Since 1989, September 20 every year has been National Love Teeth Day. This year’s theme is very interesting, called “Oral Health, Whole Body Health”.
How can oral health be related to general health?
Periodontal disease is the most common kind of [dental disease] that we often say. It is an inflammatory disease caused by pathogenic microorganisms adhered to the biofilm or dental plaque on the tooth surface in daily life, including gingivitis and periodontitis.
However, in recent years, the association between periodontal disease and cardiovascular and cerebrovascular diseases such as ischemic stroke, hypertension and atherosclerosis has attracted much attention.
Dental Loss and Ischemic Stroke
Joshipura followed 41,380 male subjects without cardiovascular diseases and diabetes for 12 years and found an interesting conclusion:
The risk of ischemic stroke is significantly higher for patients with fewer than 24 teeth than for patients with more than 25 teeth, which proves that periodontal disease can independently increase the risk of ischemic stroke.
In addition, periodontal disease may also affect the prognosis of ischemic stroke, including neurological impairment and cognitive impairment.
Slowik et al. Conducted a study on 169 patients with ischemic stroke for the first time, showing that the neurological impairment in patients with severe periodontitis or edentulous is significantly heavier than that in patients with periodontal health and mild periodontitis.
However, its mechanism is still unclear and may be related to inflammation, immune response, oxidative stress and other factors.
However, although more and more studies suggest that there is a close relationship between periodontal disease and ischemic stroke and its prognosis, most of them are observational studies, which cannot confirm that periodontal disease is the cause of ischemic stroke, nor can it prove that treatment of periodontal disease can prevent ischemic stroke.
Dental hypertension is what again?
Previous studies have shown that periodontal disease can lead to hypertension, and even the term [dental hypertension] has appeared. A recent epidemiological study has also confirmed that chronic periodontitis in Uygur adults is independently related to hypertension.
Periodontal disease can lead to vascular dysfunction through inflammation and immunity, bacterial infection and oxidative stress, metabolic disorders through insulin resistance or hyperglycemia, and hypertension through renin-angiotensin system of gingival tissue related to periodontitis.
Oral Health Worse in Patients with Myocardial Infarction
A case-control study by Mattila et al. Included 100 patients with acute myocardial infarction. The results showed that after adjusting for age, social class, smoking, blood lipid level and current diabetes, the oral health of patients with myocardial infarction was significantly worse than that of healthy control group.
In addition, a large epidemiological study followed up for 14 years (n = 9 760) found that periodontal disease was associated with an increased risk of coronary heart disease.
In vitro experiments have proved that Streptococcus sanguis can cause platelet aggregation. The mechanism of correlation between oral infection and coronary heart disease may be that bacteria affect cells involved in atherosclerosis and thrombosis.
Diabetes and periodontal disease
Periodontal disease is one of the risk factors of diabetes, and diabetes can aggravate periodontal disease, which is even called the sixth largest complication of diabetes.
Inflammation is the key mechanism of the correlation between periodontal disease and diabetes:
Advanced glycation end products and their receptors in periodontal disease tissues of diabetic patients can promote inflammation and aggravate periodontal disease. Inflammatory cytokines produced in periodontal disease can aggravate insulin resistance, damage vascular endothelial cells, and lead to vascular regulatory dysfunction.
Hyperhomocysteinemia
Hyperhomocysteinemia is one of the possible mechanisms of cardiovascular and cerebrovascular diseases caused by periodontal disease.
Joseph et al’s research shows that under the condition of similar fasting blood glucose, blood lipid and body mass index, the plasma homocysteine (Hcy) level in patients with chronic periodontitis is significantly higher than that in healthy controls, suggesting that hyperhomocysteinemia is one of the possible mechanisms of cardiovascular and cerebrovascular diseases caused by periodontal disease.
Some studies have shown that the low level of serum folic acid in elderly periodontal disease patients leads to metabolic disorders, which often leads to hyperhomocysteinemia.
Why is this happening?
Doubts are inevitable: [because the teeth lost due to periodontal disease do not fall into the brain, how can cerebral vessels be blocked…]
Because, from periodontal disease to systemic diseases, it is not only regulated by oral cavity, but also a systemic inflammatory reaction process.
Bacteria from patients with periodontal disease invade gingiva and periodontal tissue to cause local inflammation. Inflammatory cytokines produced by the body can aggravate inflammatory reaction, damage vascular endothelial cells, and lead to vascular regulation dysfunction. Eventually causing cardiovascular and cerebrovascular diseases.
Moreover, continuous studies have shown that the infection rate in oral cavity or other parts of patients with ischemic stroke, myocardial infarction and hyperlipidemia is significantly higher than that of healthy people.
Fortunately, periodontal disease is largely preventable.
Correct brushing methods and regular tooth washing can effectively reduce the occurrence of periodontal disease.