You may have heard the saying that the mouth is the doorway to good body health. Scientists have long tried to build a connection between oral and overall body health. Before dental health journal research could coin the term oral-systemic link, scientists in the late 19th century drew connections between the oral cavity and body health.
In 1879, Will Miller observed a link between oral microbes and brain abscess, pulmonary and gastric illnesses. Miller described the mouth as foci of infection that caused several systemic diseases. In 1910, William Hunter gave a talk at McGill University in Montreal. Hunter argued that oral sepsis causes systemic diseases.
The connection between oral and systemic health has been a subject of dental scholarly research for more than a century. Yet oral-systemic health is a dynamic field, and dental health scholars keep updating new findings in journal research publications.
Dental health journal research is essential for dentistry practitioners and health educators. It informs how they collaborate with clients and other stakeholders to bolster overall good health by ensuring proper dental health. This article examines emerging dental health journal research on oral and systemic health.
Oral-Systemic Health Association
Although knowledge about the oral-systemic health link has been available for decades, it has received more attention lately. On a wider scale, holistic health has gained more relevance. If one part of the body is unwell, the whole body suffers.
The connection between oral health and systemic health is two-way. Systemic conditions such as diabetes can manifest themselves through deteriorating oral health. On the other hand, poor oral health can impact overall body health. The American Dental Association (ADA) has also drawn a relationship between social and behavioral disorders with oral health.
Conventional health research has identified a specific link between oral and systemic health. Yet, the link is often controversial because of the lack of hard evidence showing the role of one variable (systemic health) on another variable (oral health). Current dental health journal research focuses on one or more aspects of the oral-systemic link.
Following current research on oral-systemic health and the COVID-19 pandemic, the ADA passed resolution 84H-2020. The resolution strongly advocates for dentistry as an essential and independent profession that ensures public health through collaboration with other healthcare providers.
Pathways for Systemic Conditions Impacting Oral Health
One of the findings in current oral health research is a hypothesis on potential mechanisms for oral-systemic associations. System illnesses may make it challenging to practice proper oral health, indirectly affecting oral health. The following are two mechanisms identified:
Chronic inflammation: Hypothetically, chronic inflammation increases inflammation markers in the bloodstream. Consequently, the auto-immune response level is heightened. The overall burden of disease also increases.
Bacteria Reservoir: The oral cavity acts as a bacteria reservoir. The bacteria enter the bloodstream causing systemic diseases or distant site infections.
Current Studies Relevant to Oral and Systemic Health
Systemic conditions directly affect people or inhibit them from practicing proper dental hygiene. A collaborative report by the National Institute of Dental and Craniofacial Research and the National Institute of Sciences spanning two years and involving 400 authors highlighted nearly 60 adverse conditions that affect oral health, including:
- Dementia and Alzheimer’s Disease
- Chronic kidney disease
- Radiation therapies
- Sleep Apnea
The adverse conditions can affect oral health directly or through treatment options such as therapy. While current dental health journal research focuses on diverse conditions and aspects concerning the oral-systemic health link, we will only review the most common and current findings.
1. Cardiovascular Diseases
A classical 1989 study published by the BMJ has long established a relationship between poor oral health and cardiovascular diseases, holding all other factors constant. After a robust study involving more than one article, periodontal diseases are accepted as risk factors for atherosclerotic vascular disease.
According to a paper published on Decisions in Dentistry , one can explain the oral-systemic link between periodontal diseases and cardiovascular diseases using the inflammatory and bacteria reservoir mechanisms. In the inflammatory pathway, inflammatory markers cause a response that travels beyond the periodontal site. A lung response causes systemic inflammation. In the bacteria reservoirs pathway, periodontic microbes travel to the bloodstream and disrupt cell integrity.
A more recent study (2021) published in the Scientific Reports Journal has drawn an association between periodontal diseases and cardiovascular disease mortality. The study focused on senior adults aged between 71 and 92. A similar 2021 study published on the Journal of Cardiology associated poor oral health with physical frailty in CVD patients. The findings demonstrate the urgent need for affordable dental care for aging adults because poor oral health is a risk factor for mortality through cardiovascular diseases.
The oral-systemic link is two-way. And thus, chronic disease can impact oral health. Diabetes is known to manifest complications through periodontal diseases. In a 2018 systematic review published on Acta Diabetal, researchers found that diabetes increased the risk of Periodontitis by 86%. Diabetes makes periodontal tissues more vulnerable to periodontal destruction. Diabetes works through systemic inflammation.
Dental health journal research suggests that diabetes does not affect microbe biota. If the patient does not get any interventions, the systemic inflammation produces by-products that block normal tissue repair and trigger increased tissue damage. Dental health research shows that seeking dental service might offer some relief, although evidence is often contradictory.
One 2021 study published in the Journal of Clinical Periodontal shows that periodontal therapy for patients with diabetes type two showed some improvement through glycemic reduction. Other studies show slight or no improvement. The results of these studies show the essential role of collaboration between the patient’s orthodontist and their physician.
A more recent journal published in the International Dental Journal in August 2022 highlights the ameliorating role of proper dental care for people with diabetes. The researchers used data from the National Health and Nutrition Examination Survey involving 2191 respondents. The study found that proper oral practices, like dental flossing, help reduce inflammation.
