Can't ever find the time to take care of your teeth? About half
of Americans don't
floss daily, and one in five don't brush twice daily -
so you're not alone.
But you may want to reconsider.
"Taking
care of your teeth and gums isn't just about preventing
cavities or bad breath," the American Dental Association warns. "The mouth
is a gateway into your body's overall health."
It's almost impossible to prove a cause-effect relationship between dental
neglect and various conditions because researchers would have to create a
control group that ignored their teeth completely for a long time - something
that would likely be harmful enough to be considered unethical. But there's
mounting evidence that shows an association between poor dental hygiene and a
wide variety of ills.
You should visit the dentist at least once a year, and the
ADA recommends that you
brush twice a day for
two minutes and
floss once a day. If you choose to ignore their advice,
you'll
get cavities, sure - but here are 13 other things you're at risk of,
some more common than others.
1. Gum disease
Most people don't realize this, but your gums are not supposed to bleed when
you
brush and floss. If yours do, you probably have gum disease - or are at least well on your
way.
Gingivitis, the milder form of
gum disease, makes gums red, swollen, and
quick-to-bleed - part of a response to the bacteria in the plaque that builds
up between your teeth and gums. More than half of Americans have
gingivitis.
If plaque spreads, the immune response heightens and can destroy tissues and
bones in the mouth, creating pockets between the teeth that can become
infected. (Other conditions unrelated to oral hygiene habits can also have
these effects.) At this severe stage, gum disease is called
periodontitis, and
it can become chronic. Google "
periodontitis," and you might become more
vigilant about oral hygiene.
Source: American Academy of Periodontology; Clinical
Calcium, 2012
2. Tooth loss
If you've never worried about losing your teeth, you should start. Adults 20
to 64 have lost an average of seven (permanent) teeth, and 10% of Americans between 50 and 64 have absolutely no teeth
left. Both cavities and
gum disease can end in
tooth loss.
Source: National Institute of Dental and Craniofacial Research
3. Bad breath
Bad breath, clinically called halitosis, may affect as much as 65% of the
population. A number of conditions can have halitosis as a symptom, but the
number one by far is poor oral hygiene. Food particles that linger long after
meals can start to stink, and the less you
brush and floss, the more
potentially malodorous bacteria build up in your mouth. The coating on your
tongue is also a key contributor to bad breath, and some research has suggested
that cleaning your tongue - along with regular brushing and flossing, of course
- may help reign in this problem.
Source: Internal and Emergency Medicine, 2011; International
Journal of Oral Science, 2012; Nursing
Research, 2013
4. Dementia
A large, long-term study of residents at a
Laguna Hills retirement community suggests
that there may be a link between poor dental health and dementia, although it's
possible that people with better oral hygiene have better health habits in
general. Researchers followed 5,468 people for 18 years and found that - among
those who still had teeth - those "who reported not brushing their teeth
daily had a 22% to 65% greater risk of dementia than those who brushed three
times daily." In addition, a small study found that the brains of patients
with Alzheimer's had more bacteria associated with
gum disease than did those
belonging to the cognitively healthy.
Source: Journal of the American Geriatrics Society, 2012; Journal of
Alzheimer's Disease, 2013
5. Pneumonia
When pathogens lurk in your mouth, you inhale them right into your lungs,
where they can wreak all kinds of havoc. One major review pointed to this
process as the reason for an association between poor oral hygiene and
hospital-acquired pneumonia. Improving
oral hygiene - through some methods
beyond brushing and flossing in this case - reduced the incidence of such
pneomonia by 40%. Another study of 315 patients in a Brazilian hospital found
that those with periodontitis were almost three times as likely to have
pneomonia.
Source: Annals of Periodontology, 2003; Journal of
Periodontology, 2013; Gerondontology, 2013
6. Erectile dysfunction
A connection between dental disease and erectile dysfunction may seem
remote, but preliminary research suggests that the conditions could be linked.
They both have been tied to Vitamin D deficiency, smoking, and general
inflammation, but the exact reason for the association is still a mystery. One
study in rats found that
periodontitis impaired penis function. While it's
unclear whether the same direct effects would be found in humans, in a group of
patients between 30 and 40, 53% of those with erectile dysfunction had severe
periodontitis, while only 23% of those without ED did. "We think that it
will be of benefit to consider
periodontal disease as a causative clinical
condition of ED in such patients," the authors wrote.
