Seventy-five percent of Americans have some form of gum disease, according to The New York Times .
Former president of the American Association for Dental Research, Dr. Robert Genco, calls periodontal disease — an advanced form of gum disease that affects half of Americans — a public health concern. “[It] is one of the most prevalent non-communicable chronic diseases in our population.”
While gum disease can cause bad breath, inflammation, infection and tooth loss, studies suggest that it affects the rest of your body as well. Chief Executive of the British Dental Health Foundation, Dr. Nigel Carter, explains, “The link between oral health and overall body health is well documented and backed by robust scientific evidence.” Periodontitis is associated with osteoporosis, stroke, diabetes, heart disease and low-birth-weight infants.
There are obvious and heavily reported culprits of gum disease, including smoking, consuming sugary or acidic foods, poor oral hygiene and stress. But an increasing body of evidence points to fluctuations in hormones as an additional cause. The American Academy of Periodontology concedes, “Some drugs, such as oral contraceptives, antidepressants, and certain heart medicines, can affect your oral health.”
Indeed, the connection between dental health and sex hormones is well established. Increased estrogen levels, particularly during puberty and pregnancy, stimulate blood flow in the mouth and change the way gum tissue reacts to irritants in plaque, causing gums to become red, tender, swollen and more likely to bleed — ripe conditions for gum disease. Periodontitis prior to puberty is, therefore, very rare. In both cases, “the elevation of female hormones (estrogens) causes blog vessel changes in their gums, making them more susceptible to the effects of bacteria,” says President Elect of the American Academy of Periodontics, Dr. Susan Karabin, DDS.
A recent analysis by researchers at Case Western Reserve University, which reviewed 61 journal articles with nearly 100 studies for a collective answer on “whether hormones have a relationship to gum disease and specific women’s health issues”, predictably found that women are at greater risk for dental problems — and the conditions associated with them — because of their hormones.
So it’s no surprise that oral contraceptives, which increase estrogen and/or progesterone levels in the body to prevent pregnancy, impact dental health, too.
In one study, current pill users ages 20-35 had deeper gum gaps, more severe tooth attachment loss and more bleeding sites upon probing than non-users. The study concluded decisively that “current users of oral contraceptives had poorer periodontal health.”
In another study, the mean amount of gum destruction was significantly higher in women on oral contraceptives compared with those using other forms of birth control. The longer users had been on birth control, the worse their gums were.
In yet another study, women using oral contraceptives had 16-fold higher levels of certain mouth bacteria and two-to-three times more tooth bone inflammation than women on other forms of birth control. Likewise, women on the pill experience “a statistically significant increase in gingival inflammation.”
What do we do?
For one, some assert that it’s not as bad as we think. Cleveland Dental Clinic notes: “The most profound changes in the gums are seen in the first few months after starting the birth control pills”; and, because newer birth control pills have lower concentrations of hormones, inflammatory responses may be less than what they once were — though the studies I cite are recent. One UK site recommends changing to a pill with a lower concentration of progesterone, though no research has been conducted on this specific proposal.
Dr. Angela Evanson, DDS, of Parker, Colo. emphasizes that there’s often no one factor contributing to gum disease. For this reason, dentists need to closely examine their patients’ history and habits, not just their teeth. Dentists should know if their patients are on the pill not only to help them take additional steps to prevent gum disease but also because oral contraceptives can lower the effectiveness of certain antibiotics used to treat it.
But dentists can only do so much. Patients are ultimately responsible for their own health, from their prescription choices to how much they floss.
In the end, timely, thorough treatment is most important. Evanson told me:
I see [patients with] gum disease from all sorts of things, but the solution is usually the same: minimize plaque by using an antimicrobial mouthwash, floss, don’t smoke, avoid sugar and soda, reduce stress. These simple measures can prevent—and even resolve—gum disease when practiced consistently.
