CATES: One change at time: Dental health

By Carol A. Cates, MSN, MBA, RN

Chief Nursing Officer

Odessa Regional Medical Center

I am one of those people who rarely shows their teeth when smiling. It’s because I am what is known as a tetracycline kid.

Today, the antibiotic tetracycline is rarely given to kids who have not gotten permanent teeth. I am part of a group of kids who are the reason why.

When I was little, physicians and pharmacists didn’t know of an odd side effect from tetracycline that can happen in kids whose teeth are still forming. Tetracycline can turn forming teeth gray. It’s not a gray that can be fixed with whiteners because it goes through the entire tooth. The only way to make teeth like mine white is to do porcelain laminates on every tooth. That wasn’t an option when I was younger, so at an early age, I learned to smile without showing my teeth much.

I told you this story because there is a much stronger relationship between teeth and the rest of the body than I think most people realize. For me it was getting an antibiotic for an infection that affected my teeth, but for most people it’s the other way around. Dental and oral health can have a big impact on overall health.

The list of conditions that can be impacted by oral health is substantial. Heart disease, diabetes, respiratory disease, osteoporosis, and rheumatoid arthritis can all be impacted by oral health.

In a study done on over 1,000 patients at the University of North Carolina School of Dentistry, people who have gum disease are twice as likely to die from a heart attack and three times more likely to have a stroke than people who do not have gum disease.

According to the Mayo Clinic, in addition to those conditions, gum disease has also been linked to pregnancy and birth complications like prematurity and low birth weights. Diseases like HIV/AIDS and Alzheimer’s disease can also increase people’s risk for gum disease which creates a very vicious circle for those people. Their condition contributes to gum disease which then increases their risk of other conditions that can make the conditions that contributed to the gum disease worse. The Mayo Clinic states there are also links between oral health and eating disorders, certain cancers, and an immune system disorder called Sjogren’s syndrome.

Physicians, dentists, and researchers don’t completely understand the whys of how oral health affects overall health, but a major contributor is that gum disease and tooth decay allow bacteria in the mouth to bypass the normal routes of the immune system, mainly the digestive tract, and get into the blood stream. This mechanism is a major cause of endocarditis, a condition where bacteria begin growing on the structures of the heart, particularly, the heart valves. If that occurs, generally the only fix is to have open heart surgery to remove the infected valve and replace it. Inflammation caused by bacteria in other organs is thought to be a major part of the why oral health affects overall health as well.

Poor oral hygiene can allow bacteria in the mouth to get out of control making it easier for that bacteria to get to places it shouldn’t like the respiratory system. Medications that decrease saliva flow, such as decongestants, antihistamines, pain medications, diuretics (water pills), and antidepressants, can add to the issues, because saliva is one of our defenses against the bacteria on our mouths.

To protect your oral health, practice good oral hygiene every day. Brush your teeth at least twice a day for two minutes each time. Use a soft-bristled toothbrush and fluoride toothpaste. Replace your toothbrush every 3-4 months or sooner if the bristles are worn or bent sideways. Floss daily. Use mouthwash after brushing and flossing to help remove any remaining particles. Schedule regular appointments with your dentist for checkups and cleanings and avoid tobacco use. If you take medications that cause dry mouth, talk to your primary health care provider. There may be alternative medications which do not have that side effect. If there aren’t alternatives available, talk to your dentist for recommendations on preventing dry mouth.

Making sure you are maintaining good oral health is one thing that can have a major impact. It is a small, one change at a time thing that can have a big payoff in terms of overall health.