Oral health and overall health: Why a healthy mouth is good for your body
 Taking good care of your mouth, teeth and gums is a worthy goal in and of
itself. Good oral and dental hygiene can help prevent bad breath, tooth
decay and gum disease — and can help you keep your teeth as you get older.

Researchers are also discovering new reasons to brush and floss. A healthy
mouth may help you ward off medical disorders. The flip side? An unhealthy
mouth, especially if you have gum disease, may increase your risk of serious
health problems such as heart attack, stroke, poorly controlled diabetes and
preterm labor.
The case for good oral hygiene keeps getting stronger. Understand the
importance of oral health — and its connection to your overall health.
 What's in your mouth reveals much about your health What does the health of
your mouth have to do with your overall health? In a word, plenty. A look
inside or a swab of saliva can tell your doctor volumes about what's going
on inside your body.
*Many conditions cause oral signs and symptoms*
Your mouth is a window into what's going on in the rest of your body, often
serving as a helpful vantage point for detecting the early signs and
symptoms of systemic disease — a disease that affects or pertains to your
entire body, not just one of its parts. Systemic conditions such as AIDS or
diabetes, for example, often first become apparent as mouth lesions or other
oral problems. In fact, according to the Academy of General Dentistry, more
than 90 percent of all systemic diseases produce oral signs and symptoms.
 *Saliva: Helpful diagnostic tool*
Your doctor can collect and test saliva to detect for a variety of
substances. For example, cortisol levels in saliva are used to test for
stress responses in newborn children. And fragments of certain bone-specific
proteins may be useful in monitoring bone loss in women and men prone to
osteoporosis. Certain cancer markers are also detectable in saliva.
Routine saliva testing can also measure illegal drugs, environmental toxins,
hormones and antibodies indicating hepatitis or HIV infection, among other
things. In fact, the ability to detect HIV-specific antibodies has led to
the production of commercial, easy-to-use saliva test kits. In the future,
saliva testing may replace blood testing as a means of diagnosing and
monitoring diseases such as diabetes, Parkinson's disease, cirrhosis of the
liver and many infectious diseases.
 Protection against harmful invaders: How saliva disables bacteria and
viruses Saliva is also one of your body's main defenses against
disease-causing organisms, such as bacteria and viruses. It contains
antibodies that attack viral pathogens, such as the common cold and HIV. And
it contains proteins called histatins, which inhibit the growth of a
naturally occurring fungus called *Candida albicans*. When these proteins
are weakened by HIV infection or other illness, candida can grow out of
control, resulting in a fungal infection called oral thrush.
 Saliva also protects you against disease-causing bacteria. It contains
enzymes that destroy bacteria in different ways, by degrading bacterial
membranes, inhibiting the growth and metabolism of certain bacteria, and
disrupting vital bacterial enzyme systems.
 The problem with dental plaque: Links to infections and diseases Though
your saliva helps protect you against some invaders, it can't always do the
job. More than 500 species of bacteria thrive in your mouth at any given
time. These bacteria constantly form dental plaque — a sticky, colorless
film that can cling to your teeth and cause health problems.
*Your mouth as infection source*
If you don't brush and floss regularly to keep your teeth clean, plaque can
build up along your gumline, creating an environment for additional bacteria
to accumulate in the space between your gums and your teeth. This gum
infection is known as gingivitis. Left unchecked, gingivitis can lead to a
more serious gum infection called periodontitis. The most severe form of gum
infection is called acute necrotizing ulcerative gingivitis, also known as
trench mouth.
Bacteria from your mouth normally don't enter your bloodstream. However,
invasive dental treatments — sometimes even just routine brushing and
flossing if you have gum disease — can provide a port of entry for these
microbes. Medications or treatments that reduce saliva flow and antibiotics
that disrupt the normal balance of bacteria in your mouth can also
compromise your mouth's normal defenses, allowing these bacteria to enter
your bloodstream.
If you have a healthy immune system, the presence of oral bacteria in your
bloodstream causes no problems. Your immune system quickly dispenses with
them, preventing infection. However, if your immune system is weakened, for
example because of a disease or cancer treatment, oral bacteria in your
bloodstream (bacteremia) may cause you to develop an infection in another
part of your body. Infective endocarditis, in which oral bacteria enter your
bloodstream and stick to the lining of diseased heart valves, is an example
of this phenomenon.
 *Plaque as cause of common conditions?*
Long-term gum infection can eventually result in the loss of your teeth. But
the consequences may not end there. Recent research suggests that there may
be an association between oral infections — primarily gum infections — and
poorly controlled diabetes, cardiovascular disease and preterm birth. More
research is needed to determine whether oral infections actually cause these
conditions, which include:

   - *Poorly controlled diabetes.* If you have diabetes, you're already
   at increased risk of developing gum disease. But chronic gum disease may, in
   fact, make diabetes more difficult to control, as well. Infection may cause
   insulin resistance, which disrupts blood sugar control.
   - *Cardiovascular disease.* Oral inflammation due to bacteria
   (gingivitis) may also play a role in clogged arteries and blood clots. It
   appears that bacteria in the mouth may cause inflammation throughout the
   body, including the arteries. This inflammation may serve as a base for
   development of atherosclerotic plaques in the arteries, possibly increasing
   your risk of a heart attack or stroke. Some research suggests that
   people with gum infections are also at increased risk of heart attack and
   stroke. The more severe the infection, the greater the risk appears to be.
   And gum disease and tooth loss may contribute to plaques in the carotid
   artery. In one study, 46 percent of participants who'd lost up to nine teeth
   had carotid artery plaque; among those who'd lost 10 or more teeth, 60
   percent of them had such plaque.
   - *Preterm birth.* Severe gum disease may increase the risk of preterm
   delivery and giving birth to a low birth weight baby. The National Institute
   of Dental and Craniofacial Research, in fact, estimates that as many as 18
   percent of preterm, low birth weight babies born in the United States each
   year may be attributed to oral infections. The theory is that oral
   bacteria release toxins, which reach the placenta through the mother's
   bloodstream and interfere with the growth and development of the fetus. At
   the same time, the oral infection causes the mother to produce
   labor-triggering substances too quickly, potentially triggering premature
   labor and birth.

 A compelling case for good habits If you didn't already have enough reasons
to take good care of your mouth, teeth and gums, the relationship between
your oral health and your overall health provides even more. Resolve to
practice good oral hygiene every day. You're making an investment in your
overall health, not just for now, but for the future, too.


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