Chronic health conditions create a massive burden on the health of individuals as well as the entire healthcare system. Oral hygiene is one of the most important aspects that many people ignore or are unaware about it. Routine and regular dental care not only prevents periodontal disease but also helps to apprise the patients who are at significant risk for more serious systemic conditions. Majority of the population need a visit to the dentist only in case of a persistent symptom like toothache.
Among the systemic conditions that are impacted, either coincidentally or causally, by oral conditions are atherosclerotic disease, pulmonary disease, diabetes, pregnancy, birth weight, osteoporosis, and kidney disease.
1.Atherosclerotic disease – Atherosclerosis, the pathologic narrowing of arteries due to the deposition of cholesterol and cholesterol products in vessel walls, is the primary cause of most cases of coronary heart disease and cerebrovascular disease. Patients with periodontal disease and poor oral hygiene suffer from frequent and severe gingival inflammation and frequent bacteremia, both of which activate the host inflammatory response. While several studies have demonstrated that periodontal disease and poor oral hygiene have a strong association with the risk of coronary heart disease and acute myocardial infarction.
Diabetes Mellitus
Diabetes is a disease of disrupted glycemic control resulting from a lack of insulin production (type 1) or systemic insulin resistance (type 2)
The relationship between diabetes and periodontitis is truly bidirectional, as it is well proven that hyperglycemia negatively impacts oral health and severe periodontitis can negatively impact glycemic control. Individuals with diabetes have at least a 3 times greater risk of periodontitis than those without diabetes. However, studies have shown that patients with well-controlled diabetes have no increased risk of periodontitis compared to individuals without diabetes.
2. Pregnancy complications and low birth weight – Pregnancy is a time of great change in a woman’s body, and the changes impact both the oral cavity and the maternal-fetal complex. Gastric acid secretion and the reflux of the acid into the oral cavity leads to worsening of enamel erosion, increased caries risk, xerostomia, and increased tooth mobility and loss. So it is very important to do dental visit regularly to alleviate other complications of health issues
It also affects the Other conditions like In osteoporosis, an imbalance between bone loss and formation results in decreased bone mineral density. Decreased bone density in the jawbone leads to greater alveolar bone resorption, increasing the depth and number of gingival pockets, which in turn allows invasion by periodontal pathogens. This chronic infection leads to local and systemic increases in interleukin 6, which is a known predictor of bone loss. it is impossible to state that perio- dontal disease is causal to osteoporosis, but the studies seem to lean toward a positive relationship between the conditions.
Periodontal disease and other conditions that result in poor oral health are common in patients with chronic kidney disease. These oral conditions can lead to systemic inflammation, infection, protein wasting, and the development of atherosclerotic lesions, all of which worsen morbidity and mortality in chronic kidney disease patients.
Primary prevention of disease is the best approach but often difficult to achieve. From a primary care standpoint, it is vital that physicians and dentists increase collaboration and share information that can impact the patient’s health. Most patients with these chronic conditions probably do not think that a problem in their mouth can affect their heart or bones. So it’ is mandatory to visit a dentist regularly to avoid other systemic conditions.
The writer is Oral & Maxillofacial Surgeon, Director of centre for Dental care & Head of Department of Healing Tree Hospital, Indirapuram.
