Poor oral hygiene is related to diabetes and dementia – 04/13/2023 – Equilíbrio

The inside of the mouth is the perfect place for bacteria to thrive: it’s dark, warm and humid, and the food and drinks we consume provide nutrients for them to feed on.

However, when harmful bacteria build up around teeth and gums, people are at risk of developing periodontal (or gum) disease, experts say, which is an infection and inflammation of the gums and bones surrounding the teeth.

And such conditions in the mouth can influence the rest of your body, says Kimberly Bray, professor of dental hygiene at the University of Missouri-Kansas City.

A growing, albeit limited, body of research, for example, has found that periodontal disease is associated with a range of health conditions, including diabetes, heart disease, respiratory infections and dementia.

Exactly how oral bacteria affect your overall health is still poorly understood, Bray points out, since existing research is limited and no studies have established cause and effect.

But some conditions are more closely associated with oral health than others, experts say. Here’s what we know.

Health problems related to oral hygiene

About 47% of people age 30 and older in the United States have some form of periodontal disease, according to the US government’s Centers for Disease Control and Prevention.

In its early stages, called gingivitis, the gums can become swollen, red or tender and can bleed easily. If left untreated, gingivitis can turn into periodontitis, a more serious form of the disease in which the gums can regrow, bone can be lost, and teeth can become loose or even fall out.

With periodontitis, bacteria and their toxic byproducts can move from the surface of the gums and teeth into the bloodstream, where they can spread to different organs, says Ananda P. Dasanayake, professor of epidemiology at the New York University School of Dentistry. York.

This can happen during a dental cleaning or flossing, or if you have a cut or sore inside your mouth, he says.

If you have inflammation in your mouth that goes untreated, some of the proteins responsible for that inflammation can spread throughout your body, Bray points out, and potentially damage other organs.

Diabetes

Of all the associations between oral health and disease, the one with the most evidence is between periodontal disease and diabetes, says Bray. And the two conditions appear to have a two-way relationship, she added: Periodontal disease appears to increase the risk of diabetes and vice versa.

Researchers have yet to understand exactly how this works, but in a review published in 2017 researchers wrote that systemic inflammation caused by periodontal disease can worsen the body’s ability to signal the need for insulin and respond to it.

In another study, published in April, scientists found that diabetics who were treated for periodontal disease saw their overall healthcare costs decrease from 12% to 14%.

“You treat periodontal disease, you improve diabetes,” says Dasanayake.

Pneumonia

If large amounts of bacteria from the mouth are inhaled and settle in the lungs, a person can get bacterial aspiration pneumonia, points out Frank Scannapieco, professor of oral biology at the University at Buffalo School of Dental Medicine.

This phenomenon has been seen mostly in hospitalized patients or elderly people in shelters, and it’s a concern for those who can’t floss or brush their teeth on their own, says Martinna Bertolini, assistant professor of dentistry at the University’s School of Dental Medicine. from Pittsburgh.

Preventative dental care, such as professional teeth cleaning or periodontal treatments such as antibiotic therapy, can reduce the risk of developing this type of pneumonia, indicates Scannapieco.

Cardiovascular disease

In a report published in 2020, an international team of experts concluded that there is a significant link between periodontitis and heart attack, stroke, plaque buildup in arteries and other cardiovascular conditions.

While researchers haven’t determined how poor oral health can lead to worse heart health, some evidence suggests that periodontal bacteria from the mouth can travel to the arteries in patients with vascular disease, potentially playing a role in the development of the disease.

And a 2012 statement from the American Heart Association noted that inflammation in the gums was associated with higher levels of inflammatory proteins in the blood, which have been linked to poor heart health.

Some research also suggests that better oral hygiene practices are linked to lower rates of heart disease.

pregnancy complications

Several studies and reviews have found associations between severe periodontal disease and premature babies with low birth weight, says Dasanayake. But more research is needed to confirm the relationship.

In a 2019 review, researchers found that treating periodontal disease during pregnancy improved birth weight and reduced the risk of premature delivery and death of the fetus or newborn.

And in a 2009 study, researchers found that oral bacteria can travel to the placenta — potentially playing a role in chorioamnionitis, a serious infection of the placenta and amniotic fluid that can lead to premature birth or even life-threatening complications if left unchecked. treated.

Research also suggests that bacteria in the mouth can activate immune cells circulating in the blood, causing inflammation in the uterus and potentially harming the placenta and fetal tissues.

There is long-standing research showing that periodontitis can induce premature labor in animals such as mice, and treating this infection can protect against low birth weight and premature labor.

Insanity

Researchers are increasingly interested in the role of oral health in dementia, particularly Alzheimer’s disease, says Scannapieco.

“The bacteria that are found in the mouth have actually been identified in the brain tissue of patients with Alzheimer’s,” he says, suggesting a potential role for them in the disease.

In a recent review, scientists noted that oral bacteria – especially those related to periodontitis – can affect the brain directly through “central nervous system infection” or indirectly by inducing “chronic systemic inflammation” that reaches the brain.

However, there is no evidence that oral bacteria alone can cause Alzheimer’s disease, the review authors wrote. Rather, periodontal disease is just one “risk factor” among many for people predisposed to Alzheimer’s disease or other forms of dementia.

Other conditions

Oral bacteria have also been strongly linked to a number of other conditions, such as rheumatoid arthritis and osteoporosis, says Bray. And emerging research is beginning to link oral bacteria to kidney and liver disease, as well as colorectal and breast cancer.

What can you do

The best way to maintain good oral health is to follow classic dentistry advice, such as brushing your teeth twice a day and flossing daily, says Scannapieco.

Translated by Luiz Roberto M. Gonçalves