2024-03-08 23:37:00
Worldwide, according to the World Health Organization, 3.5 billion people have oral health problems.
Caries affects 2.5 billion people and periodontal disease affects 1 billion. Aside from the oral cavity, poor oral hygiene can harm overall health. Overview of the health risks of a mouth in poor condition.
- Periodontal diseases: gingivitis and periodontitis
Periodontitis is an inflammatory reaction affecting the periodontium, that is to say all the structures which allow the anchoring of the teeth (gums, ligaments, alveolar bone). It is caused by gingivitis, a local inflammation of the gums which has not been treated. Periodontitis is responsible for a gradual resorption of the gums, and where applicable, tooth loss. It is also the primary cause of tooth loss. This disease and the bacteria linked to it are also associated with many other diseases: cardiovascular diseases, diabetes, cancers, etc.
- Cardiovascular illnesses
Infective endocarditis is a serious infection of the endocardium (the tissue lining the chambers of the heart), associated with a high mortality rate. It is often the result of the presence of bacteria in the blood (bacteremia), the starting point of which is generally oral and dental, underlines the High Authority for Health. Concretely, the infection comes from the bacteria in dental plaque which enter the bloodstream to reach the heart and attach to its internal cavities.
Several studies have also pointed to an association between periodontal disease and atherosclerosis – the formation of atherosclerotic plaques in the walls of arteries – which is the cause of most cardiovascular diseases. According to the specialized online magazine Dental floss, two distinct mechanisms might be at work, or even combine. On the one hand, periodontal bacteria are found in the blood circulation and enlarge the pre-existing atherosclerotic plaques. On the other hand, “periodontal diseases cause an immuno-inflammatory reaction which results in the production of pro-inflammatory mediators, pro-thrombotic factors which, through systemic circulation, are found at the level of atherosclerotic plaques”.
The relationships between diabetes and periodontal disease have been widely documented. Thus, poorly controlled diabetes would triple the risk of developing periodontal disease. Indeed, chronic inflammation associated with diabetes contributes to the destruction of periodontal structures.
Conversely, “chronic inflammation generated by periodontitis increases insulin resistance and in turn disrupts blood sugar control,” summarizes the Prevention Observatory of the Montreal Heart Institute (Canada).
Periodontitis and inflammatory bowel disease (IBD) are also believed to be linked. Bacteria ingested via saliva contribute to intestinal inflammation by disrupting the intestinal microbiome (the intestinal flora, composed of billions of microorganisms). As with diabetes, the converse is true.
Periodontal disease may be linked to Alzheimer’s disease, once more due to bacteria from the gums passing into the bloodstream. According to a study, P. gingivalis, the bacteria most frequently found in periodontitis, has been identified in the brains of patients with Alzheimer’s disease. It would act negatively on the Tau protein and amyloid peptides, the main components of the neuropathological lesions of Alzheimer’s disease.
Rheumatoid arthritis is a chronic inflammatory disease that affects the joints. The disease progresses in outbreaks until the joints are destroyed. Several epidemiological studies reveal an association between this disease and chronic periodontitis. According to a 2020 study, “the inflammation caused by periodontitis stimulates the production of cells that increase bone resorption in the joints”, relays the Prevention Observatory of the Montreal Cardiological Institute.
A 2016 study published in the journal Annals of Oncology points out the links between poor oral hygiene and the occurrence of head and neck cancer. “Good oral hygiene is associated with a lower risk of head and neck cancers,” concluded the authors.
Furthermore, the Prevention Observatory relays several studies on this possible association. The most recent (2022) concludes that the incidence of colorectal cancer is 50% higher in individuals with a history of periodontitis. Additionally, periodontal bacteria have been observed in colorectal and oral cancers. And high levels of antibodies once morest P. Gingivalis are associated with the occurrence of pancreatic cancer.
- Risks during pregnancy
Finally, if cause and effect links remain difficult to establish, periodontitis might produce harmful effects in pregnant women. According to a medical thesis defended in 2022, which aimed to review the literature on the subject, “the presence of Porphyromonas gingivalis can be the cause of a reduction in birth weight but also of an increase in the inflammatory reaction which can lead to pre-eclampsia and therefore premature delivery”.
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