MEDICAL CONDITIONS AND ORAL HEALTH

The Mouth-Body Connection

You've heard of the mind-body connection, but what about the mouth-body connection To many people, a dental visit is only about teeth. But what goes on in the rest of your body affects your mouth, and what goes on in your mouth affects the rest of your body.
Many diseases and conditions can affect your oral health, and therefore, the state of your mouth often can provide information about your overall health. Your dentist can be instrumental in helping to diagnose many diseases and conditions that have oral effects and refer you to the proper specialist for treatment. He or she also can make sure you get specialized oral and dental care if you have a chronic condition that requires it and, when necessary, refer you to an expert in oral medicine.
Your oral health also can affect other medical conditions.
Here are some examples of the connections between oral health and medical conditions.

New research is suggesting a link between gum disease and diabetes. While it's established that people with diabetes are more prone to developing gum disease, this new research implies that chronic gum disease may be a risk factor for diabetes.

How does this happen Gum disease can cause bacteria to enter the bloodstream and activate cells that produce inflammatory biological signals that have a destructive effect throughout the body. In the pancreas, the cells responsible for insulin (blood sugar) can be damaged or destroyed. Once this happens, it may trigger Type 2 diabetes — even in a healthy individual with no other risk factors for diabetes.

If You Already Have Diabetes, if your blood glucose levels are poorly controlled, you are more likely to develop gum disease and lose more teeth than non-diabetics. Like all infections, gum disease can be a factor in causing blood sugar to rise and make diabetes harder to control. Other oral problems linked to diabetes include: thrush, an infection caused by fungus that grows in the mouth, and dry mouth which can cause soreness, ulcers, infections and cavities.

People with diabetes have special needs and your dentist is equipped to meet those with your help. Keep your dentist informed of any changes in your condition and any medication you might be taking. Postpone any non-emergency dental procedures if your blood sugar is not in good control.

Overall, the data indicates that chronic gum disease may contribute to the development of heart disease, the nation's leading cause of death in both men and women.

How does this happen Gum disease is a bacterial infection that can affect conditions outside your mouth. In heart disease, one theory is that gum disease can cause bacteria to enter the bloodstream where they attach to the fatty deposits in the heart blood vessels. This condition can cause blood clots and may lead to heart attacks.

If You Have Heart Disease, to maintain the best oral health, you should:

• Establish and maintain a healthy mouth. This means brushing and flossing daily and visiting your dentist regularly.
• Make sure your dentist knows you have a heart problem.
  
• Carefully follow your physician's and dentist's instructions, and use prescription medications, such as antibiotics, as directed.

If you have certain preexisting heart conditions, you may be at risk for developing bacterial endocarditis — an infection of the heart's inner lining or the valves. Anytime there is bleeding in the mouth, certain oral bacteria can enter the blood stream and may settle on abnormal heart valves or tissue weakened by an existing heart problem or heart condition. In these cases, the infection can damage or even destroy heart valves or tissue.

There are precautions you need to take if you have any of the following conditions:

• Artificial (prosthetic) heart valves
  
• A history of endocarditis
  
• Congenital heart or heart valve defects
  
• Heart valves damaged (scarred) by conditions such as rheumatic fever
  
• Mitral valve prolapse with a murmur
  
• Hypertrophic cardiomyopathy

• Be sure to tell your dentist if you have a heart condition, and what, if any, medications you are taking for it. Your dentist will record important health information in your record and coordinate treatment with your physician.
  Dental Problems Associated with HIV/AIDS

Dental problems such as sore bleeding gums, herpes sores in the mouth, and fungal and candida (yeast) infections may be among the first signs of AIDS. However, you should not assume you are infected if you have any of these symptoms as these occur in the general population as well. The only way to determine whether you are infected is to be tested for HIV infection. Consult with your physician or other healthcare professional.

Anorexia and bulimia can damage your teeth in several ways.

A bulimic individual engages in a cycle of binge eating and vomiting. The stomach acids in the vomit pass through the mouth and can erode tooth enamel, causing cavities, discoloration and tooth loss. Since teeth appear worn and yellow, a dentist may be the first to notice signs of this eating disorder. Cosmetic dentistry can help correct deteriorated tooth enamel.

In anorexia, semi-starvation deprives the body of the nutrients it needs. Osteoporosis can develop, weakening the bones in the jaw that support teeth, leading to tooth loss.

In both diseases, it is critical to treat the underlying causes that lead to anorexia and bulimia as well as the dental complications resulting from them. While a dentist can correct the deteriorated tooth enamel, he or she cannot treat the actual eating disorder. Should you have an eating disorder - or think you might - talk to your physician.

Growing evidence suggests a link between gum disease and premature, underweight births. Pregnant women who have gum disease may be more likely to have a baby that is born too early and too small.

More research is needed to confirm how gum disease affects pregnancy outcomes. But it appears that gum disease triggers increased levels of biological fluids that induce labor. Data also suggests that when gum disease worsens during pregnancy, there's a higher risk of having a premature baby.

The best advice to women considering pregnancy is to visit their dentist for a checkup and to treat any oral problems before becoming pregnant.

During your pregnancy, your teeth and gums need special attention. Regular brushing and flossing, eating a balanced diet and visiting your dentist regularly will help reduce dental problems that accompany pregnancy.

Studies show that many pregnant women experience pregnancy gingivitis — when dental plaque builds up on the teeth and irritates the gums. Symptoms include red, inflamed and bleeding gums. Pregnancy gingivitis occurs more frequently during pregnancy because the increased level of hormones exaggerates the way gums react to the irritants in plaque. However, it's still plaque — not hormones — that is the major cause of gingivitis.
Keeping your teeth clean, especially near the gumline, will help dramatically reduce or even prevent gingivitis during your pregnancy.

Be sure to let your dentist know you're pregnant when you schedule your appointment. It's best to schedule your dental visit during the fourth to sixth month of your pregnancy. This is because the first three months of pregnancy are thought to be of greatest importance in your child's development. During the last trimester, stresses associated with dental visits can increase the incidence of prenatal complications.

Typically, X-rays, dental anesthetics, pain medications and antibiotics (especially tetracycline) are not prescribed during the first trimester, unless it's absolutely necessary. During the last three months of pregnancy, sitting for long periods of time in the dental chair can become uncomfortable. And there is evidence that pregnant women can be more prone to gagging. Your dentist, however, is prepared for this situation.

If you need to schedule an emergency visit, let the office know about your pregnancy before you arrive. Discuss any stresses, past miscarriages and drugs you are taking as these can all have an influence on how your dentist attends your needs. Your dentist may also want to consult with your physician before any treatment is started.

If you have any doubts or concerns, insist that your dentist and physician discuss your particular needs. If your dentist prescribes medication, do not exceed the prescribed dosage. This includes aspirin.