\n<\/p>\n
I<\/span>sn\u2019t it weird that dentistry and medicine have been kept largely separate? Why should our mouths be treated differently from the rest of our bodies? Going to the dentist often feels like more of a lifestyle and cosmetic add-on, especially for adults in the UK. And, even if you can find an NHS dentist, the service is not free at the point of use like medical doctors are.<\/p>\n The origin story for this rift is that dentistry began, in the middle ages, as a trade \u2013 with tooth extractions handled by \u201cbarber surgeons\u201d and dentures crafted by jewellers and blacksmiths. Today, dentistry and medicine still have their own separate training routes, professional bodies and NHS setup. Generally speaking, medical doctors can\u2019t act as dentists, and dentists aren\u2019t medical doctors. But the tide is turning on this conceptual separation, because the links between oral health and systemic healthcare are becoming ever more apparent.<\/p>\n Cardiologists and doctors treating type 2 diabetes, for example, are increasingly concerned with the state of their patients\u2019 mouths. Specialists in everything from rheumatoid arthritis to cognitive decline may soon be too, if recent research is any indication.<\/p>\n \u201cPeople forget that the mouth is an open portal, a gateway into the bloodstream and your lungs, and inside your body,\u201d says Steve Kerrigan, professor of precision therapeutics at RCSI University of Medicine and Health Sciences\u2019 school of pharmacy and biomolecular sciences in Dublin. Our mouths host about 700 species of bacteria, he says. Gum disease is extremely common: around half of UK adults have it in some form, caused by bacteria-harbouring plaque building up on teeth. Gingivitis is the milder, reversible version (a tell-tale sign is bleeding when you floss or brush). Periodontitis is when inflammation leads to teeth detaching from gums; this is the main cause of adult tooth loss and is irreversible.<\/p>\n \u201cGum disease is now classed as a chronic inflammatory condition in its own right,\u201d says Kerrigan, \u201cup there with asthma, COPD [chronic obstructive pulmonary disease], Crohn\u2019s disease and ulcerative colitis.\u201d Some studies have shown that \u201cup to 90% of people with cardiovascular disease also have gum disease\u201d, he says. Research into the relationship between the two is the most advanced in terms of investigating oral and systemic health, showing some actual causation, rather than mere associations. This is an important question when it comes to the connections between oral and general health. It is one thing knowing that people with gum disease are more likely to also have certain other conditions; but how do we know which is causing which, or whether both are simply signs of a body compromised by general poor health?<\/p>\n <\/span>An orthodontist checks a patient\u2019s teeth. <\/span> Photograph: Posed by models; Tom Werner\/Getty Images<\/p>\n It is already well established that oral infections can cause bloodstream infections. This is why patients with replacement heart valves, for example, have long been given prophylactic antibiotics before tooth extraction or deep descaling procedures. But oral bacteria can also leach into the bloodstream through rotten teeth or bleeding gums and slowly, imperceptibly, damage the cardiovascular system in other ways.<\/p>\n There\u2019s a condition called atherosclerosis, where cholesterol, fat and calcium build up into plaque on artery walls, restricting blood flow. This plaque is different from dental plaque, which is a sticky bacterial film, although both harden over time and are associated with inflammation. \u201cThe majority of bacteria in atherosclerotic plaque is from the mouth,\u201d says Kerrigan. Now, scientists need to figure out whether bacteria from the mouth get into the bloodstream and cause atherosclerosis to develop, or whether the plaque was triggered by some other mechanism but is sticky, so when the bacteria from the mouth are in the bloodstream, they adhere to it. Either way, once the bacteria are there, they can increase inflammation and create other health problems.<\/p>\n Oral bacteria can also increase the risk of blood clots and strokes. \u201cOnce these bacteria breach the barriers in the mouth,\u201d says Kerrigan, \u201cthey get into the bloodstream, and they can bind to the blood clotting cells, called platelets.\u201d Platelets help stop us bleeding when we cut ourselves. \u201cWhen these bacteria bind to platelets, it causes them to stick together the exact same way as when you cut yourself. What that means is that you\u2019ve got a clot circulating in your bloodstream, and that clot will eventually get stuck in a small blood vessel. And if that small blood vessel is feeding the brain, then you end up with either a transient ischemic attack \u2013 a mini-stroke \u2013 or a full-blown stroke.