Health & wellness COACH & PractiTIoner In Kingston upon Thames

As a Health and Wellness Coach who happens to have a 40 year background as a Dental Hygienist behind me, it is not surprising that my interest in the link between oral and systemic health and disease has been piqued.

Gum disease, used to be seen as a localised issue, a condition that only affected the tissues within the mouth, but the truth is much more complex. There is an ever increasing amount of research that demonstrates that gum disease is deeply connected to whole body health. What happens in the mouth, does not stay in the mouth - It has far reaching consequences on the entire body.

As a Health and Wellness Coach, I take a holistic approach to wellbeing, and recognise that stress, inflammation and imbalances anywhere within the body impact upon physical, mental, and emotional health. Gum disease is indeed a powerful example of how a seemingly minor health issue can ripple throughout the entire body, affecting not only whole body health, but resilience and vitality too.

In this blog, I am going to explore the holistic link between oral disease and systemic health, and how stress plays a role. I am also going to look at what you can do to protect both your oral and overall wellbeing.

GUM DISEASE IS MORE THAN JUST BLEEDING GUMS

Gum disease is an inflammatory condition that that affects the tissues surrounding the teeth. There are two main stages:

1. GINGIVITIS - The early stage, characterised by red, swollen and bleeding gums. Gum disease is reversible at this stage.
2. PERIODONTITIS - If gingivitis progresses into a more advanced stage, the bacteria present around the gums breaks down and destroys the ligaments and fibres that connect the gum to the tooth, creating pockets to form around the teeth - inaccessible spaces for bacteria to accumulate. The gums recede and bone loss occurs, which over a period of time can eventually lead to mobility and tooth loss. This stage is not reversible, and once diagnosed and treated by a dental professional, with patient compliance, the disease can potentially be stabilised and managed.

THE LINK BETWEEN HEALTH AND THE ORAL MICROBIOME

The oral microbiome is a key factor in oral health and disease. Much like the gut microbiome, the oral microbiome is a complex microbial ecosystem that is present within the whole mouth, and is essential for maintaining both oral and whole body health. A key component of the oral microbiome is the oral biofilm, consisting of a structured layer of microorganisms that adheres to the surface of the tooth within a protective extracellular matrix. When in balance, this biofilm layer protects against harmful bacteria, supports tooth and gum health and maintains an optimal pH.

However a dysbiosis - or imbalance, within the oral microbiome and biofilm microflora, which can potentially be caused by poor oral hygiene practices, poor nutrition, stress or hormonal imbalances, may contribute towards oral and systemic inflammation. The subsequent increase in inflammatory markers in the bloodstream triggers a host immune system response, increasing the risk of a range of oral and systemic health conditions and disease.

PERIODONTITIS, INFLAMMATION AND THE SYSTEMIC LINK

Emerging evidence demonstrates the relationship between periodontitis and systemic disease through one common factor -  Inflammation, and as an inflammatory condition, periodontal disease has been linked to over 55 different inflammatory conditions, including:

• Cardiovascular disease - bacteria from the mouth enters the bloodstream, triggers inflammation in the arteries contributing to atherosclerosis, and increasing the risk of heart attacks and strokes.
• Alzheimer's disease - Specific disease causing bacteria and their toxic byproducts can enter the brain across the blood-brain barrier and via the cranial nerves, contributing to cognitive decline, dementia and Alzheimer's disease.
• Respiratory diseases - bacteria from gum disease can be inhaled in tiny droplets of saliva, into the lungs increasing the risk of inflammatory lung diseases such as pneumonia, asthma, and COPD.  Bacteria may also reach the lungs via the bloodstream.
• Rheumatoid arthritis - A bio-directional link where disease causing bacteria in periodontitis trigger an auto-immune response that targets inflammation within joints. Patients with RA also have a higher incidence of periodontal disease.
• Type 2 Diabetes - a bio-directional link where diabetics are more prone to periodontitis, which impacts the effectiveness of diabetes control, and patients with periodontal disease have a higher risk of diabetes.
• Inflammatory bowel disease - harmful bacteria from the oral microbiome can be swallowed in the saliva and cause imbalance within the gut microbiome. The bacteria can also reach the gut through the bloodstream and immune cell migration.
• Cancers - including oral cancer, lung cancer, stomach, oesophageal, breast and gall bladder cancers.
• Adverse pregnancy outcomes - pregnant women with periodontitis may have a higher risk of pre-term birth and low weight births.
• Aging - weakens the immune system and together with increased inflammation makes it easier for bacteria to cause disease. An increased risk of Osteoporosis as women get older can manifest in loss of jaw bone predisposing to an increased risk of tooth loss, and physically, it may also be harder for elderly patients to clean their teeth. Manual dexterity may make it harder to brush, floss and use interdental aids.
• Obesity - leads to low grade systemic inflammation and altered immune responses triggered by an increase of inflammatory byproducts from fat cells, leading to increase gum inflammation and tissue destruction and bone loss.

