DENTAL HEALTH AND ITS LINK TO CARDIOVASULAR HEALTH

Oral-Heart-Connection.jpg

Your oral health has a bigger impact on your overall health than you may suspect. Inflammation and disease in the mouth can have a negative impact throughout your whole body and lead to some very serious conditions. These include arterial disease (heart attack and stroke), metabolic disease (insulin resistance/prediabetes/Type 2 Diabetes), cancer, dementia, high risk pregnancy and inflammatory arthritis.  

One of the key players in this oral systemic connection are the bacteria that live in your mouth. There are both good and bad bacteria that can inhabit your mouth.  The goal is to rid yourself of the bad bacteria and create an environment in the mouth to promote good bacteria.  Brushing and flossing are the foundation of good oral hygiene, but may not be enough to deal with the issue if bad bacteria have taken hold in your mouth.  Visual inspection alone may not pick up the presence of high risk problems, including certain high risk bacteria. Even if your mouth tissues are currently apparently healthy, the presence of these bacteria may indicate subtle pockets of inflammation or be opportunistic for the lapse in hygiene or immunity that can convert colonization into infection and inflammation, both local and systemic.

We use the Oral DNA MyPeriopath test to identify and measure the amount of the bad bacteria in the mouth. Below you will see an example of a portion of the report.

Screen Shot 2018-11-21 at 2.45.05 PM.png

With these results, a plan can be developed by the dental professional to address this concern. The key is to reduce and eliminate the bad bacteria because they contribute to chronic disease, both periodontal and the others previously listed.

Your dentist can also use x-ray and cone beam ct scans to look for abscesses and other issues that are missed by routine examination. These conditions don't always cause symptoms that would call attention to them and make you see your dentist.  Sometimes the first symptom is a heart attack! Or it may cause poor control of diabetes and prediabetes.

We recommend our patients get cone beam CT because plain xrays may miss some abscesses (even without symptoms) that  could be driving arterial inflammation and increase the likelihood of a heart attack.  When possible and there is mutual interest in your overall health, we will work with your current dentist to get this information. 

Alternatively, we may refer to dental partners who offer these services for a limited consultation.  We would do this only because our priority is the optimal care for you!

CBCT Scan Ballantyne Dentistry.jpeg

Making sure that there is not an underlying problem that could lead to further oral damage as well as systemic damage is a key in preventing arterial disease. Addressing any current issues and treating them is key to prevention. 

Screen Shot 2018-11-21 at 2.39.03 PM.png

What Can I Do to Avoid Oral Health Issues?

First, go regularly to your dental professional, make sure they give you an ongoing treatment plan for any issues, and follow their plan. Choose a dental professional that understands the concerns beyond tooth issues. 

Consider the OralDNA MyPeriopath test to find bad bacteria that may be present. We have seen patients that have no obvious issues or new cavities that have significant levels of dangerous bacteria in spite of their current plan. 

Make sure that you are following a daily routine to disinfect your mouth to kill and prevent bacteria from growing in your mouth. Daily brushing and flossing can be accompanied with: use of a waterpik and dental picks, making sure that your are using toothpaste that doesn't contain sugar or alcohol, making sure to brush the entire mouth not just the teeth and gums, and going to bed with a clean mouth. Depending on the level of bacteria or disease discovered antibiotics, special cleaning or dental work may be recommended. 

Make sure that you are regularly getting cleanings and follow the advice of your dental provider. They are you best resource to avoid disease and oral systemic issues that can result. 

Treating and preventing inflammation in your mouth will lower your risk of heart attack and stroke, Type 2 Diabetes and possibly dementia and some cancers.  Something as simple as dental floss can save your life!

Why is this not well known? Traditionally, dentists and doctors work in separate parts of the health care system. The Center for Prevention is collaborating with dentists to encourage them to play a larger role in the overall health of their patients.  Our patients leave their appointment with information to share with their dentist and an invitation to connect and collaborate for the benefit of our patients. 

What if my dentist is still unconvinced testing for oral pathogenic bacteria is of any value?

Let’s try this analogy:

You think you live in a nice neighborhood.  But you still lock your doors at night.  But if you forget to lock the doors one night, you are probably still pretty safe.  This is standard oral hygiene practices with confirmation of a “clean” or low burden Periopath report.

 But if you live in a neighborhood where there are known killers, violent gangs and other threats of violence and theft, you not only lock the doors but also activate a good security system with monitoring, a loyal and protective watchdog and other means of protection to your level of skill, training, comfort and attitude.  Maybe you become comfortable with means of protection you never thought you would accept. 

 This is more urgent if your home and family has already suffered a robbery, home invasion or life or limb threatening violent attack or if the neighborhood watch identifies a serial killer or malicious gang in the neighborhood.  Think of enhanced hygiene practices provoked by clinical findings on exam and high burden of high risk pathogens on Periopath.  Or maybe it took a heart attack or stroke instead of a “spit” sample to find out about the bad guys in your neighborhood.

 If the police were able to round up the bad guys, would you not encourage them?  If they could clean up the neighborhood, maybe tear down the buildings where they congregate, get rid of the environment that supports them, would you not welcome that?  Think of pathogen focused treatment like root planing and deep scaling, antibacterial rinses, trays, ozone, laser, GLO, oral antibiotics.) 

 Once the effort is made to round up the bad guys, wouldn’t you now periodically verify that the neighborhood has not attracted a new set of bad guys?  Would you turn off the security system and leave the doors unlocked and sedate the dog?  Of course not.  This is continued care and monitoring once the problem is “cleaned up.”

 Rise in MPO, LpPLA2, MACR and CRP are like the alarm going off.  Time to call the police and release the dog!

 But a well lit house with locked doors and a sign indicating protection with an effective security system and an occasional bark from the dog inside tells the bad guys: “Not this house! Move on” so the invasion that triggers the alarm never gets triggered.  It pays to monitor the environment and repel small threats before they become serious threats.

 The attitude of the traditional approach is “Wait and call 911!”.  Well, when seconds count, the police will be here in minutes and 90 minutes after arrival in the ER is considered good enough for a timely opening of an artery, assuming they didn’t pronounce you dead on arrival.  Good luck with THAT!  Not good enough for me or my loved ones, including you!

 You probably are justified in your trust that you live in a safe neighborhood, but it is always a good idea to verify that you don’t provide sanctuary in your mouth to bad guys who will harm you if your doors are unlocked.  

 There is strong evidence of causation by periodontal pathogens for arterial disease and at least correlations with prediabetes and Type 2 Diabetes, increased cancer risk, arthritis, and high risk pregnancy. 

 Even if this test costing less than $200 isn’t covered  by insurance, are you going to let an insurance payer determine whether you know all you should know about your “neighborhood”?

Yes, this added information can make a difference that is a lot less than the cost of the testing and discussion.