The ‘Heart-Mouth’ Connection

Dr. K. S. Kotwal
The infancy stage of dental profession is         significantly over. The importance of teeth for life long, the bad effects of dental diseases on general health are being taken seriously by majority of the general public.
The exhaustive research on dental diseases and its relation with vital organs is changing the entire face of the profession and from dentistry it may be renamed as Cardio-Dontology.
The mouth cavity is considered as a mirror of the general health, because it harbors about 300 diseases and about 400 species of microorganisms and many symptoms of systemic diseases.
The researchers who worked for 15 long years on the issue of link between heart and periodontal disease (inflammatory disease of supporting structures of teeth) have stated that there is lot of guidance to suggest that inflammation can be Hidden Killer.
In a recent development the scientist at University College of London (UCL)
Published a study in the “New England Journal of Medicine”, demonstrating that an intensive treatment of gum disease improves the health of blood vessels in the body.
The presence of highly toxic bacteria like PorphyromonasGingivalis, BacteroidForsythus, Campylobacter Rectus and others found in advance periodontal disease are also present in the Aortic Atherosclerotic Plaque in a heart patient.
The gingival inflammation sets in motion for the release of inflammatory mediators (cytokines), which create inflammation of blood vessels. The micro-blood vessels of cardiac tissues when inflamed can get blocked. The process is further helped by the dysfunction of the platelets causing aggregation and blockade.
It is important to explore the risk factors in periodontal disease, as many are similar to cardio-vascular disease.
The stroke rate in cardiac patients with periodontal disease is higher than the heart patients with healthy mouth.
Undiagnosed heart failure cases are referred to as ‘Idiopathic Cardiomyopathy’.
This condition could have been caused by previous history of long-standing Periodontal disease, sending bacteria and virus into the blood stream causing low grade ‘sub acute bacteremia’.
A condition called as ‘sub acute bacterial endocarditis’ has been long before identified especially in young children with unripe immune system.
The involvement and importance of dentist today, is highly demanding manifold. He has to be guardian of general health and not only a tooth-oriented doctor.
The focus on heart-mouth relation may bring the drastic change in nomenclature of the profession.
Today’s dentist may be tomorrow’s ‘Cardio-dentist’.
In addition to saving heart from getting infection, the dentist has many opportunities to pre-empt and pre-diagnose threatening diseases like diabetes, pre-cancerous stages, sub mucous fibrosis in a routine dental examination.
A dental patient with spongy gums with pus discharge may be a diabetic also.
A dental patient who is also a chain smoker or tobacco chewer and has non-healing ulceration on lining of oral cavity or white patches can be suffering from pre-cancerous lesions.
A dental patient with above habits and difficulty in opening the mouth may be a patient of sub-mucous fibrosis. These diseases can be pre-empted in a routine dental examination and rendered a great service to the patients by early diagnosis and treatment.
Any person in dental chair must be educated and motivated regarding dental health and disease because if you know dental disease, there will be no dental disease.
Preventive measures
* Smoking is harmful for mouth, lung and heart.
* Pan and tobacco chewing can lead to cancer
* Unhealing ulcers in mouth and recurrent attacks of candidiasis may be HIV infection.
Teeth are for life long
* Keep mouth hygiene at a high standard.
* Get once a year check up.
* Do not postpone dental treatment.
* Don’t get treatment from quacks and ill equipped clinics.
* Milk teeth are very important for child’s health, growth of the jaw, learning of proper speech and eruption of permanent teeth normally.
* Gum disease has link with vital organs.
* Learn effective brushing from a dental specialist.
*Brush after every meal.
* Eat fibrous food and avoid sweets in between the meals.
* Teeth are more needed in old age. Maintain them for whole of the life and smile for miles.


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