It’s one of the easiest ways to care for your health, a ritual we participate in daily: brushing those osseous outcroppings, our teeth.
For those of us who heed the pleas of our dentists, flossing is a part of our routines, too. But the state of affairs of our glistening maws – the density of plaque, the presence of gingivitis, a full set of chompers – is important beyond mere aesthetics. Good oral fitness, particularly steps taken to limit the bacterial status quo, plays an important role in the goings-on of our body as a whole; a dirty mouth – and not the kind prone to sailor-like profanity – can provide important clues as to how susceptible you are to heart attacks and strokes.
Periodontitis is a chronic bacterial infection of the scaffolding of teeth, including the gums, connective tissue, and jawbone that surround and encapsulate a tooth. It may well be one of the most common diseases of man: in the United States, anywhere from 30 to 50% of the adult population has a mild form of the disease, while an additional 5 to 15% suffers from a severe form.
That disease begins with dental plaque or calculus, a layering and mineralization of pathogenic microbes that thrive in the dark, wet, and (occasionally) nutrient-rich crevices of our mouth. Over 500 microbes have been implicated as residents of these so-called periodontal pockets, those clefts and rifts between tooth and gum, forming complex biofilms and microbiotic communities of Gram negative rods, Gram positive cocci and rods, and spirochetes.
Periodontitis can incite additional infections: burrowing tooth cavities or caries; gingivitis, an infection of the fleshy gums; and, most severely, destruction of the alveolar jawbone that props the teeth (3).
But periodontitis is not just a local infection, limited in its effects to the body’s entranceway. It goes beyond the pearly whites and has the potential to wreak havoc farther afield, upon our thrumming arteries, heart, and brain.
The microbes responsible for periodontal disease assist in forming atherosclerotic plaques, which travel in the blood and set up shop in arteries. One bacteria commonly found in our mouths and which is responsible for oral disease is Porphyromonas gingivalis. But outside the oral cavity, this bacteria can attract vital cells responsible for blood clotting, platelets, which in turn can form thromboses, leading to the embolisms responsible for heart attacks and strokes.
When the severity of periodontal disease was directly measured in a 2006 Swedish study by counting existing pockets of infection and decay, it was found to be associated with hypertension in a dose-dependent manner (7). In other words, the lack of oral maintenance that allows build-up of bacteria on our chompers allows a similar build-up in less visible but far more life-threatening locales as well.
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