Related Illnesses

There are numerous health problems related to your mouth.  Concerns range from cavities and tartar to much more serious aliments. For some of the ailments, there is growing evidence (that may not yet be totally concrete) that these problems lead to other whole body illnesses.

This section will link to a growing list of related illnesses and provide information as we obtain it.

The Link to Heart Disease

Heart disease and periodontal disease are drawing increased attention to determine if there is a close relationship between developing oral health issues and heart disease.

Certainly, periodontal disease and heart disease have several things in common. First, periodontal disease is defined by the inflammation which breaks down the gum tissue and bone structure that hold teeth in place. In heart disease, similar inflammation narrows the coronary arteries. Some medical research is studying whether bacterial pathogens or inflammatory chemicals resulting from periodontal disease are being carried to the heart and causing the inflammation there that results in coronary disease.

Currently, animal research has shown indications that such a relationship may exist. Specifically, periodontal bacteria have been found in the plaque deposits that narrow coronary arteries. In observational human studies as well, it has been found that heart disease is much more likely to occur in patients with periodontal disease.

Importantly, more research needs to be done to better define the relationship. In the meantime, everyone should exercise caution and be conscientious about managing the health of their gums. It is better to be safe than sorry!

Pregnancy And Oral Wellness

Increasing evidence is suggesting that poor oral hygiene during pregnancy can adversely affect the health of newborns.

During pregnancy, the increase in hormonal activity can cause gums to bleed more easily--leading to opportunities for bacteria to gain a foothold in the mouth and grow. As the bacteria gains a foothold in the gums, the bacteria from dental plaque can enter the bloodstream through small ulcers in the gum and can be sent throughout the body.

The problem in pregnancies occurs next when oral bacteria in the mother's bloodstream breaches the placenta and reaches the fetus. It can then trigger an immune and inflammatory response in the fetus--stressing the unborn child. Early studies suggest that such infections may account for up to 50% of premature births as well as miscarriages.

It thus becomes very important for women early in their pregnancies to get a full oral health exam and immediately manage any issues that may lead to bacterial problems.

Diabetes And Oral Wellness

The relationship between diabetes and oral wellness possesses a particular challenge to patients and oral professionals. There is a two-way interaction between diabetes and oral health that is very serious and requires proper attention.

As background, there are currently about 20 million Americans affected with diabetes, and about one-third of these people are unaware they have the disease. Of those who have been diagnosed, less than half have the ailment under control.

With diabetes, the body does not properly produce or use insulin--a hormone which regulates how sugar enters the cells and provides energy to the cells. In both Type 1 and Type 2 diabetes, sugar cannot enter the cells and builds up in the bloodstream. Cells become starved for energy. Over time, high blood sugar in the bloodstream can damage vision (even causing blindness), trigger kidney damage, nerve damage, and heart disease. It also causes wounds to heal poorly.

With regards to oral health, diabetes also increases the risk for periodontal disease. It has been shown through research that periodontal disease occurs more frequently in diabetics.

Importantly, new research shows that conversely, periodontal disease in diabetics can adversely affect their ability to control their blood sugar levels, and can contribute to diabetic complications such as heart and kidney disease. However, proper treatment of the periodontal condition reduces the level of inflammation in the tissues around the teeth, and actually improves the ability of the diabetic to control their blood sugar levels.

Thus, diabetes often causes periodontal disease which in turn affects blood sugar level control--causing a downward spiral of health. It is crucial that diabetic patients work closely with their dentists to address this vicious cycle and pay proper attention to the management of oral and diabetic health.

Osteoperosis And Oral Wellness

A recent University of Buffalo study has shown a fairly consistent relationship exists between oral infection and osteoporosis--especially in women 70 years old or older.

Further study is required to determined if periodontal disease causes osteoporosis, or whether individuals with a genetic disposition to bone loss are also more vulnerable to periodontal destruction and bone loss in the jaw.

At this time, there is no definitive cause and effect relationship, but older patients who are seeing bone quality loss need to be aware of the implications for oral issues that likely may result concurrently.

Oral Cancer

This year alone, more than 30,000 Americans will be diagnosed with oral cancer and 8,000 will die of the disease. More common than leukemia, Hodgkin's disease, and cancers of the brain, liver, bone, thyroid gland, stomach, ovaries, and cervix, oral cancer is a major cause of death and disfigurement in the United States, according to the National Cancer Institute (NCI).

