The Mouth: A Window To Good Health

Taking care of your teeth and gums isn’t just about looking good.  Your oral health provides important clues about a variety of health-related problems, with the mouth often being the source.  

Periodontal or gum disease can cause oral pain and discomfort as well as tooth loss.  Most people don’t realize that it can also affect a person’s overall health.  This is especially important for the aging population, the elderly and medically compromised patients who are at high-risk for disease and have specific oral health needs.   

The connection between oral infections and other diseases in the body is becoming understood and accepted within the health-care community.  In the last several years, scientific evidence and scholarly articles have uncovered the link between oral health and systemic diseases.

At the University of Manitoba, a first-of-its-kind centre — the International Centre for Oral-Systemic Health — was established in 2008 to investigate the relationship between oral health and overall health.  Based on strong scientific evidence, governments, educators, medical and oral health professions have identified the need to increase awareness and the application of the systemic connection.

In addition, evidence presented in a position paper published by the American Academy of Periodontology (AAP) in 1998, (“Periodontal Disease as a Potential Risk Factor for Systemic Diseases”), confirms the correlation between oral health and a person’s general health and personal well-being.  In 2013, the AAP collaborated with the European Federation of Periodontology to publish a series of consensus reports that analyze the scientific evidence linking periodontal disease, specifically periodontitis, to other diseases in the body.

The findings in these reports emphasize the importance of good oral hygiene and the dental hygienist’s role in preventing oral disease and educating the public about attaining and maintaining good oral health.

Periodontal disease is one of the most common diseases of humans.  According to the College of Dental Hygienists of Ontario (CDHO) as many as 75 per cent of adults over the age of 30 may suffer from some form of gum disease at some point in their life.  

If left untreated, infective bacteria from the gums can enter the blood stream or airways, increasing the risk of stroke, heart and respiratory diseases, and adverse pregnancy disorders, according to the AAP position paper. It also states that controlling diabetes is more difficult in the presence of gum disease.

Over time a buildup of bacteria in a film called plaque collects at the gum line and if not removed on a daily basis may eventually harden on the teeth forming calculus or tartar. Brushing and flossing help get rid of plaque.  The longer plaque and tartar are on the teeth, the more harmful they become. Only professional cleanings can remove tartar.  If it is not removed, inflammatory destruction of gum tissue may ultimately result in bone and tooth loss.

What to watch for

Key indicators of periodontal disease are swollen and red gums that bleed when flossing or brushing.  Bleeding gums should never be considered normal. With regular and comprehensive oral care to remove bacterial plaque and tartar buildup, gum disease can be prevented, controlled or even reversed.  

Other symptoms include:
• Bad breath that won’t go away
• Painful chewing
• Sensitive and/or loose teeth
• Receding gums or longer appearing teeth

Keep your mouth healthy

Less than five minutes a day is all it takes to maintain or improve oral hygiene. Dental hygienists recommend brushing twice a day with a soft toothbrush for two minutes using fluoridated toothpaste.  As well, people should floss or clean between teeth and scrape or brush the tongue once a day.

Oral health tips:
•  Replace your toothbrush every couple of months as it can harbour bacteria, fungi and viruses.  Also replace when bristles splay or after a cold or flu.
•  Watch what you eat.  Frequent consumption of acidic foods (pop, juices, citrus fruits, etc.) can eventually dissolve tooth enamel, causing sensitivity, unsightly appearance and possibly tooth loss.  Rinse with water or chew sugarless gum after eating to help stimulate saliva and reduce acids that cause enamel erosion and tooth decay.
• Choose raw fruit and vegetables or hard cheese for between-meal snacks. Chewing increases saliva flow, which has a natural cleansing action to help protect the teeth from decay.
• Wear a mouthguard at all times when participating in sports or any activity that could cause injury to your mouth or jaw.
• Schedule regular dental hygiene checkups throughout your lifetime, even if you wear dentures.  
• Avoid smoking and chewing tobacco.

“If left untreated, infective bacteria from the gums can enter the blood stream or airways, increasing the risk of stroke, heart and respiratory diseases, and adverse pregnancy disorders.”

Partners in oral health

Maintaining good oral health and overall health requires a collaborative or “team” approach.  As integral members of the health-care team, dental hygienists have a distinctive clinical role to prevent gum disease and tooth decay.  In addition to cleaning (scaling) teeth, they also take medical history; record any health changes; examine head, neck and mouth; plan and implement treatments; provide oral care education; and develop in-home care programs.  

Dental hygienists work closely with other health-care providers, making certain their clients receive the treatment and referrals they need to keep mouth and body healthy.  They contact physicians to ensure clients at risk are properly medicated prior to treatment; make referrals to oral surgeons and dermatologists when suspicious sores or lesions are detected during oral cancer screening; and confer with pharmacists, nurse practitioners, dentists and dietitians.

Good oral health is important at any age.  However, the growing aging population presents a different set of challenges for oral health professionals.  A CDHO report published in October 2014 shows that as many as three million Ontario adults have not seen an oral health professional in more than a year. A significant number are affected by lack of access to oral care services because they are sick, living in remote areas or in long-term care (LTC) homes, or they can’t afford the care they need.

Proactive oral care

Dental hygienists are making inroads to help this most vulnerable segment of the population.  Legislation changes allow dental hygienists to work outside the traditional dental office — a welcome shift in proactive oral health care.  Today there are more than 250 independent dental hygiene clinics and mobile practices in Ontario, and this number is steadily growing.  This means increased community access to affordable oral care treatment.

More and more seniors are keeping their natural teeth. That becomes a care issue, especially once they are in LTC, where teeth are often neglected.  Declining oral health can have a profound effect on a person’s social, mental and physical well-being.  Caregivers require special skills and knowledge for providing proper oral care to residents, especially those who are chronically ill and cannot care for themselves.  To help with this, the Ontario Dental Hygienists’ Association provides educational resources for caregivers in LTC homes in Ontario.

For everyone — from infants to seniors — dental hygienists work with you to keep your mouth healthy.  Those armed with knowledge and information will have more success in adhering to an oral care maintenance program.  Let your dental hygienist get you started on your journey to good health.

Terri Strawn practises at the Whitby Dental Centre and teaches dental hygiene at Durham and Algonquin colleges.  She is ODHA president and serves on the executive of the Ontario Restorative Dental Hygiene Study Club.  A graduate of the dental hygiene program, with a specialty in restorative, she also holds a bachelor’s degree of dental science in dental hygiene.