22 Oct Life Expectancy and Oral Health
A Simple Guide to a Complex Relationship
In a sentence, cleaning your teeth helps you live longer. Clearly, it’s a bit more complicated than that. In fact, the relationship between good oral health and life expectancy is very complicated indeed.
A study, published in the ‘Community Dentistry and Oral Epidemiology journal’, investigated the link between tooth loss and mortality. It revealed the number of teeth a person retains has a statistical relationship to how long they can expect to live. The study suggested that people with 20 teeth or more at the age of 70 were more likely to live longer than those with fewer than 20 teeth.
So why is this?
The mouth is a zoo
The human mouth is home to around 600 different species of bacteria at any given time (some sources claim as many as 1,000 species). Fortunately, most of them are harmless. The majority of the others can be managed by regular oral hygiene practices such as brushing and flossing. But left to their own devices they will cause problems as they multiply out of control, fuelled by our sugary ‘western’ diet. The results lead to bad breath, tooth decay, inflammation, and gum disease. And the toxins they produce as waste products affect many other organs and bodily functions.
One of the reasons for this is that gums have a high concentration of blood vessels in comparison to other parts of the body. Inflamed and diseased gums easily start to bleed. This is an open wound that allows the bacteria in your mouth to travel throughout your body. And where they find a hospitable home, they can quickly start another infection.
Heart conditions and oral health
It’s widely understood that one of the systems affected by bacteria from the mouth is the heart and circulatory system. Blood vessels and organs become inflamed as they try to fight the bacteria. This places an increased load on the heart as blood vessels become constricted, increasing blood pressure in the process. If the bacteria develop in the blood vessels of the heart, this constriction can lead to chronic heart conditions or even a heart attack.
It has also been noted that patients who suffer heart conditions are more likely to also suffer poor oral health and gum disease as a result. This two-way, cause and effect relationship can become a bit of a feedback-loop if left unchecked. This has been investigated by the Mayo Clinic. Researchers found that the same bacteria that cause gum disease can also infect the soft tissues within your heart if they are damaged. This was found to cause the heart condition, endocarditis (an infection of the inner lining of your heart chambers – the endocardium).
The blood clotting process that occurs as gums heal also causes heart problems. In fact, it has been linked to clogged arteries, high blood pressure, heart disease and stroke. Blood clots from healing wounds increase the chance of a clot breaking loose from one place and getting stuck elsewhere in the cardiovascular system.
Certain bacteria from the mouth can also transfer into the lungs. Some of them can cause pneumonia and other respiratory diseases.
Oral health and diabetes (types I and II)
As a diabetic, this is very personal to me. I was diagnosed when I was pregnant with my first child. The condition took me from being a healthy, athletic member of the Essex County Hockey team (and a competitive trampolinist), to a pretty sick person in a matter of months.
Like many pregnant women, despite meticulous care, my oral health started to suffer. As I was putting on weight and feeling ill, my dentist recommended that I get a blood test the next time I visited the doctor. And, indeed, I was diabetic.
The link between oral health and diabetes is starch and sugar. The bacteria that cause gum disease thrive on the starch and sugar in our diet. As diabetes affects the way our bodies metabolise and store starch and sugar, advanced gum disease can be an indicator of the condition.
Again, there is a closed-loop system between gum disease and diabetes. Because the condition impairs the body’s immune system, diabetes can put gums at risk. Indeed, gum disease is more frequent and severe among people living with diabetes.
But it works to our advantage as well. Research also shows that people who have gum disease struggle to control their blood sugar levels (the key problem caused by diabetes). It appears that good periodontal care can help control diabetes and therefore improve blood sugar management.
Other conditions and diseases that, like diabetes, damage the immune system, also cause damage to the gums and oral cavity. Sufferers of HIV and AIDS, for example, commonly develop painful mucosal lesions and make existing oral health problems more severe.
Healthy gums, healthy baby
We all know that pregnant women are entitled to free NHS dental treatment. But it’s not just their teeth that pregnancy affects. When researching this article I found out that periodontitis has been linked to premature birth and low birth weight. So, yet another reason to encourage them to take full advantage of their free treatment. AND a reason for a woman to double-up on oral care if she’s trying to fall pregnant.
Dementia and oral health
It’s not just length of life, but the quality of life. Although there is no proven direct cause of poor oral health leading to Alzheimer’s disease, there is plenty of evidence that the oral health of Alzheimer’s disease sufferers declines as the condition develops. And that leads to an increased likelihood of the other conditions brought on or worsened by poor oral health at a point where the sufferer is already vulnerable.
If your mouth feels good then so do you
The diseases and conditions brought about or contributed to by poor oral health have an impact on life expectancy. They can at the very least make life less enjoyable. They can even have an impact on areas of life you wouldn’t automatically think about, such as insurance rates.
Levels of bacteria and infection in the mouth increase toxicity and inflammation through the whole body. Bacteria entering the bloodstream from the mouth places a load on the immune system, which has work harder to manage them. Over time this leads to increased physical stress, fatigue, slower healing, and an increase in the risk of contracting other diseases. Basically, it will make you feel ill.
When medicine makes you ill
Some medications — such as decongestants, antihistamines, painkillers, diuretics and antidepressants — reduce the flow of saliva. This is important as saliva helps move food from the mouth. It also acts as a buffer, neutralising acids produced by bacteria, reducing the decay and making conditions for bacteria to multiply less favourable. Certain drugs used in the treatment of osteoporosis can damage the bones of the jaw. This leads to gum disease and tooth loss.
So now you know …
I wrote this article because I am fascinated by the way people think about teeth. It’s characterised by a TV advert from a leading manufacturer of toothpaste. The ‘gym bunny’ fronting the ad knows how to keep her bum, hips and heart-healthy, but asks what she should do to keep her mouth healthy. I don’t understand why people think of their mouths as somehow
separate from the rest of their bodies. If you badly cut your arm you would seek treatment to stop bleeding, repair the damage and avoid infection. Yet some people are quite happy to ignore a broken tooth or a cut gum until it becomes infected.
Could it be that we complain to our GP about aches and pains in every other part of ourselves except our teeth? For that, we instead complain to an entirely separate person – our dentist. Some people take a similar attitude towards mental health and psychologists/psychiatrists. That separation by profession is the best reason I can think of for the separation of ‘attitudes’.
But the point of this article is that you simply CAN’T separate oral health from bodily health. To minimise the risk or mitigate the damage of many bodily diseases you first have to have a healthy mouth.
I would be very keen to hear other people’s thoughts, so please email them to me at email@example.com and we will publish any suitable points as comments on the Pearl website.
Pearl provides the most complete support for the whole patient journey. And that includes excellent Periodontal charting facilities, and an interface to Spacemark D’s application to map Periodontal interdental treatment regimes. For more information about Pearl and what it can do for your practice, please call us on 0116 275 9995 or email us at firstname.lastname@example.org.
About the author
Cary Cray-Webb is a registered dental nurse and director of Precision PR Ltd. As well as working on the Pearl Dental Software PR programme, Cary also works as an NHS administrator and nurse at Dental HealthCare Services in Cambridge. Her articles have been published in a number of professional magazines including BDJ-Team.