Risk Factors

Approximately 75% of all oral cavity and pharyngeal cancers--mouth, tongue, lips, throat, parts of the nose, and larynx--are attributed to the use of smoked and smokeless tobacco, according to the Centers for Disease Control and Prevention (CDC). Those who choose to use cigarettes, cigars, pipes, chewing tobacco, snuff, and/or bidis (cigarettes from India that come in a variety of flavors and contain less tobacco than regular U.S. cigarettes, but have three times more nicotine and five times more tar) place themselves at a much higher risk of developing oral cancer and other diseases, such as heart disease and chronic obstructive pulmonary disease (COPD)--a term used to describe emphysema and chronic bronchitis. Studies also have linked chronic alcohol use to oral cancer. Researchers believe that chronic alcohol use, combined with the use of tobacco products, multiplies the risk. In addition, sun exposure is a risk factor for lip cancer.

According to CDC, oral cancer occurs twice as often in males as in females. This is considerably different from the 5:1 male to female ratio of 40 years ago. Increased tobacco use among women is the main reason for the changes in cancer rates compared with the rates in the 1950s. Age is also a factor; 95% of oral cancer occur in persons over the age of 40, with 60 being the average age of diagnosis.

Early Detection Is Key

In its early stages, oral cancer can be treated in up to 90% of cases. However, if the cancer goes undetected, it can spread to other parts of the body and become more difficult or nearly impossible to treat. The oral cancer screening--head and neck exam--is one of the most critical components of a routine dental hygiene and dental exam. Dental hygienists and dentists can alert patients to suspicious growths and changes, noted during head and neck exams, and urge them to seek medical care.

Signs and symptoms of oral cancer can include:

  • Sores that do not heal
  • Lumps on the lip or in the mouth or throat
  • White or red patches on the gums, tongue, or lining of the mouth
  • Unusual bleeding, pain, or numbness in the mouth
  • Sore throats that do not go away, or a feeling that something is caught in the throat
  • Difficulty or pain with chewing or swallowing

New Testing Breakthroughs

Now we have new wellness exam technology that dramatically improves our ability to screen for oral abnormalities that could lead to oral cancer. Because early detection is essential to increase chances for successful treatment, we always check your whole mouth (tongue, lips, cheek lining, and gums).

We have recently acquired Vizilite, a state-of-the-art, painless, non-invasive screening tool that helps us to see what we can't see with the unaided eye during your routine oral cancer checkup.

What can you expect during a Vizilite examination? We'll ask you to rinse vigorously with a safe non-toxic solution for 30-60 seconds. The solution tastes a bit vinegary. After you rinse, we'll dim the lights and take a look inside your mouth with a special light that looks much like a glow stick. The entire procedure takes only about ten minutes. All of the screening kit components are discarded after use, so you will be the only patient ever tested with that kit.

Because the chemiluminescent technology will highlight any surface irregularities including normal scarring from chewing or rubbing on your gums or cheek, we mark everything down on a map or atlas of your mouth. This gives us a baseline for future reference.

We want all of our patients to have a bright and smiling future. And because in it's earliest, most treatable stages, oral cancer usually causes no pain or discomfort, we will perform this test for you every year.

Treatment

As researchers continually seek out more effective drugs and drug combinations to help combat oral cancer, the most common current treatment for oral cancer, according to NCI, is to remove any tumors surgically. Oral cancer also may be treated using intensive chemotherapy. Chemotherapy uses drugs to destroy the cancer cells. Anticancer drugs stop cancerous cells from growing and multiplying. Often, combination chemotherapy--multiple drugs administered together--are more effective than single agents.

Radiation is another option for patients with small tumors. Larger tumors may require both radiation and surgery. Recovery usually takes place through outpatient therapy that requires several days a week for multiple weeks for best results. To help prevent serious problems and eliminate the chance for undesirable side effects, patients should see their oral health care providers at least two weeks before starting radiation, for a full mouth evaluation.

Rehabilitation may range from speech therapy and reconstructive plastic surgery to nutritional and psychological counseling. Whatever the treatment used to treat oral cancer, regular oral health care is essential to prevent infection and support the healing process. And for more information about oral health care, please ask your registered dental hygienist, visit the ADHA Web site at www.adha.org

Source: National Institute of Dental and Craniofacial Research's (NIDCR) National Oral Health Information Clearinghouse in partnership with the National Cancer Institute, the National Institute of Nursing Research, the Centers for Disease Control and Prevention, and the Friends of the NIDCR.