However perfect your oral hygiene, your mouth is still filled with microbes — about 700 species of them, give or take. While some of these organisms are beneficial, many others are responsible for the growth of plaque, the sticky film that paves the way for tooth decay and gum disease. What’s more, the same germs that can cause bad breath and lead to bleeding gums have been linked to an array of systemic health problems that, at first glance, might seem like they have little to do with your mouth.
The exact relationship between oral health and conditions such as heart disease and dementia is still being teased out, and there’s no proof that failing to floss directly causes them. Yet it’s already clear that oral health and full-body health are inextricably linked.
“Studies suggest that periodontitis, which is an infection of the gums and surrounding tissues, is associated with conditions like dementia, heart disease and diabetes,” says Ada Cooper, a New York-based dentist and consumer adviser and spokesperson for the American Dental Association. By the same token, she notes, periodontitis is more likely to be present in people who have those other conditions. While she stresses that these for now are only associations, not known causes and effects, “they’re interesting and concerning, and we want to know more.”
Inflammation could explain the mouth-body link
At the moment, there are two main theories to explain why problems in the oral cavity — especially gum disease (aka periodontitis) — might increase the risk of disease in far-flung parts of your body. “One is inflammation,” says Frank Scannapieco, doctor of dental medicine and chair of oral biology at the University at Buffalo School of Dental Medicine. He likens gum disease to an abscess on your leg: Tissue gets wounded, and inflammatory chemicals rush in to help it heal and keep invaders like bacteria at bay.
When this happens in your gums, “the same inflammatory mediators produced by cells in the tissue there can be released into the blood,” which enables these substances to travel to other organs and damage them, he explains.
The second theory also has to do with inflammation, albeit indirectly. Periodontitis makes the gum tissue more permeable, which means it’s easier for bacteria and other microbes in the mouth to enter the bloodstream. The bacteria can then migrate to various body parts and cause inflammation and damage in those areas.
Either way, older adults are particularly at risk. Periodontal disease and other oral health problems become more common with age, at a time when many people lack the resources to properly address them. “The lack of dental access through programs like Medicare has left more than 26 million people without dental benefits,” says Julie Frantsve-Hawley, director of analytics and evaluation at the CareQuest Institute for Oral Health.