▎ WuXi AppTec content team editor
There is an old Chinese saying called "illness comes from the mouth", which means that eating what should not be eaten and drunk should not be drunk will cause disease.
The oral cavity is not only a repository of more than 300 microorganisms, but also a channel for many risk factors for chronic diseases to enter the human body, and a way for many infectious diseases, such as hepatitis B.
At the same time, with the progress of scientific research, scientists have a new understanding of "disease from the mouth". In their view, the oral cavity also has an impact on the health of the whole body. Oral diseases not only affect oral health, but also directly or indirectly affect the health of the whole body and the quality of life.
The World Health Organization also emphasizes that oral health is a key indicator of overall health, well-being and quality of life.
Recently, a new study published in the international journal BMJ Open, a sub-journal of the British Medical Journal, found that having periodontal disease is associated with an increased risk of a variety of chronic diseases, including cardiovascular disease, cardiometabolic disease, autoimmune disease and psychiatric disease.
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Before we start introducing the new study, we need to understand what periodontal disease is.
Periodontal disease is one of the two major types of diseases in the oral cavity (the other is caries) and is also the main cause of tooth loss in adults.
After the disease, the patient first appears gums red and swollen, easy to bleed when touched and other symptoms, if not treated in time, there will be further gum atrophy, alveolar bone resorption, periodontal bag formation, tooth loosening and displacement, etc., sometimes cause periodontal overflow, oral odor, and finally lead to tooth loss or extraction.
Periodontal disease can be divided into two types: gingival disease and periodontitis:
Gum disease is a lesion that occurs in the gum tissue, mainly caused by plaque or non-plaque, including inflammation of the gum tissue and symptoms of systemic diseases in the gums. Gum disease caused by plaque, if not treated in time, will have the potential to develop periodontitis.
Periodontitis is a chronic infectious disease that occurs in the periodontal tissue and is the first cause of tooth loss in Chinese adults.
In the new study, the researchers followed up 315,540 participants with an average age of 44. Of all participants, 43 percent were male; 20.4 percent were periodontal disease patients, and 79.6 percent were control populations without periodontal disease.
At the beginning of the study, the researchers counted the participants' basic health information, lifestyle information, and disease information about periodontal disease. In addition, during the follow-up period, the researchers also counted the incidence of different chronic diseases in the participants, including:
Cardiovascular disease (CVD), such as heart failure, ischemic heart disease, stroke, vascular dementia, etc.;
Cardiometabolic diseases (CMD), such as high blood pressure, type 2 diabetes, etc.;
Autoimmune diseases (AID), such as type 1 diabetes, psoriasis, rheumatoid arthritis, inflammatory bowel disease, etc.;
Mental illness (MIH), such as depression, anxiety, severe mental illness, etc.
During the average follow-up period of more than 3 years, 5.4%, 9.6%, 3.3% and 11.7% of patients with periodontal disease were new-onset cardiovascular diseases, cardiometabolic diseases, autoimmune diseases and psychiatric diseases, while in the control group, the proportion of patients with new or more chronic diseases was 4.5%, 8.6%, 2.4% and 8.3%, respectively, which was significantly lower than that of patients with periodontal disease.
After stripping away factors such as age, sex, body mass index (BMI), smoking status, and diet, the researchers found that having periodontal disease was associated with an increased risk of a variety of chronic diseases.
Specifically, compared with the control group participants, participants with periodontal disease had an 18% increased risk of cardiovascular disease; a 7% increased risk of cardiometabolic diseases, of which the risk of type 2 diabetes was the most pronounced at 26%,; the risk of autoimmune diseases was increased by 33%,; and the risk of developing mental illness was increased by 37%.
In addition, the researchers found similar associations in different types of periodontal disease patients. However, in patients with periodontitis, the increased risk of cardiometabolic diseases and autoimmune diseases is not very obvious.
The researchers analyzed that periodontal disease may increase the risk of chronic disease development in a variety of ways.
