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Dental Health

Dental care is an often neglected facet of one's health. Recent studies have identified associations between unhealthy teeth and gums and cardiovascular disease. This link may occur as a result of activation and stimulation of the immune system by a low-grade infection, which leads to inflammation. There may also be a direct link between bacteria residing in the teeth and gums and the subsequent potential for a bloodstream infection that could lead to cardiovascular disease. (This is the reason why people with abnormal heart valves are advised to take antibiotics before and after dental work).

Tooth retention has also been directly related to bone health and the absence of osteoporosis. (How many times have we heard people brag about the health of seniors in terms of "still having all their own teeth?")

Poor dental health may lead to cavities or eventually lead to a root canal or implant. These may be a source of smoldering infections. Lots of cavities often means lots of silver (amalgam) fillings, which can often result in toxic exposure to excess mercury.

A Good Smile May Mean Good Health

If you think that having healthy teeth are only important for chewing, you may learn something by reading on. It's long been felt that good, healthy teeth are an indication of health in general. How many times have you heard someone brag about their elderly mother or grandmother by saying something like “She's ninety years old and still has all her own teeth”? Why is it that your veterinarian always checks your animal's teeth and gums when they have a check-up? Why do horse buyers always check the dentition of their prospective purchase? Besides being a readily visible part of the body's skeleton, the health of our teeth offers important insights into the health of other parts of our bodies including the cardiovascular system, the gastrointestinal system, as well as our skeletal system.

Although seemingly disconnected, our teeth play an important role in the health of our hearts, our brains, our bones, and our reproductive systems. Research published last October in the Archives of Internal Medicine found that periodontal disease apparently doubled the risk of stroke in adults over the age of 25. Researchers concluded that “periodontal disease is an important risk factor for stroke.” Research from the Harvard Dental School and Brigham and Women's Hospital in Boston , published in the Journal of the American College of Cardiology this past February showed higher rates of heart attacks, death from cardiovascular causes, and stroke in people with periodontal disease.

These researchers, however, felt that other cardiovascular risk factors such as smoking or cholesterol may have accounted for both the poor dental health and the higher rates of heart disease. The idea that poor dental health can be a cause of heart disease or stroke is a controversial one, but one that has a plausible explanation. Medicine is now recognizing the important relationship between inflammation and the cardiovascular system. The research is now overwhelming that inflammation is an important cause of heart attack and stroke. This inflammation represents activation of the immune system, which courses through our bloodstream.

If our immune system has been activated by a dental or periodontal infection, the cells of our immune system trigger inflammation as they “sound the alert” and put our normally defensive immune system into the “search and destroy” mode. These cells travel through our bloodstream and can damage the blood vessels themselves, as well as distant organs. Even more importantly, these cells release cellular messages, called cytokines, which intensify the inflammatory process by recruiting even more cells of our immune system and triggering a cascade of inflammation. We are just beginning to learn more about these important cellular messages, and many different types have already been identified.

Some examples include “TNF-alpha, or tumor necrosis factor – alpha”, Interleukin-1, Interleukin-6, and NF-kappa-B. These cytokines have been implicated in the development of a large number of health conditions. Pharmaceutical companies are spending millions of dollars annually researching new drugs to block the effects of specific cytokines. Some of these new medications are already available and have been shown to have powerful effects in treating many inflammatory conditions such as rheumatoid arthritis and Crohn's disease, for example.

Often, a simple blood test is sufficient to detect even minor degrees of inflammation; this test is called the C-reactive protein . Even mildly elevated levels of C-reactive protein have been shown to be highly predictive of the risk of heart attack and stroke. One of the sources of this inflammation can originate from tooth and gum problems. By targeting and treating the tooth or gum problem, the level of C-reactive protein and inflammation are reduced.

Besides being a source of possible inflammation that can affect our immune and cardiovascular systems, the teeth are also a natural extension of our bones. Tooth retention has been linked to favorable bone density and a lower risk of osteoporosis. Cavities also indicate a diet that may be too high in sugar. Dental decay has also been associated with eating disorders such as bulimia and anorexia nervosa. These seemingly unrelated conditions highlight the importance of good dental and gum health for our overall longevity and vitality.

Our recommendation is for good preventive maintenance – brushing after each meal and flossing daily. We also recommend a visit to your preventive dentist at least annually.