Still, not everyone knows that neglected teeth cause health damage throughout the body. It even increases the risk of stroke and heart attack.
“Please take care of your teeth, in this way you will protect yourself against a heart attack and stroke”. With these words, dentists could motivate patients to care for their oral cavity better than the classic exhortation to clean their teeth three times a day for three minutes, which will help them protect themselves against caries. It would not be a dishonest advertisement – dental diseases actually cause damage to the entire body. Those who rarely brush their teeth and suffer from inflammation run a greater risk of having a stroke or heart attack. According to estimates by the World Health Organization, in Germany alone, every fifth inhabitant suffers from periodontitis, i.e. inflammation and infection of periodontal tissues. Many of these people, however, avoid the dentist like a plague. And hardly anyone knows how negatively it can have a negative effect on his health.
Meanwhile, professional removal of tartar reduces the risk of a heart attack, as Emily Zu-Yin Chen from the Veterans Hospital in Taipei recently announced at the Congress of the American Society of Cardiology in Orlando. The cardiologist studied over 102 cases in adults who had not had a stroke or a heart attack by 2000. Half of the participants in the experiment in the next seven years had at least one dental tartar removal procedure, while the other half did not. It turned out that the more regularly this was done, the less often the patients experienced a heart attack. “The risk of a stroke with annual tartar removal was reduced by 13 percent, and the risk of a heart attack was reduced by as much as 24 percent,” says Chen.
Also, people who have few holes in their teeth and healthy gums are less likely to have a heart attack. Anders Holmlund from Uppsala University in Sweden, in his study of 8 volunteers, found that people with eleven or more cavities in their teeth have a 69 percent higher risk of having a heart attack. The comparative group consisted of people of the same age with complete dentition. In addition, in patients suffering from gingivitis, i.e. gingivitis combined with the exposed necks of the teeth, deepening of the gingival pockets and frequent bleeding, the risk of a heart attack is increased by 53 percent.
However, experts criticized the fact that both Chen and Holmlund failed to take into account other lifestyle characteristics of the volunteers. For example, they ignored the classic risk factors for blood vessel obstruction, such as smoking, high blood pressure, diabetes or elevated blood lipids. Age, body weight and physical activity were also omitted in the experiment. This may distort the statistics, as it is possible that participants in the study, like their teeth, neglect other parts of their body.
However, the main thesis of these studies was confirmed by other works, including an analysis carried out by Scottish scientists last year. According to her, in a group of approximately 12 volunteers, the risk of a heart attack increased by 70 percent if they brush their teeth less than once a day, and therefore their dental condition was poor. This group was compared with participants who brushed their teeth at least twice a day. The influence of other risk factors contributing to the occurrence of myocardial infarction was also investigated and identified.
“The mouth, jaw and face should be treated as an organ system that can disrupt the work of others if it does not function properly,” says Heinz Kniha, an oral surgeon from the University of Munich. The build-up of plaque can lead to gingivitis and even make your teeth wobbly. When they fall out, gaps in the teeth will create an extra room for bacteria to multiply. So a general rule applies here: the worse the condition of the teeth, the more often inflammation occurs in the mouth. “The natural bacterial flora is then killed, and pathogenic germs that enter the bloodstream through small sores in the gums,” explains Kniha. As a result, bacteria can nest in the calcifications of the aorta and carotid artery and even lead to their closure, with disastrous consequences: heart attack or stroke.
At the same time, any inflammation causes a lot of stress for the immune system. To stimulate the body’s immunity, the liver then throws an increased number of so-called acute phase proteins into the blood, including C-reactive protein (CRP) and fibrinogen. The latter plays an important role in the blood clotting process – increasing its level thus helps to close the arteries in which bacteria have already settled. Thus, the risk of a heart attack increases even more. Also, elevated CRP values can harm blood vessels in the long run and contribute to their calcification. The exact mechanism of these processes is not clear, but C-reactive protein is known to increase significantly during bacterial infections.
If someone has neglected teeth, they run the risk of calcification not only in the arteries leading to the heart or brain, but also in those that supply blood to the kidneys or legs. Chronic kidney failure or intermittent claudication, which is also typical of smokers, may develop, in which the affected person begins to experience sudden pains in the legs after a short walk and has to stand up for a while. “We also note that periodontitis, regardless of other risk factors, increases the risk of developing diabetes,” says dentist Thomas Kocher of the University of Greifswald. Since 1997, he has been conducting extensive research on the impact of inflammation of the tooth suspension apparatus on the entire body. His team has already shown that blood glucose levels decrease markedly after treatment of periodontitis. Some researchers even believe that dementia and premature births are related to poor dental health, although the evidence to support these claims is still insufficient.
Patients who already have a weakened organism are particularly vulnerable to the resulting diseases. “Smokers and diabetics are more likely to complain of gingivitis and periodontitis, and therefore have elevated levels of bacteria in their blood,” says Heinz Kniha. In patients with artificial heart valves or congenital heart disease, the bacteria can in addition lead to inflammation of the endocarditis, the inner wall of the heart. That is why these patients must take an antibiotic before dental procedures.
“Diseases are interdependent in this complex process,” notes jaw surgeon Kniha. Therefore, it is all the more important to take care of the condition of the whole organism, and you should start with your teeth. “Professional tartar removal reduces inflammation and helps to reduce the incidence of cardiovascular disease,” adds Emily Zu-Yin Chen of Veterans Hospital in Taipei. In Germany alone, over 2010 people died of these diseases in 350. Thus, according to the Federal Statistical Office, they accounted for 41,1 percent of all deaths. This is more than malignant tumors.
It is possible that modern dentists will also receive completely new tasks. – Twice a year, we examine half of the population and we often do it much earlier than doctors of other specialties. Therefore, we have the opportunity to conduct awareness campaigns among patients, and perhaps also take small preventive measures, such as measuring blood pressure or blood sugar – says dentist Thomas Kocher. This is what medics at New York University postulate in an article in the American Journal of Public Heath. In their latest research, they found that around 20 million people in the US regularly visit a dentist while avoiding their GP.
Text: Moritz Pompl