases. As gum disease is treated the level of CRP goes down therefore stabilizing heart diseases.
There is a whole new level of care emerging in USA and the concept is to get rid of any inflammation in the body to prevent triggering heart attacks. It is called the Bale-Doneen method and they actually warranty their patients by offering refunds to patients who suffer from ischemic heart attacks or strokes under their care. It focuses on identifying and eliminating the root cause of the vascular disease. In this method it is essential to screen patients for periodontal disease as part of cardiovascular health assessment and history.
Diabetes
Diabetes is a very common and debilitating chronic illness which damages the whole body and is very difficult to manage. 93% of periodontal disease patients are at a higher risk of developing diabetes. Inflammation sets up a reaction in the body that makes us less responsive to insulin hence leading to type 2 diabetes. Any infection or pus in the body stimulates liver to release excessive sugar in the blood because body derives energy from sugar to fight that infection, but diabetic patients don’t have the proper transport system, that is insulin, to take sugar inside the cells thus hyperglycemia never settles. That is why diabetic patients don’t fight off infections very well. Oral infection does the same thing and worsens diabetes. By getting rid of oral infection, blood sugar level significantly decreases, diabetic condition improves and usage of anti-diabetic drugs also decreases significantly.
Gum disease cause diabetes but diabetes also negatively affects gum disease. Just as oral infection makes diabetes worse, high blood sugar level provides perfect environment for bacteria to grow that invade our gums thus worsening oral infections such as periodontal disease and patients end up losing their teeth sooner.
There is a link between uncontrolled periodontal disease and pregnancy complications such as premature labor and pre-eclampsia (rise in blood pressure). Oral bacteria from the mother can enter the blood circulation and can affect the baby by travelling through the placenta causing premature births and low birth weight babies. Studies have shown that bacteria responsible for tooth decay are passed from mother to the child in utero. In periodontal disease estrogen levels are disturbed and this can lead to conception issues in some of the females
Studies have shown that 50% of failures in orthopedic replacement surgeries are related to oral infection. It’s not that only the bacteria are responsible for it but because body has utilized its healing capabilities in mouth and is unable to heal that new wound introduced by surgery.
Studies have found positive association between gum disease and pancreatic cancer. In one study, men with a history of gum disease had a 63% higher risk of developing pancreatic cancer than those with no history of gum disease. People with chronic inflammation caused by gum disease harbor higher levels of harmful bacteria in the mouth and gut. Over many years, this can lead to higher amounts of cancer-causing nitrosamines.
Research suggests that exposure to inflammation early in life quadruples one’s risk of developing Alzheimer’s disease. An inflammatory burden early in life, as represented by chronic periodontal disease, might have severe consequences later on as a risk factor to Alzheimer’s.
A specific strain of bacteria responsible for periodontal disease creates an enzyme called PAD which exacerbates the condition by speeding up onset, progression and severity. Numerous clinical and epidemiological studies have shown that individuals with periodontal disease have an increased prevalence of rheumatoid arthritis and, conversely, periodontal disease is at least 2-fold more prevalent in those patients. Tooth loss has been found to be involved with joint symptoms. Patients with less than 10 teeth have more severe arthritis and higher disease activity score.
Oral Infections lowers the healing capacity of the body to fight against infectious diseases and also delays healing of wounds present anywhere in the body. This has become even more important after emergence of COVID-19. We know corona virus is worse for those who have compromised immunity.
Those patients who have crowding, narrow arches, missing or rotated teeth and even have just few pre mature contacts, they end up having occlusal trauma, cracks, fractured or chipped teeth. Most people don’t even notice these for years before it’s too late. Loss of vertical dimension because of occlusal wear adds to problems.
Dentists need to pay close attention in identifying such potential issues in advance to save natural tooth structure. Occlusal considerations must be integral part of our treatment planning for orthodontic testament and any restorative dental work. We should focus beyond getting front teeth aligned for aesthetic reasons and pay close attention to establishment of a balanced occlusal table after the treatment is done.
When we do any direct or indirect restorative work, our aim must be to follow original morphology present in the space we are working on. Any over contoured restorations will cause pre mature contacts and lead to TMD issues. We are living in a changing world and we must adopt accordingly and must raise our bar for the standard of work. Patients eventually find out the exact status and reasons for their ongoing dental issues through another dentist or online search.
If patients don’t have a proper occlusal table because of missing teeth or over contoured restorations, it will lead to an over load on the Gastro Intestinal system. One of the functions of oral cavity is to chew food to very small particles so they can be absorbed into blood stream from GI system. If we don’t have proper occlusion it will cause the GI issue.
By treating oral infections, we can improve the overall health of our patients and reduce the total health care cost. A study conducted by united Concordia looked at the health of around 1.7 million people and found that over 200,000 patients had both periodontal disease and chronic conditions. The financial savings of those who were treated for their gum disease were impressive.
- Diabetes annual savings $3,291
- Heart disease annual savings $2956
- Stroke annual savings $1029
- Rheumatoid arthritis annual savings $3964
- Pregnancy annual savings $2430