ORAL CARE:  PUT YOUR HEALTH WHERE YOUR MOUTH IS

Say aaahhhh.

Let’s take a look inside the most complex, wondrous and bacteria-laden portal into the human body.    There’s more than meets the eye.

Most of us, as adults, faithfully brush our teeth twice daily.  Some of us even overachieve, and brush after lunch.  We all should.  Flossing, unfortunately, is not a practice as popular as brushing.  It should be.

“Let me look into my patient’s mouth, and I can give you a general prediction of how healthy they are likely to be throughout their lifetime.”  This notion is gaining popularity among many medical professionals, but a generation ago, this would likely not have been uttered by any doctor.  The connection between a healthy mouth and a healthy body was not acknowledged.   If, as the saying goes, the eyes are indeed a window to the soul, then, the mouth is seen not only as a door into the body, but as a window as well.

The human mouth is teeming with bacteria, most of it the good kind.  The bad kinds are easily overpowered by the good ones with regular and efficient oral care—except when they are not.

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The average adult mouth has 32 teeth, including four wisdom teeth.  This includes 8 incisors, 4 canines, 8 premolars (also known as bicuspids), and 12 molars, including the wisdom teeth, which normally come in sometime around age 18.  A person loses their “baby” teeth around ages 12-13.  Barring any accidents or decay due to lack of care, an adult can expect to enjoy their mouthful of teeth well into their senior years.   This lack of care, however, can spell an early death for adult teeth.

Among women, pregnancy is a major factor in calcium loss, which, in turn, affects the health of a woman’s teeth.  There is a wive’s tale—or perhaps it is based in truth—that a woman eventually loses one tooth for each pregnancy she experiences.    Osteoporosis, which is most common with women, is being investigated as a result of periodontal bone loss and tooth loss as well.  Clearly, women have a unique set of circumstances and situations that can uniquely affect them.

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There is an element of the mouth that is underappreciated:  saliva.

Most of us see saliva as an unfavorable aspect of the human mouth.  This notion should be re-examined, because without it, we are stuck—literally and figuratively.  Dry mouth is a condition most of us have experienced at one time or another due to many possible factors, including medication, lack of water intake and illness.  Saliva bathes the mouth in a cleansing fluid that washes food away, allows bad bacterial to be neutralized, and it lubricates solids as we chew them in order to moisten food in order to swallow them safely.  In addition, saliva is filled with digestive juices that promote good digestion.  Therefore, chewing food for longer periods allows more efficient digestion to take place, because more saliva is produced, thus, more digestive juices are present.   Certain medications, namely, decongestants, antihistamines, painkillers and diuretics can reduce saliva flow, thus setting the stage for bacteria growth, because when saliva flow is limited, its cleansing action in the mouth is reduced.

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Inflammation is being recognized as a contributor to many health conditions.  New research is investigating the link between the inflammation and infections that oral bacterial can cause, and how these are connected to heart disease and stroke.   The inflammation associated with severe gum disease—periodontitis—is suspected to play a role in certain diseases.  Periodontitis is also linked to premature birth and low birth weight.

Diabetes, which reduces the body’s resistance to infection, puts the gums at risk for gum disease, as it is noted much more frequently among those with diabetes.  Additional research shows that people with gum disease have greater difficulty controlling their blood sugar.

Another interesting topic of study by respected institutions is the link between early tooth loss, poor oral care and Alzheimer’s:  while it is still in the early stages of being proved with multiple research projects, it is suspected that the bad bacteria present in the mouth that takes over when oral care is not performed, eventually travels to the brain whereby it is quick to kill off neurons, thus creating a perfect atmosphere for dementia to set in.   The flip side of this stance is that poor oral care is a consequence, rather than a cause of dementia.  Further research will bear out the true cause in time, but it behooves all of us to at least be aware that this connection is suspected.

While good oral care is a good habit that is cultivated, there is one particularly bad habit that is practiced that is detrimental to oral health:  smoking.  According the Centers for Disease Control (CDC), the risk of severe gum disease is three times higher than that of a non-smoker.  Also, the nicotine in cigarettes causes blood vessels to constrict, interfering with their ability to fight infection.  When gum surgery is necessary, the recovery is more difficult and the surgery tends to be complicated by smoking.

Another habit that can adversely affect gum health is overeating.  Obesity has been linked to gum disease in several major studies, as it does appear that periodontitis progresses more quickly in the presence of increased body fat.

