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Updated: November 21, 2010 18:40 IST

How healthy are your teeth?

Geeta padmanabhan
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Start early: To catch dental problems in time Photo: K. ananthan
Start early: To catch dental problems in time Photo: K. ananthan

Issue Did you know that bad teeth are an indicator of other more serious problems? Doctors tell you why dental hygiene is important

Returning for a post-procedure check-up, a patient reported: “Doctor, my joint pain has gone after you removed the infected wisdom tooth. Do you see a connection?” Another said after a successful root-canal: “My eyes would water when I worked at the computer, but that's stopped now!”

Several middle-aged and elderly people have reported health improvement after they got dentures fitted. Increasingly, records in dental clinics are proving a theory that dental surgeons have suspected for some time — oral health is closely connected to general health.

Take diabetes and tooth decay — an established connection. Among the hundreds of written discussions on the subject, one by Mayo Clinic warns: “The higher your blood sugar level, the higher your risk of tooth decay.” Larger supplies of sugars and starches in the diabetic interact with mouth bacteria to form plaque. Acids in the plaque cause cavities. Diabetes reduces the ability to fight bacteria, slows healing, and the plaque goes on a rampage. You get gingivitis (swollen/bleeding gums) and periodontitis (damaged soft tissue/bone supporting gums), which means your teeth loosen and fall.

But, here's the scary part — infections such as periodontitis may also cause blood sugar levels to rise, making diabetes more difficult to control.

“Many research findings indicate that poor oral hygiene and advanced periodontal (gum) disease may be linked to diabetes, cardiovascular problems, stroke and pre-term low-birth weight babies,” says C.D. Dwarakanath, periodontist and president of Indian Society of Periodontology. And, bacteria in the mouth can be aspirated into the lungs, causing respiratory diseases such as pneumonia.

People with gum disease are almost twice as likely to suffer from coronary artery disease. “Treating inflammation in the mouth is not just important for a healthy mouth, but also to better manage inflammatory conditions in the body,” he adds.

Bacterial infection

S.C. Selvamuthukumar of Shakthi Dental Care links specific bacteria in gum disease to poor overall health. “These bacteria attack the not-so-well defended gums, and the body reacts by producing anti-bodies,” he says. “Tests have showed that anti-bodies produced to repel the bacteria in bad teeth were found in the joints.” In what is known as “focal infection theory”, the infection that begins in the oral cavity travels in the bloodstream, creating trouble in joints. Infection elsewhere reaches the heart.

All this makes poor oral health a symptom as well as a cause of serious problems.It's difficult to say which comes first — coronary heart disease/rheumatoid arthritis/diabetes/lung problems or gum disease. When an inflammatory condition is suspected or diagnosed, it is important to consult both a general physician and a dental health professional, says Dr. Dwarakanath. “We ask about medical history,” says Dr. Selvamuthukumar, “and order a blood investigation. In fact, diabetes has been detected in such investigations. Which is why it is vital to divulge physical and mental health-related problems. We need a complete picture. Else, the pills you pop may interact with the medication we prescribe,” he adds.

Either way, open your mouth to your dentist.

“Healthy-looking gums could hide diabetes,” says Dr. Selvamuthukumar. “Gum disease could be inherited. Cysts formed at the base of the teeth remain painless, whereas bleeding gums could mean just a localised problem. Or, a first indicator of diabetes, renal trouble or liver disease.” His bottomline: “Even when gums feel normal, do not bleed or pain, there could be a problem. Periodic visits to your dentist are a must.”

Here's the important bit. A brush-rinse-spit routine doesn't guarantee good dental health. Oral hygiene demands attention to teeth, gums, the supporting bone, mouth tissues, tongue and lips. “See a dentist in case of bad breath, swollen/bleeding gums, toothache or decay,” says Dr. Dwarakananth. “Adopt a preventive oral-care regime. Brush well, rinse with anti-microbial mouthwash for total protection, floss to remove particles stuck between teeth and limit intake of sugary-starchy foods,” he adds.

Dr. Selvamuthukumar gives a thumbs-down to a carb-rich dinner, beverages before bed, lime juice at any time (use a straw, if you must!). “If you lose a tooth, get it replaced,” he says. “The remaining teeth drift out of position to compensate the loss. They change the bite, leading to cavities and gum problems. Avoid removable teeth. Dentures are non-performing assets,” he adds.

CAUSE AND EFFECT

Diabetic patients are more likely to develop periodontal disease, which, in turn, can increase blood sugar and diabetic complications.

Preventing and treating periodontitis can help improve blood sugar control.

Tell the dental surgeon if you have BP, diabetes or have had valve replacement.

Smoking increases the risk of complications from diabetes and gum disease.

If you have bad breath, check for chronic sinusitis, gum problems, digestive tract acidity, indigestion.

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