“Oral health is a human right, an integral part of general health and essential for overall well being” – World Health Organisation. The mouth is a major portal through which body receives nourishment, and it plays a central role in many important processes like respiration, speech, digestion and protection against microbial infections. As a gateway to the body, mouth is constantly challenged by various invading organisms like bacteria, viruses, fungi and parasites.
It is equipped with formidable mechanisms for sensing the external environment and defending against toxins or invading pathogens.
The mouth contains an extensive and diverse microbial community of than 500 bacterial species. One gram of plaque, a sticky biofilm of bacteria that forms constantly on tooth surfaces, may contain trillions of microorganisms and the role of healthy gum tissue is to act as a barrier to prevent these from circulating throughout the body, creating widespread inflammatory response.
Oral health and general health have a synergistic and dynamic relationship and diseases of the oral cavity may inflict damage on distant tissues and organs. Maintenance of good oral health is critical for sustenance of general health and vice versa. Poor oral health causes disability and is significantly associated with major chronic diseases.
General health problems in turn may cause or worsen oral health conditions. Nutritional status and oral health also share a reciprocal relation. The tissues in the mouth are composed of cells with a rapid turnover and require a regular and adequate supply of nutrients to maintain their integrity. Early signs of suboptimal nutritional status are usually first seen in the mouth and the dental surgeons are well placed to notice symptoms and signs of compromised nutrition, and initiate an appropriate action. A large body of contemporary research indicates a striking association between oral health and systemic health. The most simple and plausible explanation for this association is that any infection in the body stresses the immune system, and it is possible that inflammation of the mouth triggers generalised inflammation throughout the body.
Gum disease can weaken the immune system, and make a person more susceptible to diabetes, heart disease and cancer. The risk it poses to overall health is directly proportional to the severity of gum disease. Unfortunately, gum disease is painless until well advanced and does not get the attention needed. Current research has shown that gum disease can increase the risk of a heart attack by 20 to 40 percent, as well as double the risk of a stroke, in addition to being a cause of nearly one in five preterm births, and a factor in rheumatoid arthritis.
Few studies have also shown that gum disease can make arteriosclerosis and diabetes worse. Menopausal women are especially prone to periodontal (tissues around the mouth) disease, due to changes in calcium levels in the body, impeding the repair of bone loss. Thorough evaluation of a patient’s full mouth X-ray in this group of patients may aid in the diagnosis of osteoporosis, leading to a timely referral for specialist care. Dentist may be the first health care provider to suspect diabetes when gum disease is found in a routine checkup. Interestingly, significant improvement has been noted in diabetes control in some preliminary studies, when periodontal health is improved. Optimal oral health is therefore considered as important to controlling diabetes as diet and exercise.
Oral bacteria are also implicated in respiratory diseases and patients with periodontal disease and untreated decay of teeth are more prone to respiratory infection. There is a correlation between oral diseases and chronic obstructive pulmonary disease and particularly, the risk of pneumonia due to inhalation of oral bacteria in the medically compromised or sick patients cannot be over emphasized. Digestive disorders are also often first discovered by the dental health professional.
Bulimia or acid reflux can lead to specific erosion of the teeth and characteristic cobblestone fissures and swollen lips are associated with gastro-intestinal conditions such as Crohn’s or similar diseases. Chronic liver disease or hepatitis can result in thin, yellowish gum tissue.
Candidiasis (thrush) will cause white patches in the mouth. Mouth contains derivatives of all of the primordial germ layers and includes tissues not seen anywhere else in the body. It lends itself for an easy visual investigation or examination by palpation. It is a mirror that reflects and unravels many of the human body s internal secrets and it has been utilised as an indicator for systemic disorders for a long time. The art of tongue diagnosis which is an integral part of traditional Chinese and Ayurvedic medicine originates from this concept. There are over 400 systemic diseases with oral manifestations and often oral manifestations are the first sign or the most significant sign of systemic disease.
The dental health professional is frequently the first medical person to encounter such disorders. As the eye cannot see what the brain does not know, it is incumbent upon the dental surgeon to have an in depth knowledge of these manifestations and their significance. Saliva has hundreds of components that may serve, to detect systemic diseases or as evidence of exposure to various harmful substances, as well as providing bio markers of health and disease status.
The testing of saliva is a diagnostic technique that involves the laboratory analysis of saliva to identify markers of endocrine, immunologic, inflammatory, infectious, and other types of conditions. There are various types of saliva testing are considered to be more specific than blood testing. The mouth is aptly described as a mirror of health or disease, and serves as a sentinel or early warning system.
About The Doctor: Dr (Prof). Ramakanth Reddy Dubbudu MDS, MFDSRCS(Eng), FFDRCS(Ire), FDSRCS(Ed), FIBCSOMS Consultant Oral and Maxillofacial Surgeon Sunshine Hospitals – Gachibowli Branch Hyderabad.
About Sunshine Hospitals:
A Multi Super Speciality Institution, 500 bedded Sunshine Hospitals (Paradise Circle, Secunderabad) is promoted by globally reputed Joint Replacement Surgeon Dr. AV Gurava Reddy (Orthopedic Doctor) and like-minded associates who share the objective of making world-standard healthcare available, affordable and accessible to the common man.