Many people know that poor oral hygiene can lead to gum disease, tooth decay and even lost teeth. But are you aware that failing to brush or visit the dentist regularly also can lead to more serious health issues? According to Colgate, recent research suggests that there may be an association between oral infections, particularly gum disease, and cardiovascular disease and preterm birth.
A healthy mouth is good for more than just a pretty smile. Oral health can affect the entire body, making dental care more than just a cosmetic concern.
Many people know that poor oral hygiene can lead to gum disease, tooth decay and even lost teeth. But are you aware that failing to brush or visit the dentist regularly also can lead to more serious health issues? According to Colgate, recent research suggests that there may be an association between oral infections, particularly gum disease, and cardiovascular disease and preterm birth. Gum disease also may make diabetes more difficult to control, since infections may cause insulin resistance and disrupt blood sugar.
Your mouth also can serve as an infection source elsewhere in the body. Bacteria from your mouth can enter the bloodstream through infection sites in the gums. If your immune system is healthy, there should not be any adverse effects. However, if your immune system is compromised, these bacteria can flow to other areas of the body where they can cause infection. An example of this is oral bacteria sticking to the lining of diseased heart valves.
Other links have been found between oral health and overall health. In 2010, researchers from New York University who reviewed 20 years of data on the association concluded that there is a link between gum inflammation and Alzheimer's disease. Researchers in the UK also found a correlation. Analysis showed that a bacterium called "Porphyromonas gingivalis" was present in brains of those with Alzheimer's disease but not in the samples from the brains of people who did not have Alzheimer's. The P. gingivalis bacterium is usually associated with chronic gum disease and not dementia.
Researchers also have found a possible link between gum disease and pancreatic cancer. Harvard researchers found that men with a history of gum disease had a 64 percent increased risk of pancreatic cancer compared with men who had never had gum disease, based on studies of men from 1986 through 2007.
While oral health issues may lead to other conditions over time, symptoms also may be indicative of underlying conditions of which a person is unaware. Inflammation of gum tissue may be a warning sign of diabetes. Oral problems, such as lesions in the mouth, may indicate the presence of HIV/AIDS. Dentists may be the first people to diagnose illnesses patients don't even know they have.
An important step in maintaining good overall health is to include dental care in your list of preventative measures. Visit the dentist for biannual cleanings or as determined by the doctor. Do not ignore any abnormalities in the mouth. Maintain good oral hygiene at home by brushing twice a day and flossing at least once per day. Mouthwashes and rinses also may help keep teeth and gums healthy.
Oral health and other systems of the body seem to be linked. Taking care of your teeth promotes overall health.
A brilliant smile, fresh breath -- and the ability to sip a frozen margarita or two without any unnecessary pain -- are the best case scenarios when it comes to oral health, right? "There are three key factors that affect the health and appearance of our teeth: oral health routine, diet and lifestyle choices," Cosmetic dentist and Philips Zoom ambassador Dr Luke Cronin from Quality Dental said.
"Make sure you clean your teeth regularly and effectively, this means morning and night for around two minutes. Electric toothbrushes are clinically proven to remove more plaque than manual brushing. You should also floss every day, flossing removes the food particles and subsequent plaque that can get lodged between teeth that cannot be reached by your toothbrush. The final element of good oral health -- and a great smile -- is regular check-ups and cleans at the dentist."
1. Plaque Problems
"In the absence of effective daily brushing and flossing, plaque build up will occur on your teeth and below the gum-line. Bacteria then forms, which can lead to decay of the tooth's external enamel and other dental problems such as gum disease," Dr Cronin said. "A worst-case scenario is where tooth decay and/or gum disease is undetected or ignored, the structure of the tooth and the surrounding tissues are damaged to the extent that teeth either fall out or have to be removed."
