The Mouth

Q:My dentist is recommending expensive treatments for my bad breath, teeth, and gums. She said my gum disease is interfering with my blood pressure and blood sugar. Is she just scaring me to get business?

A:It’s impossible to judge the integrity of your dentist based on your question. The substance of her argument, however, is sound, and we hope this was also emphasized by your medical doctor, if you have one. Here are the facts (and they may be scarier than what was already said!).

The mouth is a special window through which your bodywide (systemic) health or disease state can be observed. Oral disease is associated with and, indeed, may cause systemic diseases. Periodontal (gum) disease, like well-known chronic medical conditions, takes quite a while to develop. It may first be noticeable as bad breath and gingivitis (inflammation of the gums), in which the gums bleed easily with brushing and become swollen and red. As it worsens, it becomes periodontitis, in which the gums separate from the teeth, the underlying bone becomes thin, and the teeth may loosen or fall out.

This, however, is just the tip of the iceberg, since it seems that the inflammation that accompanies gum disease affects the susceptible tissues of the entire body.

Bad breath has a variety of causes that originate not just in the mouth; one pathway is through the production of sulfur-containing chemicals that make the delicate gum tissues porous to bacteria and their toxins, which, in turn, enter the body’s circulatory system. Masking bad breath with mints and mouthwash does not deal with the causative bacteria, so definitive treatment should be sought.

Gum disease is associated with atherosclerotic vascular disease and heart attack, lung disease, diabetes, pregnancy-related complications, osteoporosis, rheumatoid arthritis, kidney disease, high blood pressure, liver and pancreatic cancers, even Alzheimer’s disease. Preventing and treating gum disease is part of the chronic disease risk-factor reduction strategy and adjunctive therapy for these conditions.

Just for the record, you are not alone—in one large, multinational anaysis 73 percent of people with diabetes didn’t know that their oral health affects and is affected by their diabetes. You might consider asking your doctor and dentist to collaborate with your care, since good evidence suggests that treating either the diabetes or the gum disease positively impacts the other.

Facts at a Glance:

Gum disease affects:

• more than 538 million people globally.

• 50 percent of U.S. adults over 30 (as brushing-induced bleeding).

• 60 percent of dental students in one study.

• 80 percent of U.S. adults over 35.

• 95 percent of Americans with diabetes.

• males more often than females worldwide.

• pregnancy by increasing the risk of low-birth-weight babies sevenfold.

• blood vessels, blood pressure, and blood sugar; the heart, liver, immune system, and pancreas; and the risk of stroke, heart attack, rheumatoid arthritis, and cancer.

The good news is that gum diseases are preventable and manageable. But as with tooth decay, they are infectious. Effective, daily self-care, including meticulous oral hygiene, the judicious use of antibacterial rinses, and appropriate professional care, are essential components of a total health regimen.

Peter N. Landless, a board-certified nuclear cardiologist, is director of the General Conference Health Ministries Department. Zeno L. Charles-Marcel, a board-certified internist, is an associate director of Adventist Health Ministries at the General Conference.