Worldwide, according to the World Health Organization, 3.5 billion people have oral health problems.
Caries affects 2.5 billion people and periodontal disease affects 1 billion people. Aside from the oral cavity, poor oral hygiene can harm overall health. Overview of oral health risks in poor condition.
- Periodontal diseases: gingivitis and periodontitis
Periodontitis is an inflammatory reaction affecting the periodontium, i.e. all the structures that allow anchoring of the teeth (gums, ligaments, alveolar bone). It is caused by gingivitis, a localized inflammation of the gums that has not been treated. Periodontitis is responsible for gradual resorption of the gums and, where applicable, tooth loss. It is also a primary cause of tooth loss. This disease and the bacteria associated with it are also associated with many other diseases: cardiovascular diseases, diabetes, cancer, etc.
- Cardiovascular diseases
Infective endocarditis is a serious infection of the endocardium (tissue lining the chambers of the heart), associated with high mortality. It is often the result of the presence of bacteria in the blood (bacteremia), the starting point of which is usually oral and dental, underlining a higher authority for health. Specifically, the infection comes from bacteria in dental plaque that enter the bloodstream to reach the heart and attach to its internal cavity.
Several studies have also pointed to a connection between periodontal disease and atherosclerosis – the formation of atherosclerotic plaques in the walls of arteries – which is the cause of most cardiovascular diseases. According to the exclusive online magazine Dental care, two different mechanisms may be at work, or even integrated. On the one hand, periodontal bacteria are found in the blood circulation and enlarge pre-existing atherosclerotic plaques. other side, “Periodontal diseases cause an immune-inflammatory reaction that results in the production of pro-inflammatory mediators, pro-thrombotic factors that, through the systemic circulation, are found at the level of atherosclerotic plaques”.
The relationship between diabetes and periodontal disease has been widely documented. Thus, poorly controlled diabetes will triple the risk of developing periodontal disease. Indeed, the chronic inflammation associated with diabetes contributes to the destruction of periodontal structures.
On the contrary, “Chronic inflammation caused by periodontitis increases insulin resistance and in turn disrupts blood sugar control,” Summary of the Prevention Observatory of the Montreal Heart Institute (Canada).
Periodontitis and inflammatory bowel disease (IBD) are also thought to be linked. Bacteria ingested through saliva contribute to intestinal inflammation by disrupting the gut microbiome (gut flora, made up of billions of microorganisms). As with diabetes, the converse is true.
Periodontal disease may again be associated with Alzheimer’s disease due to bacteria passing through the gums into the bloodstream. According to one study, P. Gingivalis, bacteria often found in periodontitis, have been identified in the brains of patients with Alzheimer’s disease. It will act negatively on tau protein and amyloid peptides, key components of the neuropathological lesions of Alzheimer’s disease.
Rheumatoid arthritis is a chronic inflammatory disease that affects the joints. The disease progresses until the joints are destroyed. Some epidemiological studies reveal a connection between this disease and chronic periodontitis. According to a 2020 study, “Inflammation caused by periodontitis stimulates the production of cells that increase bone resorption in joints”, Montreal Cardiology Institute’s Prevention Observatory relays.
A 2016 study published in the journal Annals of Oncology Shows links between poor oral hygiene and incidence of head and neck cancer. “Good oral hygiene is associated with a lower risk of head and neck cancer,” The authors conclude.
Additionally, the Prevention Observatory presents several studies on this potential association. The most recent (2022) concluded that the incidence of colorectal cancer is 50% higher in individuals with a history of periodontitis. Additionally, periodontal bacteria have been found in colorectal and oral cancers. and high levels of antibodies against P. Gingivalis Associated with the incidence of pancreatic cancer.
- Risks during pregnancy
Finally, if cause and effect links remain difficult to establish, periodontitis may cause harmful effects in pregnant women. According to a medical thesis defended in 2022, which aimed to review the literature on the subject, “The presence of Porphyromonas gingivalis can be a cause of low birth weight but also an increase in the inflammatory response that can lead to pre-eclampsia and therefore preterm delivery”.
