Oral health: a leading indicator of overall health

Close up portrait of young happy African American woman pointing finger on white teeth isolated on background. Health care, dental treatment concept

Your oral health is closely linked to your overall health. And recent research has connected it with more serious conditions, including Alzheimer’s, diabetes, depression and heart disease.

“Oral health and systemic health are connected more than many people realize,” says Dr. Ghiath Almasri, a medical director with BlueCross BlueShield of Tennessee. “But because people in general don’t make that connection, they often don’t pay as much attention to their oral health as they should.”

Alzheimer’s disease

Dr. Almasri: Your brain’s health may be much more closely linked to the health of your mouth than you might know. For example, consider Alzheimer’s disease. It affects about 1 in every 9 people who are who are over the age of 65—including 120,000 people in Tennessee.

Your mouth is home to more than 700 species of bacteria. This includes many that cause gum disease (also known as periodontal disease or periodontitis). And, there may be a link between that gum disease-causing oral bacteria and Alzheimer’s disease. The bacteria can cause problems in your mouth like bleeding gums and tooth loss. But it causes even more trouble when it leaves your mouth.

It can travel through your bloodstream to your brain, where it can then cause inflammation there, just like it does in your mouth. Research suggests that your brain responds to this bacteria by creating plaques of beta-amyloid protein, which are a key hallmark of Alzheimer’s disease.


Dr. Almasri: Diabetes is another serious health concern that you might not automatically associate with oral health. More than 730,000 people have diabetes in Tennessee. And experts believe that at least 158,000 more people probably have diabetes but haven’t been diagnosed yet.

We already know that diabetes is a major risk factor for periodontitis. But as it turns out, the conditions may be what some researchers call a “two-way street.” They’ve found that people with diabetes who also have periodontal disease seem to struggle more to control their blood sugar levels. And they’ve found more gum damage and destruction in people with diabetes.


Dr. Almasri: Periodontitis is also associated with depression. Depression can interfere with your commitment to taking good care of your oral health. Depression is also often linked with alcohol use and smoking. And both can take a toll on the health of your mouth.

Some experts have also suggested that depression might actually change your immune system in a way that makes you more vulnerable to developing gum disease. However, scientists are still investigating whether there is actually a causal relationship between depression and periodontitis.

Bacterial endocarditis

Dr. Almasri: Bacterial endocarditis is a bacterial infection of the lining of your heart’s valves. It can also affect your heart’s chambers. Left untreated, it can seriously damage your heart. If you have an artificial heart value, a pacemaker or a history of heart valve disease, among other conditions, you may be at greater risk for this type of infection.

That potentially harmful bacteria can come from your mouth. It can travel through your bloodstream to your heart, where it can cause this type of infection. If you’re already at elevated risk for bacteria endocarditis, this could be a very dangerous situation. In the past, doctors and dentists prescribed antibiotics for people at risk before they underwent any dental procedures. Now, experts typically prescribe antibiotics only for people who are the most at risk.

Key steps to maintain your oral health

Dr. Almasri: There are other conditions, too, that seem to have a link to oral health, and researchers are working to learn more about them.

An important thing that you can do to protect the health of your mouth—and possibly also your brain, blood vessels, heart, and other parts of your body—is with good oral hygiene. A good place to start might be seeing a dentist with specific training in oral and systemic interactions who can coordinate with your medical provider if necessary.

Here are key steps to help improve and maintain your oral health:

  • Brush your teeth with fluoride toothpaste twice daily.
  • Floss daily to remove plaque from in between your teeth
  • Drink water with fluoride in it.
  • Visit your dentist at least once a year—or more, if your dentist recommends it
  • Don’t smoke.
  • Maintain good control of your blood sugar levels if you have diabetes.

Also, if you take any medication that causes dry mouth, talk to your doctor about other options. Saliva can wash away bacteria, so a lack of saliva can raise your risk for developing plaque, cavities and gum disease.

More from Dr. Almasri on WellTuned.

Jennifer Larson

Jennifer Larson is Nashville-based writer and editor with nearly 20 years of experience. She specializes in health care and family issues.

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