(By Dr. Joseph D. Lim and Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI)
THERE is growing evidence on the close association of oral health and non-communicable diseases, the most prevalent form of ailments worldwide.
These diseases – including cardiovascular disease, diabetes and Alzheimer’s – are linked not just to overall health but also to oral health.
It reflects the growing importance of oral health as an indicator of overall health.
Take for example periodontitis or deep gum disease, the most common oral health diseases affecting Filipinos after dental caries or tooth decay. Based on the 2018 National Survey on Oral Health, half of the Philippine population at the time have gum disease.
It is the same in the United States where gum disease is the second most widespread oral disease after cavities. Gum disease affects nearly half of American adults over the age of 30. By the age of 65 and older, 64 percent have either moderate or severe periodontitis.
Worldwide, gum disease is the 11th most common disease.
Periodontitis is a hidden disease, with most people unaware of the condition until its very advanced stage. It is an infection deep below the surface of the gums.
The first stage is gingivitis found on the gum surface. Then the infection spreads into pockets below the gumline near the tooth root where they erode the structures that hold the tooth in place.
For many years after the infection, bacteria spread in the bloodstream.
Even without evident symptoms, the disease-causing bacteria wreak havoc in the gums and spread in the bloodstream, ultimately affecting oral and overall health.
“If you imagine the bloodstream as a bus, it will take passengers on – things like bacteria in the mouth – and it will go everywhere around the body,” says Sim K. Singhrao, Senior Research Fellow in the School of Dentistry, University of Central Lancashire, United Kingdom.
“Some will get off in the brain, some in the arteries, some in the pancreas or the liver,” Dr. Singhrao tells Martha Henriques, Editor of BBC Future Planet.
Left untreated, the bacteria cause inflammation worsen other inflammatory and other diseases from cardiovascular disease, diabetes, Alzheimer’s, to obesity, cancer, rheumatoid arthritis, Parkinson’s, pneumonia and complications in pregnancy.
Gum disease may worsen conditions such as atherosclerosis, the hardening of the artery walls. And vice-versa: atherosclerosis may also lead to periodontitis.
Of all non-communicable diseases, diabetes is associated closest to periodontitis. People with type 2 diabetes, for example, have a three-fold greater risk of developing periodontitis than people without, writes Ms. Henriques of BBC.
For people who have type 2 diabetes and periodontitis, the infection worsens their body’s ability to control blood sugar levels, she points out.
Left untreated, periodontitis may cause tooth loss. And there lies a deeper problem.
The more teeth lost, the more risks of cognitive decline and dementia, according to Dr. Bei Wu, Dean’s Professor in Global Health at New York University’s Rory Meyers College of Nursing.
Dr. Wu has studied the health data of 34,000 American patients, the largest study of its kind, and found that for every tooth someone loses, they have a 1.4 percent increase in risk of cognitive impairment and 1.1 percent heightened risk of dementia.
Compared with similar individuals who have complete sets of teeth, those who had lost teeth had a 48 percent more risk of cognitive impairment while 28 percent were more at risk of dementia, Dr. Wu tells the BBC.
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Dr. Joseph D. Lim, Ed. D., is the former Associate Dean of the College of Dentistry, University of the East; former Dean, College of Dentistry, National University; Past President and Honorary Fellow of the Asian Oral Implant Academy; Honorary Fellow of the Japan College of Oral Implantologists; Honorary Life Member of the Thai Association of Dental Implantology; and Founding Chairman of the Philippine College of Oral Implantologists. For questions on dental health, e-mail or text 0917-8591515.
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Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI, graduated Doctor of Dental Medicine, University of the Philippines, College of Dentistry, Manila, 2011; Bachelor of Science in Marketing Management, De la Salle University, Manila, 2002; and Master of Science (MSc.) in Oral Implantology, Goethe University, Frankfurt, Germany, 2019. He is an Associate Professor; Fellow, International Congress of Oral Implantologists; Member, American Academy of Implant Dentistry and Fellow, Philippine College of Oral Implantologists. For questions on dental health, e-mail ./PN