\u201d<\/p>\n <\/span>Good oral hygiene is linked with good mental health. <\/span> Photograph: Posed by models; The Good Brigade\/Getty Images<\/p>\n If the clot gets stuck in one of the vessels in your heart, he says, \u201cyou can suffer a heart attack as well\u201d. And when a clot forms on your heart valves, \u201cthat leads to a condition called infective endocarditis. This prevents your valve closing properly, which can lead to heart failure. These things are quite well recognised.\u201d Nearly all of the bacteria found that trigger these clots are oral bacteria, says Kerrigan.<\/p>\n Diabetes is another condition with a fairly well-established link with oral health. One of the latest developments was recorded in a 2025 study, which found that having root canal treatment significantly lowered blood sugar levels (diabetes is characterised by excessively high blood sugar levels). Root canal treatment also lowered blood cholesterol and fatty acid levels, providing an additional boost for heart health. This finding suggests that removing damaged or infected pulp deep inside a tooth, and sealing the roots, could not only save your tooth, but also help protect against type 2 diabetes.<\/p>\n The diabetes connection is a two-way street. If you have gum disease, you\u2019re more likely to develop diabetes, as systemic inflammation from oral infections can mess with blood sugar control; conversely, if you have diabetes and your blood glucose levels are persistently elevated, you\u2019re more vulnerable to gum disease. \u201cPeople with gum disease or periodontitis and diabetes have a three times higher mortality risk than those without gum disease,\u201d says Kerrigan.<\/p>\n <\/span>\u2018Clown doctor\u2019 Dr B Looney marks Australia\u2019s National Smile Day in Sydney\u2019s Luna Park, 2010.<\/span> Photograph: Greg Wood\/AFP\/Getty Images<\/p>\n Correlations between oral health and dementia are also under ongoing investigation, although no causal link has been proved, says Jing Kang, a senior lecturer in medical statistics at the faculty of dentistry,oral and craniofacial sciences at King\u2019s College London. And if oral diseases are affecting cognitive decline, there is again a chicken-and-egg question here, not least because cognitive impairment can make it harder to maintain oral hygiene. A 2016 study by Kang\u2019s colleagues found that the presence of gum disease was associated with a six-fold increase in the rate of cognitive decline over six months. The study also found that, over the six-month follow-up period, gum disease was associated with \u201ca relative increase in the pro-inflammatory state\u201d, which leaves us more vulnerable to major illnesses \u2013 from cancers, to neurodegenerative and metabolic diseases, to depression.<\/p>\n One theoretical route for oral health contributing to developing dementia, says Kang, is that \u201cit is all related to the immune response and inflammation\u201d. But it\u2019s hard to pinpoint a precise causal mechanism \u2013 and there could be many: \u201cIt is possible that behaviours, such as our choice of food or choice of lifestyle, could also impact on our oral health.\u201d As part of a bigger, systemic picture, cardiovascular disease and chronic metabolic diseases associated with oral health could be affecting brain degeneration, too. It\u2019s a complex, multifactored situation. Poor education in childhood could be a factor, Kang says, leading to worsening oral health gradually over time; then, when we\u2019re older, the resulting inflammation affects cognitive function. Studies usually look at people from middle age at the earliest, but whole lives need to be accounted for, she says. \u201cThere are all sorts of hypotheses, but it\u2019s hard to prove and further studies are needed.\u201d<\/p>\n Meanwhile, if we do feel gum pain, we could see it as a potential window into what\u2019s happening inside the body, says Kang. She and her colleagues are working towards establishing whether treating oral health issues promptly \u201cwould prevent or delay cognitive decline\u201d. They\u2019re only at the small, proof-of-concept study stage so far \u2013 but, she says, it\u2019s never too late to take better care of our mouths.<\/p>\n double quotation markPeople with arthritic knees are more likely to have had gum disease, and vice versa<\/p>\n The evidence for the oral-brain axis so far is more to do with gum disease and less to do with the teeth. But in terms of oral care, the two go together.<\/p>\n Advanced gum disease and tooth decay can in themselves be painful, as well as smelly and unsightly. This affects quality of life, Kang says, which can in turn affect our overall health and wellbeing: \u201cOral health is reflected in how we feel, our appearance, our confidence.