It is interesting to note that oral disease can also be a symptom of other systemic health conditions e.g. Type 2 diabetes, HIV, some cancers, and autoimmune conditions, and certain medications including anticonvulsants, as well as some immunosuppressants can also impact on the severity of gum disease.

THE LINK BETWEEN STRESS AND ORAL HEALTH

When we are stressed, we are less likely to look after ourselves, and personal hygiene practices including teeth cleaning can go out the window, and the resulting bad breath, stained and yellowing teeth can cause feelings of embarrassment and self-consciousness. Any early signs of gum disease are often ignored - a little sensitivity or bleeding on brushing are easily dismissed, but if left unchecked, these seemingly innocuous signs can progress into painful, infected and bleeding gums, leading to further feelings of worry, anxiety and distress. 

Additionally, we are more likely to engage in self-sabotaging coping strategies.  We may turn to bad habits including alcohol or drugs and smoking, that contribute to an increased risk of gum disease, as well as increasing the risk of mouth cancers. We also tend to indulge in unhealthy cravings for processed, sugary and acidic foods and drinks that fuel disease causing bacteria, increasing inflammation and increase the risk of tooth decay, gum disease and halitosis.

Pain from teeth grinding or jaw clenching can cause debilitating headaches, and even the intense pain from mouth ulcers can be draining.

Systemically, an increase in cortisol through chronic stress compromises the immune system, and causes hormonal imbalance and low grade chronic inflammation, which impacts on our overall health, vitality and resilience. We can feel tired and unwell, and not even really realise why but, with increased awareness, we can take back control of oral disease and restore our energy and our wellbeing.

A HOLISTIC APPROACH TO MANAGING GUM DISEASE

Treatment for oral health disease should ideally follow a clinical and holistic pathway, and must always start with diagnosis and treatment of the disease by dental professionals. Beyond this, there are a range of lifestyle changes that can be addressed that can complement clinical treatment:

• Supporting Home - Care - with improved oral hygiene practices that will help you to manage your disease at home - the most important aspect of disease management.
• Smoking Cessation - stopping smoking is a huge step forward in supporting oral and whole body health as well as reducing the risk of oral and lung cancers.
• Nutritional Guidance - advice on eating a healthy diet - Cutting processed food, refined sugars and unhealthy fats, and embracing an anti-inflammatory diet to combat systemic inflammation and a diet high in micronutrients and anti-oxidants to support the immune system. A diet rich in protein and Omega 3 oils, a rainbow diet of different coloured fruit and vegetables and nuts and seeds can all help to improve your health.
• Stress Management - as you can see above, stress has a huge impact on inflammation and immune health, so finding ways to manage the stress in your life can have a huge impact on oral and whole body health.
• Sleep Management - Sleep is a key factor in supporting a resilient lifestyle, and good sleep patterns can help to nurture health and wellbeing and support the immune system.
• Habit Change - support in transforming habit and behaviour change can be an enormous support on improving health and whole body wellbeing
• Personal Resilience - Oral disease can impact on every aspect of your life - physically, mentally, emotionally spiritually, socially and at work - it impacts your the way you see yourself, your confidence and self-esteem and the way that you show up for yourself. If you hide your smile from others or constantly put your hand in front of your mouth in photos or when you laugh, you're embarrassed or you just don't want to be seen, this is impacting on how the world sees you and how you are being seen in the world - there is help at hand.

Your oral health is not just about your mouth. It is a reflection of your overall health and resilience, and its importance should be considered alongside lifestyle pillars such as smoking cessation, sleep, exercise, nutrition, stress management and hydration. By prioritising your oral health care, you are building a foundation for physical vitality and inner resilience.