What the mouth tells us about the health of our body – 12/18/2023 – Balance

When you go to the dentist, you usually do so thinking about taking care of your teeth and not your mouth as a whole.

But your mouth can be an easily accessible and highly accurate indicator of what’s going on in the rest of your body.

And maintaining good oral health can be essential for the body to function in optimal conditions.

“There are some commercials” in the UK, says Professor Nikos Donos, director of research at the Institute of Dentistry at Queen Mary University of London, during a panel on the BBC’s The Evidence programme, “that ask: ‘Would you ignore your eye if it was bleeding? Why do you ignore your gums when they bleed?”

“And there are people who go through life with severe gum disease believing it is normal.”

Ample evidence links gum disease —or periodontitis— to diabetes and coronary heart disease, and there are more and more studies that claim that oral health may be one of the most neglected battlefronts in the fight against these diseases.

“When we talk about the connections and associations between different chronic diseases and other parts of the body with the mouth, we see that there is a prevalence of gum disease,” explained Donos.

“And we see that gum disease is the sixth most common chronic disease in humanity, present in almost 1.1 billion people — 11.2% of the population.”

Gum disease

Among the possible symptoms, it mentions bleeding gums, redness or pain, or persistent bad breath.

And, in addition to the damage it can cause to the mouth, there is ample evidence linking gum disease to type 2 diabetes.

“In fact, we are currently talking about a bidirectional relationship,” Donos said, “which means that patients with periodontal disease are at greater risk of developing diabetes, and patients with diabetes will also have periodontal disease.”

The relationship is so close that there are studies that ensure that good oral care in people with type 2 diabetes can help control the disease in general, easily and without major side effects.

“A study we did a few years ago showed that if you treat periodontal disease in a conventional way — without surgical intervention — there is better metabolic control in patients, a significant improvement that was maintained for almost 12 months,” said Donos.

Also participating in the BBC panel was Dr. Graham Lloyd Jones, radiologist at Salisbury Hospital, in the United Kingdom, who assured that the relationship between the mouth and diabetes “makes sense.”

“We have to see the mouth as an immune organ: if it is compromised, there will be inflammatory processes, even pathogens — bacteria that normally live in the mouth, but pass to other parts of the body — that are involved in the development and worsening of many of these diseases “, warned the doctor.

From mouth to heart

Type 2 diabetes is not the only disease related to gum disease: as out-of-control periodontitis bacteria travel through the body through the blood system, they can end up affecting the heart.

“These inflammatory components that exist in the body due to periodontitis and reach the bloodstream,” said Donos, “can form plaques, which can lead to the formation of clots, which can have consequences ranging from ischemic heart problems to heart attacks.”

A case of infection that can be lethal and that occurs when the mouth’s defenses are low — due to an immunological disease or the use of medications — is endocarditis.

“Fortunately it is a rare disease,” explains Dr. Lloyd Jones, “but it is an infectious disease in which some organisms in the mouth get out of control and affect the internal tissues of the heart.”

“It’s clear that this anatomical path through the mouth, with pathogens going out to the rest of the body, is a real thing. Over time, this excess of bacteria that crosses the physical barrier of our mouth reaches the rest of the body through the bloodstream, which can lead to illness or the worsening of existing illnesses.”

The relationship with cognition

One of them is Dr. Vivan Shaw, from the University of Cambridge, who in her studies discovered that people who reach old age with 21 or more teeth show less cognitive deterioration than those who have fewer teeth.

“Although the evidence is relatively recent, we can say that if you have some type of cognitive impairment and lose dexterity, your ability to brush or floss your teeth may be affected,” says Shaw.

“It is also related to a nutritional issue: if you have fewer teeth, you will certainly have a worse diet, which leads to greater cognitive deterioration.”

Lloyd Jones, in turn, spoke of a more direct link: “There are specific organisms that have been linked to the development and worsening of gum disease.”

“One in particular, known as gingivalis, it’s very interesting. It is covered in neurotoxins, which kill nerve cells. But this organism doesn’t just stay in the mouth. It leaves our inflamed gums and travels throughout the body, and is found in both the brain and cerebrospinal fluid of people with Alzheimer’s.”

For Professor Donos, these relationships between the mouth and different body systems reinforce the importance of preventing periodontal disease.

Oral hygiene

For the specialist, it is essential that people have access to a good oral health system and that they follow up with a trusted dentist, with a focus on prevention.

“That’s the way forward. And also integrate dentistry and medicine more closely so that when we visit our doctor, our dentist, they’re not just looking at our teeth or our liver, but they can see the body as a system and correlate symptoms.”

A specific example where this combination of specialties can work is in prenatal care: according to Dr. Shaw, due to the hormonal changes that occur during pregnancy, these oral bacteria can gain strength and put mother and baby at risk.

“It worries us a lot because it increases the risk of premature births and low birth weight babies. Therefore, it is a phase in which it is crucial to talk to mothers and provide them with appropriate care.”

For Lloyd Jones, the most important thing is to change the way we think about our mouth: “We have to think about the concept of our mouth as an immune barrier that requires our care. Taking care of the microbes that live in our mouth and that evolved with us and who are there to protect us.”

This text is an adaptation into Portuguese of a live episode of the BBC program The Evidence, which you can listen to in English here.

The report was originally published here.