Your Mouth is the Window
As the saying goes, the eyes are the window to your soul. A simple glance will reveal one's delight or anger, contentment or anxiety, admiration or disdain, honesty or deceit. As a dentist my main concern is the comfort of my patients and their eyes tell me everything I need know. There is however another window adorning your temple and that of course is your mouth; the window to your overall health.
Close examination of one's mouth will reveal habitual concerns such as illicit drug abuse, grinding or clenching of teeth, GERD or bulimia, destructive dietary behaviors, and of course poor oral hygiene. The mouth will also manifest systemic problems such as illness or disease, hormonal or nutritional imbalances, etc. In addition to making sure your teeth are strong and healthy, your dentist also looks for the signs and symptoms of these systemic problems during your routine dental exam. This article, however, concerns itself with an oral disease that has negative effects on our bodies and overall health.
Periodontal Disease (aka Gum Disease) doesn't garner the same mainstream media attention as Dental Caries (aka cavities/tooth decay). This is unfortunate considering that approximately 50% of American adults suffer from some form of the disease. The earliest manifestation of gum disease is gingivitis, a REVERSIBLE inflammation of the gums caused by poor oral hygiene. The symptoms of gingivitis are red swollen gums that bleed easily upon contact, such as flossing. If your gums bleed during brushing or flossing, you have inflammation your mouth.
If this inflammation is not addressed by a dental professional, bacteria-infested plaque will accumulate below the gum-line triggering a toxin-induced chronic inflammation of the gums. In other words the body turns on itself. Bacterial toxins in addition to the body's natural response to infection start to break down the bone and connective tissue that hold teeth in place. At this point gingivitis has progressed to periodontitis. If not treated, the bones, gums, and tissue that support the teeth are IRREVERSIBLY (1 apologize for yelling) destroyed. The teeth will eventually become loose and have to be removed.
Diagnosis of periodontal disease requires radiographic x-rays that show the bone level relative to the crowns of your teeth in addition to the measuring of your gingival pockets be- tween your gums and your teeth. Healthy gums appear firm and pink with pockets measuring in the 1-2 millimeter range. Pocket depths reflect the amount of bone loss that has occurred due to gum disease with the base of the pocket being approximately 2 millimeters from the bony crest. As bone loss occurs, our gingival pockets become deeper and more difficult to clean. This sets in motion the destructive chronic inflammation of periodontal disease.
This disease is not limited locally to the mouth and gums. Chronic inflammation has become a hot topic related to overall health and well-being. It is now widely believed that chronic inflammation that goes undetected for years contributes to many serious illnesses such as type II diabetes, heart disease, stroke, some cancers (e.g. colon cancer), neurological diseases (e.g. Alzheimer's and Dementia), autoimmune diseases (e.g. rheumatoid arthritis), inflammatory bowel diseases (e.g. Crohn's disease), as well as other diseases which have unknown causes, like allergies, fibromyalgia and migraines. Reducing inflammation is also the driving force behind nutrition trends such as gluten-free and Omega-3 fatty acids.
In a recent article titled "Attack of the Immune System," author Ethan Watters (not a dentist) describes the subtle short-term symptoms of chronic inflammation "including weight gain, fatigue, aches and pains, indigestion, and...low-grade depression." He goes on to quote, "Perhaps the most established way to court chronic inflammation is to ignore proper oral hygiene. People under 65 years old with periodontal disease gingivitis, or gum inflammation, have a higher level inflammation... having a chronic infection in your mouth, even if it's a small one, fires up your immune system and keeps it fired up for as long as you have the infection. What to do? Brush twice a day, floss, and see a dentist every six months."
Chronic inflammatory periodontal disease is a pain-free disease. This destruction of your oral tissue sounds like it should hurt, but it doesn't. There are two types of patients I see on a day-to-day basis, those who maintain a routine dental hygiene appointment and those who come in when something hurts. I am happy to treat both and understand that life happens and priorities will dictate behavior. However, if something hurts it has more often than not breached the point of simple intervention and a more complex effort is required to save the tooth and alleviate pain.
I would ask you, the reader, to ask yourself right now: "Do I want to have my 'real' teeth forever?" This will simply not happen if you do not visit a dental professional on a regular basis. I've said this before, oral health decline whether it be tooth decay or gum disease is a slow process that doesn't hurt. With routine dental care these processes will be identified and treated before any permanent damage occurs. In other words, before it hurts.
Thank you for reading and I hope that my passion for this topic comes through in my writing. Summer has arrived in Montana. Let's make sure our overall health doesn't prevent us from enjoying this amazing season.
Like always I can only scratch the surface of these topics and encourage you to learn more from the American Academy of Periodontology at Perio.org. Next time you see your dental provider ask them about periodontitis and ways that you can maintain healthy gums and manage inflammation.
Read Your Mouth is the Window and other Smile Montana articles by Dr. John F. Miller, DDS, in 406 Woman magazines.