People with periodontal disease are more likely to develop pathogenic bacteremia, which increases the risk of cardiovascular disease. At the same time, having periodontal disease is also associated with an increase in the level of pro-inflammatory mediators in the blood, which are associated with the occurrence of atherosclerosis. Studies have found that the treatment of periodontitis is associated with improvements in levels of systemic inflammatory markers and alternative markers of cardiovascular disease risk.
There is a two-way link between type 2 diabetes and periodontal disease. That is, poorly controlled diabetes is a risk factor for periodontal disease, and periodontal disease itself can also affect the progression of diabetic disease.
Periodontal disease is associated with mental health and may be related to behavior. People with periodontal disease may reduce unhealthy behaviors, such as reducing habits that promote oral health; but increase harmful health behaviors, such as smoking, which may be harmful to mental health. In addition, some symptoms of periodontal disease, such as bad breath and missing teeth, can also have a negative impact on the patient's life and work, thus affecting mood.
The association between periodontal disease and autoimmune disease is likely to be related to microorganisms in the mouth, and the number of harmful microorganisms increases, which in turn harms the immune system.
Because the study was observational, it only showed an association between having periodontal disease and an increased risk of multiple chronic diseases, and did not show a causal relationship. And the study also has some limitations, such as some data provided by participants' recalls, which may also have an impact on the results.
Study lead author Dr Joht Singh Chandan of the University of Birmingham points out: "Poor oral health is extremely common, both in the UK and globally. But until now, not much has been known about the link between poor oral health and a variety of chronic diseases, especially mental illness. Our findings provide evidence that periodontal disease is associated with an increased risk of multiple chronic diseases. ”
Dr Devan Raindi, one of the study authors and from the University of Birmingham, added: "This study shows an association between periodontal disease and various health conditions. The findings highlight the importance of preventing, early identification and treatment of periodontal disease. In order to promote overall health, we not only need to have good oral health habits, but also conduct regular oral health check-ups. ”
The World Health Organization notes that most oral diseases are largely preventable and can be treated at an early stage. Therefore, if you want to promote oral health and prevent the occurrence of oral diseases, you should pay attention to the following aspects in daily life:
Brush your teeth in the morning and evening and rinse your mouth after meals. Brushing removes plaque, soft scale and food debris. Brush your teeth at least twice a day, preferably after each meal, and brush your teeth at night before going to bed. And as long as there are teeth in the mouth, you should insist on brushing your teeth, and pay attention to cleaning your mouth without teeth.
Do one person brush one sip of cup. In the same household, one toothbrush and one mouth cup must be placed separately by each person to avoid cross-infection.
Choose a floss or interdental brush (interdental brush) to help clean the gap between teeth. Plaque and soft scale are most likely to remain in the space between teeth. When brushing teeth, the brush bristles can not fully extend the gap between the teeth, if you brush your teeth every day, you can use floss or dental brushes to help clean the gap between the teeth, you can achieve the purpose of thoroughly cleaning the teeth.
Eat sugar scientifically and drink less carbonated drinks. If you regularly consume too much sugary sweets or drink too many carbonated drinks, it will lead to tooth demineration and endanger oral health.
Do not smoke or quit as soon as possible. Smokers are 5 times more likely to develop periodontal disease than non-smokers. Smokers often have brown spots and tartar on the surface of their teeth, causing oral odor and affecting personal appearance and social interaction.
Oral health checks are done at least once a year. Oral diseases such as periodontal disease often occur slowly. Therefore, regular oral health examinations, at least once a year, can detect oral diseases in time and treat them early.
Clean your teeth once a year. Self-oral care methods can only remove plaque, not tartar removal. It is possible to come to the hospital regularly to have your teeth cleansed (washed) by a dentist, preferably once a year. Regular scaling helps keep teeth firm and periodontal healthy.
See a doctor in case of oral problems. If the mouth appears with discomfort, pain, bleeding gums, odor and other symptoms, you should go to the clinic as soon as possible, which is helpful to treat related diseases in the early stage, alleviate pain and harm to the health of the whole body.