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Take care of your mouth and live healthier, says expert

BY ANIKA RICHARDS Observer staff reporter richardsai@jamaicaobserver.com

Monday, June 30, 2014    

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IF you keep your gum healthy, you may improve your chances of maintaining a healthier heart. In fact, one Canadian oral health expert, Dr Gary Glassman, has said that people who take better care of their mouths usually lead overall healthier lives.

In a recent interview, Dr Glassman told the Jamaica Observer: "The fact that there may not be a causal relationship, although there is the correlation between oral health and systemic health, heart disease and diabetes, we find that those that take better care of their oral condition usually take better care of their whole body."

Dr Glassman and his colleague, Dr Leendert Boksman, visited the island recently as part of the Goodwill Oral Health Project, which sees them travelling to teach students in developing countries the latest technologies and procedures to eradicate tooth decay and other oral health conditions.

Admitting that the link between oral health and systematic health is more prominent today, Dr Boksman told the Observer that the most common observation is with periodontal or gum disease.

"The most common thing I think that we see are when people are not really aware of how well to take on their own oral condition, normally we see gum tissue disease... because of the accumulation of tartar on the teeth, bacteria or what we call plaque, which is a phlegm of bacteria, food debris, and tissue from the mouth... those by-products of the inflammation, which would be the irritation, the bacteria themselves, are picked up by the bloodstream and disseminated throughout the whole body," Dr Boksman said.

Admitting that the relationship between gum disease and heart disease is the subject of ongoing debate and investigation, cardiologist and founder of the Heart Institute of the Caribbean (HIC) Professor Ernest Madu explained the link between the two.

"Several studies have shown that people with periodontal disease may be more likely to have coronary artery disease than people with healthy mouths," Professor Madu told the Observer. "Some experts believe that inflammation is a common thread that links both diseases.

"Various studies have shown that bacteria in the mouth that are involved in the development of periodontal disease can move into the bloodstream and cause an elevation in C-reactive protein, a marker for inflammation in the blood vessels, "These changes can, in turn, increase the risk of heart disease and stroke," Professor Madu continued.

The founder of the HIC also said that hardening of the arteries, or atherosclerosis, has a strong component of inflammation.

"Much of the progression of plaque [building up in the arteries] is actually an inflammatory process," Professor Madu explained. "Analysis of the large National Health and Nutrition Examination Survey found that gum disease is an important risk factor for diseases of the blood vessels and the arteries that supply the brain, especially strokes, involving insufficient blood or oxygen to the brain.

"Data from another study of more than 50,000 people found that those with fewer teeth and more gum disease had a higher risk of stroke," Professor Madu continued, adding that there are other studies that have uncovered no association between gum disease and stroke.

Maternal health is another area that has been linked to gum disease, according to Dr Boksman.

"What we are also seeing, certainly for maternal health, it is absolutely critical, because we can show that women who are pregnant who have periodontal disease also gave birth to low weight babies," said the oral health expert. "So what we are finding is that maternal health and oral health are integrally linked as well."

Dr Boksman insisted that there is now more scientific evidence tying oral health to overall systematic health and that the two can no longer be viewed as separate issues.

Professor Madu, while also speaking to the importance of individuals who are at a high risk of developing an infection of the inner lining of the heart (bacterial endocarditis) to take special care to practise good oral hygiene every day, also said that it is best for patients who have had a recent heart attack to wait a minimum of six months after a heart attack before undergoing any extensive dental treatments.

"Individuals with certain cardiovascular conditions or taking certain cardiovascular medication may have unique issues with their dental care. Many patients with cardiovascular disease take anticoagulants or blood-thinning drugs, such as warfarin (Coumadin) or anti-platelet medications like clopidogrel (Plavix) or ticagrelor (Brilinta), particularly patients with drug-eluting stents, and may experience excessive bleeding during some oral surgery procedures," said Professor Madu.

"However, these drugs should never be discontinued without speaking to a cardiologist. Individuals taking a class of blood pressure-lowering drugs called calcium channel blockers may experience gum overgrowth," the cardiologist continued.

The Canadian oral health experts stressed the need to maintain good oral health.

"Visit your dentist regularly, every six months. Brush your teeth after every meal or snack, floss your teeth as many times as you eat - definitely before bedtime, definitely after every meal or snack," said Dr Glassman.

"Warm salt water rinses stimulate the circulation, draws out infection... something that's very simple that a lot of people do," Dr Glassman continued. "It is so much easier to prevent problems than have to treat them and it's so easy to prevent them with easy oral health tips like brushing your teeth and not just brushing your teeth but brushing them properly, using a soft toothbrush, not a hard toothbrush."

Dr Glassman said the technique of how to brush your teeth properly is also important and that an oral hygiene expert can teach you how to do this.

"You only want to floss the teeth that you want to save and if you ignore your teeth, they will go away," Dr Glassman said.

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