Source: The Journal of Sexual Medicine, 2011; The Journal of Sexual Medicine, 2012; Journal of Clinical Periodontology, 2012
7. Brain abscess
Often caused by bacterial infection, an abscess is a collection of pus, with
swelling and inflammation around it. In the brain, it is fatal if left untreated. "A poor dental condition,
notably destructive
periodontal disease, can be a risk for
life-threatening" disease in other parts of the body, noted a team of
scientists who pinpointed a patient's extremely poor dental health as the
likely cause of his life-threatening brain abscess. Brain abscesses are rare,
and there has been no systematic study linking them to bad dental hygiene. But
the authors noted at least 12 other case reports of brain abscess that pointed
to poor dental hygiene as the probable cause.
Source: Journal of Clinical Periodontology, 2011
8. Diabetes
Dentists have long known that diabetes is a risk factor for
periodontitis,
but now research is beginning to indicate that the relationship may be
bidirectional. Extremely poor dental health may also be a risk factor for
insulin resistance (often called "pre-diabetes") and
diabetes,
largely because it increases inflammation. Some studies have even indicated
that in patients with both conditions, reigning in
periodontitis may improve
diabetes control.
Source: Annals of Periodontology, 1998; Diabetes
Care, 2010; Diabetes & Metabolism Journal, 2012; Journal
of Applied Oral Science, 2013
9. Kidney disease
About 3.7% of
U.S.
adults have chronic kidney disease, but certain people are more at risk. People
with periodontal disease were 4.5 times more likely to have chronic kidney disease,
making poor dental health a stronger risk factor than high cholesterol. Adults
with no remaining teeth were also 11 times more likely to have chronic kidney
disease. While
dental conditions are not the strongest risk factor - people
older than 60 are 27 times more likely to have chronic kidney disease than
younger people, for example - another study confirmed that it may be a
significant risk for kidney disease, even after controlling for underlying
health conditions that may contribute to both.
Source: American Journal of Kidney Disease, 2008; Journal
of Periodontology, 2010
10. Heart disease?
Multiple studies have suggested that there may be a
connection between gum disease and heart disease, both of which are associated with inflammation.
"Adding oral health self-care... is prudent to improve patients' oral
health and possibly reduce [coronary heart disease]," concluded one study.
"Periodontal disease caused by pathogen bacteria... could represent one of
several possible causal factors of heart disease," concluded another.
The authors of a 2008 review for the U.S. Preventative Services Task Force recommended
that periodontal disease be considered a marker of risk for heart disease,
independent of traditional risk factors - even though they noted a lack of
evidence demonstrating a causal relationship.
But a scientific statement from the American Heart Association in 2012 urged
caution: Periodontal disease and heart disease share many underlying risk
factors; there's no reason to think that dental problems directly cause heart
disease; and treating periodontitis reduces inflammation but does nothing to
alter the course of heart disease, the authors concluded.
Source: Journal of General Internal Medicine, 2008; Current
Opinion in Nephrology and Hypertension, 2010; General
Dentistry, 2012; Circulation, 2012
11. Pregnancy complications
Gingivitis affects 60 to 75% of pregnant women, and it's especially
important that expectant mothers tend to their teeth. When pregnant women have
serious dental problems, their infants are more likely to develop cavities.
Poor maternal oral health is also associated with low birth weight and preterm
birth, although there's not enough evidence yet to know whether it's an
independent risk factor. Researchers suspect that one of two mechanisms may be
at play: Either overall inflammation is heightened, or oral bacteria that enter
the bloodstream eventually colonize the placenta, causing an inflammatory
response.
Source: Journal of Clinical Nursing, 2010; Ginekologia
Polska, 2012; Dental Clinics of North America, 2013
12. Ulcers
In people with periodontitis, the plaque that forms in the pockets beneath
the gum line can become a reservoir for Helicobacter pylori, the bacterium that
is asymptomatic in most but is responsible for stomach ulcers when it flares
up. Helicobacter pylori can be transmitted orally, and large epidemiological
studies have found a positive association between periodontitis and a positive
test for the bacterium, which is also a risk factor for stomach cancer.
Different researchers have come to somewhat different conclusions, but the
bacterial pockets that form during periodontitis unquestionably pose a risk for
various kinds of bacterial growth.
Source: Gut, 1995; American
Journal of Public Health, 2002; Clinical
Microbiology Reviews, 2010
13. Cancer
"Recent evidence suggests that the extent and severity of
periodontaldisease and tooth loss may be associated with an increased risk of malignantdisease," concluded one researcher, after reviewing previous studies
suggesting an association between poor oral health and cancer. Gum disease and
dental problems are also associated with HPV, which causes up to 80 percent of
oral cancers. While smoking is a major risk factor for both gum disease and
cancer, a study last year of 3,439 people identified poor oral health as an
independent risk factor for HPV, even when smoking habits were accounted for. Other
preliminary research has suggested that periodontitis may promote the growth of
cancerous cells in the mouth.
Source: Dental
Update, 2010; South Asian Journal of Cancer, 2012; Cancer Prevention Research, 2013
