Oral health is an often neglected part of one’s overall health so let’s dig into:

1. Why you should care more about it and,
2. How to take care of it.

Our general health can be significantly impacted by the condition of our teeth and gums. 

Poor oral health has been associated with various conditions such as depression, heart disease, diabetes, dementia, and even adverse pregnancy outcomes. In naturopathic medicine, we recognize the interconnectedness of our body, our environment, and our lifestyle on total health and yet oral health is an often overlooked component. Let’s change that!

How does oral health impact other body systems? 

A lot of it has to do with inflammation and the movement of bacteria from the mouth to other body systems. 

As the body’s immune system fights off the presence of bacteria in your mouth, it can lead to an ongoing inflammatory response that can spread throughout the body via the bloodstream. When we swallow, some of the bacteria in our mouth can be carried down into the digestive tract (or lungs!).

Inflammation and infection in the gums (called periodontal or gum disease) can have systemic effects on the body, including the heart and brain. While there are dozens of conditions impacted by poor oral health, let’s dive into the following 7 categories:

Mental health. Like many connections, this relationship goes both ways and is complex. We can all identify with how liking our smile (or not) can impact our self esteem. People experiencing depression are less likely to take care of their oral health, while poor oral health can worsen depression. Remember all my talk on the gut:brain connection? Don’t forget the mouth is part of the digestive tract. Chronically inflamed gums can damage the BBB (blood-brain barrier) and trigger inflammation in the brain, which we have discussed can cause symptoms of depression.

Heart Health & Diabetes. Study after study has shown that people who have poor oral health (such as gum disease) have higher rates of cardiovascular problems such as heart attack or stroke. The chronic inflammation can damage blood vessels and cause tiny clots. Studies have found oral bacteria within atherosclerotic plaques (“hardening of the arteries”). For people with diabetes, it’s a two-way connection again. Having diabetes can make you more prone to gum disease, while gum disease can make it harder to control blood sugar levels. An even more recent (pre-print) study from March 2023 found that poor oral health is associated with worse markers on brain MRIs (markers that are established risk factors for stroke and dementia).

Dementia & Alzheimer’s. A large population study (which can show an association but not causation) published in 2020 suggests that bacteria that cause gum disease are also associated with the development of Alzheimer’s disease and related dementias and that beta-amyloid plaques – a major hallmark of Alzheimer’s disease – may even occur as a response to infection. Overall, research is suggesting that oral infection preceded the diagnosis of dementia and that individuals with chronic gum disease have a significantly higher risk of developing Alzheimer’s disease compared to those without gum disease.

Pregnancy. Like there isn’t enough to worry about and take care of in pregnancy! The hormonal changes in pregnancy can affect the gums, making them more sensitive to plaque bacteria, leading to an exaggerated response known as pregnancy gingivitis. Symptoms may include red, swollen, or tender gums that bleed easily. The hormonal changes even affect the pH of our saliva (what don’t hormones affect, amiright?!) reducing its effectiveness in neutralizing acid and preventing plaque buildup. Gum disease has been associated with the following potential negative pregnancy outcomes: preterm birth, low birth rate, gestational diabetes, and pre-eclampsia. Is this blowing your mind yet?

Sexual health & fertility. Yup! Inadequate dental health can contribute to erectile dysfunction (ED). Gum disease can have a negative effect on blood vessels, including those responsible for blood flow to the penis. Chronic inflammation (like from gum disease) is also known to impair nitric oxide, the major player that signals for blood vessels in the penis to relax, allowing blood to flow in and create and maintain an erection. In terms of fertility, studies have found an association between gum disease in men and worse sperm quality as well as gum disease in women causing longer times to conceive, compared to those without gum disease. It’s important to note that gum disease and fertility issues may share common risk factors, such as smoking or certain systemic conditions (e.g., diabetes). These factors can contribute to both gum disease and fertility problems independently.

Gut health. Remember that the mouth is part of the digestive system and there is a thing called the “oral-gut-axis” or connection (similar concept to the “gut-brain axis” or connection). The oral-gut axis suggests that the mouth and the gut are connected, and they can influence each other. When there are changes in the bacteria and inflammation in the mouth due to gum disease, it might affect the bacteria in the gut and how the gut works and vice versa. Several studies have found an association between gum disease and IBD, which includes conditions like Crohn’s disease and ulcerative colitis. In fact, a dentist may be the first one to notice signs of paediatric inflammatory bowel disease. Although more research is needed to understand this connection with respect to IBS, I know I see it all the time in my practice (and have experienced the effects first hand, i.e. eating certain foods and noting increased inflammation and sensitivity of my gums).

Autoimmune disease. Given that autoimmune diseases are chronic inflammatory conditions and are so heavily influenced by gut health, this one doesn’t come as a surprise. For example, chronic gum disease and the presence of specific bacteria (e.g. porphyromonas gingivalis) in the mouth may contribute to the development and progression of Rheumatoid Arthritis (RA). Other autoimmune diseases that have been studied to be impacted by gum disease include: Lupus (SLE), Sjögren’s Syndrome, Psoriasis, and Crohn’s and Colitis.

Yeesh – if you need me I’ll be over here booking in with my dentist!

Stay tuned next week for my top suggestions to better care for your oral health.

In health, 

Dr. Willow