This past September, the Journal of the American Dental Association featured an article explaining the new definition of oral health approved by the FDA World Dental Federation General Assembly. It was decided that a common definition could bring people together to help advocate for the importance of oral health. It moves the field of dentistry from not only focusing on treating disease, but also to providing long-term care and support for oral health and well-being.
Here is the official definition of oral health:
Oral health is multifaceted and includes the ability to speak, smile, smell, taste, touch, chew, swallow, and convey a range of emotions through facial expressions with confidence and without pain, discomfort, and disease of the craniofacial complex. (Download the PDF of the full definition here)
This definition helps raise awareness across all fields that oral health does not occur in isolation, but is part of overall systemic or bodily health.
Gum Disease and Oral Health
On the opposite end of the spectrum from oral health is gum disease. Gum disease ranges in severity from gingivitis (bleeding or inflamed, “puffy” gums) to its more serious counterpart, periodontitis. Periodontitis itself can range from mild, moderate to severe case types. Typically mild cases have slight tartar or hardened deposits of bacteria built up right at, and/or slightly under the junction between the gums and teeth. Many times a deep cleaning or scaling and root planing procedure is needed to remove this bacteria and regain your oral health. In the more moderate to severe cases, not only do the gums bleed, but the gums and bone begin to erode away exposing root surfaces which can lead to sensitivity, tooth loosening and many times tooth loss. Other, often more extensive procedures are needed to help improve oral health.
If you notice that you have even a little area of bleeding in your mouth or blood in your saliva prompted either by brushing, flossing, eating or a routine dental cleaning, this bleeding is caused by inflammation as a response to a bacterial infection in your gums. Gum disease happens because of the inflammatory response which occurs because of the bacterial infection. Gum diseases can influence other diseases via a specific inflammatory protein known as CRP. Bacteremia occurs when bacteria that break off from the tartar build up on teeth/roots get into the bloodstream. This bacteremia is the initial factor that leads to the production of CRP which can ultimately influence the occurrence of negative vascular events such as heart attack and stroke.
Gum Disease and Systemic Health
Many years ago, researchers Kimmo Mattila and coworkers reported that individuals admitted to the emergency room with a myocardial infarction or heart attack were overwhelmingly likely to have periodontal disease. This made them wonder if periodontal disease might be a risk factor for cardiovascular disease. Since then, a significant amount of research has been done to enhance our understanding of how periodontal disease might affect distant sites and organs of our body, and thus its effect on overall health.
For example, diabetes has been shown to have a “2 way relationship” with gum disease. It has been found that periodontal treatment can significantly reduce the “A1c” level (up to almost 0.5%) that is commonly tracked for diabetic patients. Similarly, periodontal disease increases a person’s risk for diabetes type 2 development and progression by more than 50%.
The American Academy of Periodontology is committed to raising awareness and evidence of the connective relationship between inflammatory disease states, including periodontal disease and cardiovascular disease and diabetes. It is and will continue to be important for dentists, dental specialists such as periodontists, and other health care providers to partner together to provide the upmost health care for our patients.