The belief of the mouth body connection (oral systemic connection) is not new. Benjamin Rush, MD and a signer of our Declaration of Independence, noticed that people’s health improved after the extraction of diseased teeth. Today we know that infected teeth and gums can severely affect people’s health in ways that were once unthinkable!

Periodontal Disease and Cardiovascular Disease

People with periodontitis (gum infection with bone loss) are one and a half to two times more at risk for fatal cardiovascular disease. The American Heart Association states that one in five Americans suffer from cardiovascular disease, which is still the leading cause of death in the United States. The bacteria from gum infections can easily enter the bloodstream and ultimately wind up in the heart. The toxins and cytokines from these bacteria can exacerbate or cause atherosclerosis, which causes myocardial disease and stroke. The chronic inflammation from gum infections has also been correlated with elevated white blood cell counts and fibrinogen levels. Fibrinogen is a blood protein that is made in the liver and is one of thirteen coagulation factors responsible for blood clotting. Periodontal infections are also associated with open angle glaucoma and age related macular degeneration.

Periodontal Disease and Erectile Dysfunction

Periodontal disease is linked to ED, erectile dysfunction. Again due to inflammation of the lining of the blood vessels. In this case, the blood vessels lining the vessels of the penis. Thus, restricting the blood flow to the penis. Therefore, one would have difficulty obtaining an erection.
People with non insulin dependent diabetes (diabetes type 2) are three times more prone to develop destructive periodontal disease. Elevated glucose levels due to diabetes, enhance the growth of bacteria in the mouth causing gum (periodontal) disease. Diabetes may cause blood vessels to thicken and slow the flow of nutrients and oxygen to the gums. The inflammatory effect from gum infections produces cytokines which cause an increased blood glucose level that lingers for sometimes months after the source of inflammation has been eliminated. Diabetics with periodontitis show a higher risk of ketoacidosis, retinopathy and neuropathy than diabetics without periodontitis.

Periodontal Disease and Rheumatoid Arthritis

There is a direct correlation with patients with periodontal disease and rheumatoid arthritis. Periodontal disease precedes rheumatoid arthritis and the two have similar levels of proinflammatory proteins such as tumor necrosis factor, interleukin-1 and interleukin-6. There is also a genetic link between the two diseases. Researchers in Israel found a gene, HLA-DR4 in 8 out of 10 people that have severe, aggressive gum disease. This gene occurs very frequently in people with rheumatoid arthritis.

Periodontitis and Obesity

There is a clear relationship between obesity, periodontitis and cavities.  Recent studies show how people with normal weight that exercise have a lower incidence of periodontitis and better blood glucose control. There is a direct correlation with periodontitis and metabolic syndrome. Oxidative stress seems to be the chief culprit causing periodontitis. Also there is an association between chronic kidney failure and periodontitis. Obesity is also associated with increased rate of tooth decay, which develops secondary to xerostomia (dry mouth).

Oral Health and Alzheimer’s Disease

There is a correlation between advanced Alzheimer’s disease and poor oral health. Scientists at the School of Medicine and Dentistry, University of Central Lancashire in the UK, have discovered the presence of a substance (lipopolysaccharides) from the bacterium Porphyromonas gingivalis in the brains of those with Alzheimer’s disease. This bacteria is present in people that have gum or periodontal disease. The bacteria get into the bloodstream from the gums by way of teeth brushing and dental procedures. People of good health have nothing to worry about as far as tooth brushing and dental procedures. The healthy human body can manage the slight amount of bacteria that enter the bloodstream from tooth brushing and dental procedures. Those with Alzheimer’s disease are usually taking medications (antidepressants, antipsychotics and sedatives) that cause dry mouth (xerostomia). The lack of saliva reduces the circulation of local oral antibodies, which help to reduce tooth decay and gum inflammation. Thus, one has an increased chance for tooth decay and gum infections, while taking these medications. More study has to be done on this, because people with advanced Alzheimer’s have poor oral hygiene. So what comes first, the gum infection or Alzheimer’s or vice versa? There is also a correlation between Herpes simplex virus-Type 1 antibodies in the blood (sign of activated virus) and interaction cellular membranes containing amyloid precursor proteins in the brain.

Oral Health and Respiratory Conditions

Periodontal disease, tooth decay, uncleaned dentures, orthodontic and TMJ appliances may promote respiratory ailments such as chronic obstructive pulmonary disease, the sixth leading cause of death in the United States. The microorganisms from gum and tooth infections can be aspirated into the lungs (there are 100 million bacteria per cubic millimeter of dental plaque) and cause pneumonia and even lung abscesses, which have a 5 percent mortality rate. People with diminished salivary flow, decreased cough reflex, swallowing disorders, poor ability to perform oral hygiene, or other physical disabilities have a high risk for pulmonary infections.

Oral Health and Pregnancy

Pregnant women due to hormonal changes are more prone to periodontal disease. Researchers at the University of Alabama School of Medicine, Birmingham Al. revealed pregnant women with periodontal disease are six times more likely to have a premature delivery and a low birth weight baby.

Oral Health and HIV

Researchers at Case Western University have found by-products of bacteria (Porphyromonas gingivalis and Fusobacterium nucleatum) in gum/periodontal disease called metabolic small chain fatty acid (SCFA). The SCFA reactivates the Human Immunodeficiency Virus (HIV) in dormant T-cells, thus causing the virus to replicate. This explains why people with HIV infections and periodontal disease have greater viral titers in the saliva than HIV patients with healthy gums.

Oral Health and Other Conditions

A major discovery was recently made by scientist at the UCLA School of Dentistry, the J. Craig Venter Institute and the University of Washington School of Dentistry has exposed insights into a group of microorganisms called “microbial dark matter”, which has an importance in microbial ecology, biology and medical microbiology. Thus named because these microbes are or were uncultivable in the laboratory. In particular the microorganism called “Candidate Phyla TM7x”. This microorganism has a role in periodontal inflammation, gastrointestinal and vaginal inflammatory disease. TM7x has a competitive parasitic relationship with a bacterium called Actinomyces odontolyticus, which causes mucosal inflammation in the oral cavity.
Periodontal and tooth infections and infections in general can cause fatigue. I tell my patients that their overall energy level will improve after the treatment of periodontal disease and the removal of dental infections. All of these patients tell me they have improved health and increased energy levels after the treatment of such conditions.

Many times dentists are the first health care provider that picks up on diabetes, leukemia, survey, measles, cancer and other diseases. Maintaining a healthy mouth and regular dental examinations, dental cleanings and practicing daily oral hygiene is essential and goes hand in hand with overall health.