The link between oral and systemic health
The oral cavity is the window to the rest of the body. Oral health and systemic health are thus directly related and the impact of oral flora on systemic health plays a big role.
Several hundred types of bacteria colonise different surfaces of the oral cavity so dental hygiene in general impacts systemic health greatly. A wider number of gram negative bacteria have an adverse effect on oral conditions. Periodontitis occurs as the bacterial colony of anaerobic bacteria increases, affecting the supporting structures of the tooth, resulting in a lack of connective tissue and leading to an inflammatory response.
Periodontal disease is characterised as a chronic inflammatory oral health condition and the bacterial challenge it brings activates our host immune system inducing a cascade of events which eventually causes tissue loss. The systemic implications of dental disease are vast and many systemic conditions including arteriosclerosis, diabetes, pulmonary disease are directly affected by it.
The risk factors of arteriosclerosis are smoking, increased blood pressure, increased cholesterol, and possible aetiologies arising from the oral cavity are chronic inflammation, and vascular injury due to release of inflammatory mediators. Periodontal disease activates the host inflammatory processes in the body, leading to the release of cytokines and C-reactive proteins, and a wide cascade of event follows leading to platelet aggregation. This damages the blood vessels, narrowing their size and can lead to transient ischemic attacks and stroke.
Diabetes and periodontal disease follow a bidirectional path, as hyperglycaemia leads to poor oral health and severe periodontal disease affects glycemic control adversely. The glycation end products increase as a result and our immune system elicits a host response leading to elevated levels of inflammatory markers and cytokines production which causes loss of connective tissue and bone loss leading to periodontal disease. Decreased salivary flow, bone loss, increase in Candida infections, poor healing, multiple abscesses are all dental implications of diabetes which makes periodontitis worse. A study shows that the risk of periodontitis is increased three-fold in people with diabetes. Diabetic patients who undergo periodontal treatment also respond to treatment better as the decrease in the bacterial load aids results similar to an additional medication added.
Respiratory diseases like chronic obstructive pulmonary disease, pneumonia, bronchitis, all involves the inhalation of bacteria from the oropharynx. Periodontal disease harbours these bacteria and the declining oral condition can help multiply these pathogens causing infections. In critically ill patients, which are on intubation due to respiratory illnesses, these can lead to ventilator associated pneumonia as well. Thus to conclude, systemic respiratory disease can be made inherently worse by periodontal diseases.
Many patients are not aware of the systemic link to oral disease and vice versa. With careful monitoring and planning, many systemic diseases can be managed better and improving oral health conditions can directly aid this. We at Delaware, aim to provide quality care to our patients and improve their living conditions.