The link between oral and systemic health is becoming more obvious. Oral infections, more frequently periodontitis, have been associated with conditions like diabetes, cardiovascular disease, pneumonia, erectile dysfunction, metabolic syndrome, and rheumatoid arthritis. With ageing, people become more susceptible for developing both oral and systemic diseases.

General mechanisms behind oral – systemic health links?

1. Distant effect of inflammatory mediators - Chronic inflammation in oral cavity leads to increase in level of inflammatory markers, which can potentially affect immune response, thereby adding to the burden of disease state in body.
2. Bacteraemia - Pathogenic bacteria from oral cavity can enter bloodstream and lead to distant metastasis.

Recent updates on Oral – Systemic health links

Alzheimer’s diseases and oral health

As per the recent evidence, a bidirectional relationship between Periodontal disease and Alzheimer’s disease has been suggested. Dissemination of oral microbes into brain or low-level of systemic inflammation may have role to play in initiation or exacerbation of Alzheimer’s disease. Although further studies are required to elaborate the pathogenesis and potential causality between the two disease entities, it is important to emphasize best oral hygiene practices to prevent potential complications.

Diabetes and Periodontal Disease

Diabetes and Periodontal diseases share a two- way relationship. It is established that, poorly controlled type-1 and type-2 diabetes are known to cause increased risk and severity of periodontitis, while well-controlled diabetes patients exhibit no increased risk of progressive attachment loss relative to people without diabetes. Further, it is reported that, severe periodontitis was associated with significantly elevated HbA1C levels in people without diabetes and in those with diabetes. There are consistent evidences that show periodontal therapy results in a clinically meaningful and statistically significant reduction of HbA1C levels in people with type 2 diabetes, ranging from 0.27% to 0.48% at 3–4 months following periodontal therapy.

Respiratory diseases and oral health

Growing evidences from numerous clinical studies have shown that periodontitis and oral microflora are associated with the onset, progression, and exacerbation of respiratory diseases like pneumonia, influenza, and chronic obstructive pulmonary disease. A recent study by Dr. Twigg, Cardiff University, UK reported that uncleaned dentures can be associated with pneumonia. Direct aspiration of oral bacteria can lead to infection in lungs.

Final Note

Time and again there have been numerous evidences that show association between oral health and systemic health. Although majority of the studies show no direct causal link, better oral health can impact the quality of life of an individual. Hence, maintaining good oral health has considerable positive effects on systemic health. 

Article by Dr. Siri P.B.