2. Gum Disease
While teeth are the stars of the show when it comes to oral healthcare, our gums need TLC too. Dr Dunn -- who is Macquarie Centre's principal dentist and a Philips Sonicare ambassador -- explained that there are generally no painful symptoms until late on, so patients are often left unaware of the damage being done to their gums. "A patient may notice red and puffy gums (gingivitis) which may bleed from brushing and flossing, leading patients to shy away from effective cleaning," he said. "If left untreated, the gingivitis can progress into periodontal or gum disease. This causes teeth loosening/loss in susceptible people, due to the disease progressing into the supporting bone surrounding the teeth." Dr Dunn advises regular check ups and early intervention to aim to halt the effects of gum disease.
3. Mouth Ulcers
Not many of us haven't felt the uncomfortable sting of a mouth ulcer from time to time. So what causes them? "Ulcer's usually form from minor injuries to the mouth, including those suffered as a result of hard brushing, certain trigger foods including acidic fruits, vitamin or mineral deficiencies, allergies, braces, stress or as a result of a bacterial, viral or fungal infection,' said Dr Dunn."Some are due to generalized medical conditions including auto-immune diseases," Dr Dunn explained that ulcers present as painful lesions to the mouth tissue, on the cheek or gums. The best way to avoid ulcers is, well, avoidance and sleep. "Avoid known acidic trigger foods, follow a balanced and healthy diet, and get enough sleep - plus good oral hygiene is essential," Dr Dunn said.
4. Dental Cavities
If giving up sugar entirely isn't doable -- and we all know how hard it is to avoid office donut time -- then minimise the harm. "Regular consumption of food and beverages that are high in sugar causes the most damage to your teeth. When sugar is consumed it interacts with the bacteria that naturally occurs within the mouth," said Dr Cronin. "The bacteria feeds on the sugar to produce acids that attack the tooth's enamel, if teeth are not regularly cleaned these acids create holes or cavities in the tooth."
Dr Cronin's advice? If you do indulge in a sugary treat or a soft drink, it's worth taking the time to clean your teeth soon afterwards, or rinse your mouth out with water to remove any sugar that is sticking to the surface of your teeth. "Saliva and fluoride both contain minerals that help repair weakened enamel however they will only do so much to counter the effects of sugar on your teeth," Dr Cronin explained.
5. Discolouration In Teeth
You may not be able to start your day without a latte or two but it's not doing anything to help keep. But there are actually ways to regime an holistic boost -- and naturally whiten your teeth too? Oil pulling is an Ayurvedic practice done in conjunction with your usual brush and floss routine -- and can whiten teeth more gently. Miranda Kerr is a fan. So what is it?
"Oil pulling is a powerful detoxifying remedy that can help whiten teeth, freshen breath and prevent gums from bleeding," Cocowhirl founder Denise Gribben said.
Oil pulling involves swirling an organic coconut oil around the teeth and gums -- for up to 20 minutes on an empty stomach -- in order to draw out the toxins. The oil's natural antiobiotic and antiviral properties can brighten and clean the teeth.
If alternative methods aren't for you, Dr Cronin suggests, "your best bet is to have a regular clean at your local dentist to remove staining and stubborn plaque build-up."
Rachel Hall runs an holistic fresh breath clinic. She's seen -- and smelt -- it all when it comes to halitosis. "There are a surprising number of non dental causes of bad breath," Hall said. "Medications can cause dry mouth and without enough saliva, food particles and bacteria can stay on the teeth. Sinus infections, mouth breathing and some gut bacteria can cause bad breath too. To find out honestly if your breath is less than fresh, lick your wrist, let it dry for 10 seconds and then smell it."
If you don't like what you smell, there are simple ways to fix it. Hall suggests brushing and flossing (you can now also try interdental cleaners) regularly, buying a tongue scraper and using it daily, drinking more water and even using a saltwater gargle to keep your throat and tonsil area clean. "Chewing sugar free gum can help combat bad breath too. To care for your breath holistically, keep fit, get plenty of sleep and avoiding sugar with reduce inflammation in the body which means your mouth will naturally be healthier and fresher," Hall said.