The importance of optimal oral health
By Dr Bertrand Stuart, DDS
A FEW weeks ago, I returned from San Antonio, Texas, in the USA where I attended the American Dental Association’s Conference along with thousands of dentists from all over the world. In one of the lectures that I attended, which was conducted by a British professor of Public Health Dentistry, I was specially interested by his exposition that in the United Kingdom the cost for treating oral diseases far exceeds the expenditure for all cancers and heart diseases which, incidentally, represent the leading cause of deaths globally. On the other hand, relatively few people die from dental disease.

In the late 1990s, the dental and medical communities were hit with a revolutionary research outcome that showed a link between oral health and systemic health. The culprit is bacteria. Today, it all seems second nature. Many say that the eyes are the windows to the soul, which means that the mouth could be seen as the window to the body -- or better yet, the door. It only makes sense that what a person ingests will lead to either a healthy lifestyle or an unhealthy lifestyle. The oral cavity is not separated from the rest of the body and why it took centuries to realise that oral bacteria could contribute to declining health may be forever a mystery.

There will be short-term and long-term effects of what one does today as a result of their diet and exercise routine. Yet many people would rather live for today than worry about tomorrow. For the dental professional, it will be imperative to influence patients to make a change in their eating habits if they want to save their teeth. For other health care providers, it will be imperative to influence patients to make a change in their lifestyle in order to live a longer, healthier life.

What is oral health? Is it the same for everyone, since many people have different oral conditions, such as missing teeth, restored teeth, and so on? These are good questions to consider, since everyone has different existing conditions. Now, oral health is a standard of the oral and related tissues which enables an individual to eat, speak and socialise without active disease, discomfort or embarrassment, and which contributes to general well-being. Society in general has always viewed a pretty smile as an indicator for good teeth and healthy gums. Yet statistics are indicating otherwise, and all professional dental organizations have begun to advocate for optimal oral health.

While few people might die from oral diseases, yet the cost of treating it is astronomical… at all levels: Individuals, families, third-party insurance companies, and government agencies. The American Academy of General Dentistry is among those to promote the importance of oral health, recognising that more than 90 per cent of all systemic diseases have oral manifestations, and that oral infections can affect major organs (bacterial endocarditis). The Surgeon General reported that some types of periodontal disease (or gingivitis) affect more than 75 per cent of the population. The statistics reveal the significance of the dental professional in preventing and treating oral diseases, as they may be the first health care provider to diagnose a problem. The importance of regular oral health care and education becomes imperative for improving oral health, and will impact the well-being of all.

Since the late 1990s, as previously mentioned, it has become more apparent, with continued research, that not only is cardiovascular disease linked to oral disease, so is respiratory disease and preterm low birth weight (PLBW) babies. There are good or normal bacteria thriving in the same environment as infectious microorganisms. As medical research continues to assist in better understanding this link, oral health practitioners must continue to educate patients on the relationship that exists between oral and systemic health. Of course, bacteria are not the single influence to systemic diseases that take the life of millions each year. Other known risk factors still include stress, tobacco use, high blood pressure, family history, genetics, weight, alcohol use, and lack of physical activity. There are more and more risk factors being discovered each year that can shorten one’s lifespan.

Cardiovascular disease may be exacerbated by periodontal inflammation. The National Institute of Dental Craniofacial Research (NIDCR) reports that scientific theories cite an opportunistic infectious bacterium that colonises in the mouth from biofilms. These biofilms can activate white blood cells, releasing inflammatory mediators that may contribute to heart disease and stroke. Diseased periodontium serves as a reservoir for inflammatory mediators that can enter the circulation and either enhance or perpetuate systemic effects. This inflammation, along with other risk factors, taxes the body’s ability to fight systemic disease. In a periodontal pocket, bacterial biofilm directly contacts ulcerated epithelium. The more advanced the periodontal condition, the more surface area for bacteria to enter the bloodstream. Finally, it underscores the fact that heavy investment in national oral health ultimately saves lives.