3. Adverse Pregnancy Outcomes
Scientific research has identified some risk factors for pregnancy, including alcohol consumption, tobacco smoking, and stress. Periodontal diseases have also been identified as risk factors for poor pregnancy outcomes, such as low birth weight. Unlike diabetes, periodontal diseases risk the unborn child through both pathways: inflammatory and bacterial infections. Such infections travel to the amniotic fluid and reach the fetus.
One dental health journal research published on Periodontology in 2021 evaluated two decades of clinical research to study the relationship between periodontal diseases and negative pregnancy outcomes. Although the findings varied in describing the strength of the connection between the two variables, it was evident that periodontal diseases such as gingivitis harmed pregnancy. The study found that periodontal diseases were associated with preterm birth, low birth weight, preeclampsia, and pre-labor membrane ruptures.
A similar study published on Family Practice involving 748 792 pregnancy records shows that maternal periodontal diseases were significantly linked with low birth weight, preterm labor, and spontaneous abortion. The researchers emphasized the importance of a timely diagnosis at an orthodontist office to protect the mother and the child. There are multiple interventions, including periodontal therapy for pregnant mothers.
4. Respiratory Diseases
For people with weak immune systems, the oral cavity may be the source of respiratory illnesses such as chronic obstructive pulmonary disease and pneumonia. This risk increases for individuals requiring mechanical ventilation. Apart from the two pathways, periodontal diseases impact systemic health; there are two other mechanisms. Some enzymes derived from microbes reduce the protective effect of saliva and prevent the efficient clearing of pathogens from the mucosal surface.
COVID-19 caused a renewed interest in the association between respiratory diseases and oral health. In one dental health journal research published in the British Dental Journal, researchers hypothesized that the severity of COVID-19 was associated with poor oral health. The researchers found that the severity of COVID-19 was associated with a delayed recovery period and increased C-reactive protein. So, poor oral health could potentially impact recovery from respiratory diseases.
Similar studies have shown the intricate oral-systemic health link even in oral care management. A 1-year cohort study in Japan published in Gerontology highlighted the importance of oral health management (OHM) for individuals in long-term care facilities. Those who received OHM were less likely to contract pneumonia. Proper OHM in long-term care facilities may include having access to emergency dental services.
5. Rheumatoid Arthritis
Dental health journal research also focuses on other conditions such as rheumatoid arthritis. One could wonder if anyone would visit their family dentist because of rheumatoid arthritis. Maybe not. Yet their dentist might collaborate with a physician to ensure poor oral health is not exacerbating rheumatoid arthritis.
Rheumatoid arthritis is an auto-immune disease that causes inflammation of the joints and damage to bones, ligaments, and cartilage. So how is RA related to oral health? RA and gingivitis cause the production of similar chemicals in infected tissues. They both have similar underlying inflammatory mechanisms. So patients with RA will likely benefit from a visit to the dentist.
One dental health journal research article published in the International Journal of Environmental Research and Public Health in 2022 highlighted that non-surgical periodontal therapy (NSPT) has systemic effects self-reported through an increase in the quality of life. The positive findings emphasize periodontal care’s role in lessening RA’s effects on patients.
6. Other Conditions
Periodontal complications have also been implicated in exacerbating other existing conditions such as Alzheimer’s, erectile dysfunction, and liver and kidney disease. One study published on PloS One that followed a cohort for six months found that Periodontitis was associated with a six-fold increase in cognitive decline rate for Alzheimer’s patients. So, although the initial diagnosis may show periodontal diseases only limited to the oral faculties, its effects spread to the body through inflammation or infection.
Implications of Oral-Systemic Link on Health Education
Dental health journal research is critical for understanding the oral-systemic link and making appropriate recommendations. Although current dental health research shows clear evidence of an association between chronic conditions and oral health, it might be too early to prescribe a specific dental care approach to specific chronic conditions. A better approach is recommending proper periodontal care as a protective factor for systemic health.
The following recommendations will be helpful for dental practitioners, including those transitioning a dental practice and stakeholders in the health sector.
1. Prevention Is Better Than Cure — Always
Most periodontal diseases are preventable. Dental health education should hold up the multiple benefits of prevention over treatment. It should also start at a young age. Teachers and parents should educate children on brushing and flossing. Access to a dentist for kids should be easier and affordable to ensure good oral health from a young age.
2. Early Detection Helps Prevent Disease Progression
If periodontal diseases develop before prevention can be done, early detection will help derail the disease’s progression. It is paramount that families of all races and backgrounds access affordable family orthodontics to make detection and treatment more affordable.
3. Prevention and Controlling Gingivitis Is Vital in Fighting Periodontitis
Gingivitis is one of America’s most common periodontal conditions. Since inflammation is the common characteristic of periodontal diseases, its prevention will reduce cases of Periodontitis. Consequently, people will have better health. Preventing gingivitis will reduce the disease burden on the body and inflammation response.
4. Integrative Healthcare Aims at Holistic Health
Ultimately, the current dental health journal research points to a need for a holistic approach to health. If you have a toothache, the heart might ache too. Health education should emphasize to patients on the oral-systemic link. Health systems should allow collaboration between dentists and health practitioners specializing in other human body parts.
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