\u201d When her team has studied this, \u201cpeople who are suffering from gum disease are less confident and don\u2019t want to socialise, compared with people who have healthy teeth. That may affect the brain or other parts of the body. And because of the pain and inflammation, people need to take more medication \u2013 and some medication has side effects on oral health because it reduces saliva generation. So everything is interlinked.\u201d<\/p>\n According to Kang\u2019s research, brushing twice a day and flossing wherever possible may even help fix your aching knees. \u201cPeople who had arthritic knees were more likely to have had gum disease, and vice versa. People suffering from more gum disease were diagnosed [with arthritis]; or they saw deterioration much quicker than those who had healthy teeth.\u201d<\/p>\n None of this means we should panic and assume the worst at the first hint of toothache. Kang is careful to point out that this is all statistical evidence, \u201cfrom the population level. It does not apply to individuals. So don\u2019t worry too much, if when brushing your teeth there\u2019s blood, that you\u2019re going to get dementia the next day. It is just a message to deliver to the public to keep our teeth and gums healthy.\u201d<\/p>\n <\/span>Flossing is even more important than you think. <\/span> Photograph: Posed by model; Ekaterina Ilchenko\/Getty Images<\/p>\n The government\u2019s last oral health survey, in 2021, found that a quarter of adults with natural teeth reported teeth, fillings, crowns or fixed bridges that were damaged, cracked or broken. But getting emergency help, or even treatment, on the NHS is increasingly hard, leading to reports of people self-treating and even pulling out their own teeth. And, as Kerrigan says, even if a tooth is taken out professionally, \u201ca vast majority of people won\u2019t be able to afford implants to replace that tooth, so everything changes in your mouth. If you don\u2019t have teeth, the microbiome in your mouth is going to change. And we already know that the bacteria that are in your mouth are critically important because they are the first step in digestion.\u201d<\/p>\n What can we do to minimise the risks? \u201cYou\u2019re meant to brush your teeth at least twice a day, morning and evening,\u201d says Kerrigan. \u201cThat\u2019s the bare minimum, but during the day is great as well, if you can do that.\u201d He says electric toothbrushes with rotating heads \u201care probably much better for moving and pulling the bacteria off your teeth\u201d. Flossing, of course, and cleaning between your teeth, are recommended.<\/p>\n \u201c<\/strong>Diet plays a really important role here as well,\u201d he says. \u201cWhen you snack, it\u2019s [likely] going to be on sugary foods. So obviously, the more sugar you put into your mouth, the more you\u2019re feeding the bacteria. You want to avoid that as much as possible, because the more bacteria, the more damage they\u2019re going to do to your teeth and to your gums. But again, you have to look at the person.\u201d<\/p>\n Clearly, we shouldn\u2019t suddenly only focus on oral health at the cost of everything else; it\u2019s just one important aspect of an overall healthy lifestyle. You often find, says Kerrigan, that \u201cthe person who runs several times a week \u2013 they probably have perfect oral hygiene as well. And if you look after one part of your body, you tend to look after all parts of your body.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":" Isn\u2019t it weird that dentistry and medicine have been kept largely separate? Why should our mouths be treated differently from the rest of our bodies? Going to the dentist often feels like more of a lifestyle and cosmetic add-on, especially for adults in the UK. And, even if you can find an NHS dentist, the<\/p>\n","protected":false},"author":1,"featured_media":49302,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[51],"tags":[1868,3918,10630,24487,24488,37,5278,15985],"class_list":{"0":"post-49301","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-body","9":"tag-fascinating","10":"tag-frightening","11":"tag-gateway","12":"tag-gums","13":"tag-health","14":"tag-links","15":"tag-mouth"},"_links":{"self":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/49301","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=49301"}],"version-history":[{"count":0,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/49301\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/media\/49302"}],"wp:attachment":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=49301"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=49301"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=49301"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}