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There are several unique health conditions that are directly affected by oral health, especially among the elderly.  Not only does good oral care tend to decline with age and its accompanying maladies, this general decline in health may indeed be more pronounced because of poor oral health.  In the cases of overall decline due to aging, other bodily functions such as respiration and swallowing can be adversely affected.  If a person has been diagnosed with Chronic Obstructive Pulmonary Disease (COPD), this can be exacerbated by increasing the amount of bacteria in the lungs.

If a person develops dysphagia—swallowing disorders—due to a stroke, progressive disease or general aging, bacteria can be aspirated into the lungs when the swallow process becomes weak.  In aspiration, saliva, liquids and/or foods are ingested into the lungs instead of the stomach.  If this occurs repeatedly, and if the materials that are aspirated carry bacteria from the mouth with them into the lungs, the risk for pneumonia and other infections increases exponentially.

Oral care is normally a self-care habit that is performed independently from childhood through adulthood.  There are situations, however, when a person may become temporarily or permanently unable to perform their own oral care, and it becomes of paramount importance that another person or persons be responsible for that person’s oral health.  If a person has been injured and is physically unable to perform the tasks, or if long-term illness sets in that takes aware their awareness and/or ability to perform the oral care tasks, then they must rely upon someone else to perform oral care for them.   This must be considered an important commitment to the disabled/ill person.  In aging, dementia and disability can prevent an older person from remembering to perform the tasks, and from actually performing them.  In this case, too, someone else must be responsible for this very important task.

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Oral care may seem too simple a notion to spend much time thinking about, or analyzing one’s own habit surrounding it.  Most of us, as adults, take for granted that if we simply brush our teeth twice daily, then we will be assured of good oral health.  This is never a guarantee.  While brushing twice daily should be considered the absolute minimum, there other habits that we should all consider adopting, of we haven’t already:

  • Consider brushing in the middle of the day after lunch.  There are inexpensive, disposable toothbrushes on the market that are ready to use with a dab of toothpaste on them.  Keeping these handy allows us no excuse to slip into the restroom after lunch for a quick brush.
  • Floss DAILY.  There are no exceptions to this.  If you don’t, and then decide to floss after a long period of time, you will likely notice there is a strong smell that comes out of your mouth along with the food particles that have been stuck in your teeth.  This odor comes from the beginnings of bacteria that have been forming on those food particles.  It is not pretty, and obviously, is smells bad.  When unattended for too long, these particles become a prime breeding ground for the bad bacteria that contribute to illness.
  • Make regular dental check-ups a priority.  Twice each year is the recommended visit frequency.  If you don’t have dental insurance, the cost may be noticeable at the time, but if you consider it a form of long-term health insurance, then you can see that the benefits outweigh the cost.  Poor dental health is visible and generally not accepted well by our society as a whole.  While this is a sad reality concerning one’s looks, poor dentition, coupled with poor oral health is almost always considered a detriment in social situations.  Bad breath often accompanies poor dental health, so the added dimension of a bad odor along with the visible dental issues can be seen in a very unfavorable light.
  • Limit sugary and processed foods, and increase your consumption of fresh fruits and vegetables.  Sodas are not a good choice either, and coffee and tea can cause stains and bad breath as well.  Drinking plenty of water is crucial too, as dry mouth is a likely consequence of NOT consuming enough water daily.
  • Brush your teeth immediately upon arising, before you eat or drink anything.  The bacteria grow in the mouth overnight, creating the unfavorable taste in the mouth most mornings.  If you eat and drink before you brush, the bacteria are swallowed and ingested into the stomach, thus increasing the chances of poor heath vs. good health if the bacteria are brushed away.
  • If you get up in the night to get a drink, consider swishing your mouth out with one mouthful of water and spitting it out before you actually take the drink.  This washes away some of the bacteria that have grown, and prevents you from swallowing them.  Brushing would be most beneficial even in the night, but for most people, it is not practical.  Simply washing out the mouth with water will help.
  • Replace your toothbrush every 3-6 months, or more frequently if the bristles begin to wear, or if you have had the flu or a cold.  These bacteria may linger on your toothbrush after illness.

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Oral care is too often overlooked as a less-than-crucial part of good health.  Researchers continue to study the link between good oral health and good health in general, with all research bearing this out:  A healthy mouth is necessary for a healthy body.  Taking the few extra minutes necessary to floss daily, or perhaps adding a third brushing to your daily routine will pay off exponentially as you age.

Smile—it will give you yet another reason to take care of your mouth, and the good health it promotes will enhance your smile in return.