I am a dentist in Ottawa and scientific literature has begun to become aware to the media and our patients. The mouth has been referred to as the pathway to the body. People will recognize how liquids and food enter the body by the mouth; but, more people are becoming aware that bacteria can enter the body through the mouth. This article will be a review of how bacteria can cause severe medical problems. There are many references on the internet that can be researched..
When a child is born he / she acquires bacteria from the birth canal.
The fancy term is micrometabolic Imprinting in Infancy, which basically says that we need bacteria in and on our bodies to survive. Babies digestive tracts are completely sterile until they get their “first meal”… a dose of good and bad bacteria as they pass through the birth canal. (If they are delivered by caesarean the bacterial profile changes with less beneficial and more pathogenic stuff ) When we have primarily beneficial bacteria in our birth canals it provides babies with the strains they need to digest food, keep pathogens in check, supports the immune system and even creates vitamins such as K2. On the other hand, pathogenic bacteria can cause diarrhea and colic in the short term, with more serious effects later on
As a child matures many bacteria develop in the oral cavity. Some can cause problems as teeth develop. This is why a dental team will encourage parents to discuss oral hygiene techniques before the eruption of the first teeth. We always empathize that a child’s teeth should be brushed as soon as the first tooth starts to erupt. This is done to remove oral bacteria which can cause decay. The bacteria do not leave the mouth but are not on the tooth structure.
As a person matures into teen years and adulthood there is a progression of new bacteria introduced. Out mouths are in fact a ‘paradise’ for bacteria. It has a constant body temperature, it has moisture from saliva, there is always at least remnants of food. All that is required to allow bacteria to thrive. Good oral hygiene can reduce oral bacteria to a level where it will cause no immediate destruction. But it is very important to realize that in three days the oral bacteria can return to a mature nature.
Dental decay occurs when particular bacteria adhere to the crystalline tooth structure. The byproduct of carbohydrate breakdown by the bacteria, is an acid. The acid can decalcify the tooth surface, being enamel on the crown portion, and cementum if the root is exposed. Decay occurs and spreads when oral hygiene, which includes brushing and flossing, is not well performed. The mechanism of oral dental plaque is complex. It begins with an adherence of an oral film that acts as a frame for the bacteria and food. The bacteria adhere to the thin film and evolve into a complex group. The mature plaque then breaks carbohydrates (sugars) into acids, which decalcify the tooth structure.
In addition to oral plaque and bacteria,that can destroy tooth structure,there is a complex grouping of independent and interdependent bacteria that adhere to the teeth in the pocket that forms between the lining of the gingival (Gums) and the tooth. This bacteria will do little harm if a patient properly flosses and brushes daily.But, some figures suggest that fewer than 15% of people have a proper oral hygiene routine. It has been said that it takes 21 days to acquire a good habit. The role of the dental hygienist and dentist is to teach and motivate patients to take proper care of their oral hygiene.
Bacteria that inhabit the gum pockets have been shown to cause mild to moderate gum disease in 50% of the North American population. And some 15% of the population have severe gum disease. What happens is that just as the bacteria on the teeth find a nice home on hard structure, so the bacteria that form in the gum crevice settle in. These bacteria can cause considerable damage to the lining of the gum pocket surrounding the teeth. If flossing and brushing are well done there is minimal damage. But, if the bacteria are allowed to multiply they release toxins that can break down the thin lining of the pockets. The body reacts by increasing blood flow to the area, in an effort to remove the toxins. This increase in blood is called inflammation. It is not an infection per se but certainly a predecessor of a damaging reaction.
Many patients tell us that they avoid brushing,as their gums bleed. In fact this is a cause and effect misinterpretation. The bleeding is an effect of tissue damage. Brushing and flossing just visually exposes the potential damage. Bacteria can cause a break down in the gum pocket lining and also a reduction in the attachment of the gum to the teeth and supporting bone. This is a more severe reaction; but, it is inevitable in long term gum disease. It has also be demonstrated that smoking and some diseases such as diabetes can speed up gum loss and underlying bone loss.
The problems occur when there is a serious internal gum pocket breakdown. It is like a continuous area of raw tissue susceptible to bodily bacterial invasion. A Periodontist (Gum surgery specialist) told me that a person with severe gum disease will have raw tissue, in the gum pockets, equal to the area of the palm of the hand. If a person had an area of raw bleeding tissue, of that size anywhere else on the body, it would be of obvious concern. But, bleeding gums are usually not painful and are not always observed by the patient.
Bleeding gums are not initially a major problem; but they become an open door to oral bacteria that can enter the blood stream. Many recent essays have denoted the danger that oral bacteria can cause when they enter the internal circulatory system. Diabetes is a malady that can cause increased reaction to oral bacteria at the source. People with diabetes have reduced ability to fight inflammation and infection. They tend to have gums which are swollen more than in non-diabetic patients. As well people with this condition have a tendency to have gum pocket breakdown with a weaker defence against bacterial invasion. Some studies have shown that the bacterial invasion is greater and may cause a reduction in insulin uptake. So it is a total oral health / general health concern with interacting concern. Other conditions, that can be brought on by oral bacterial invasion, include cardio vascular problems. Oral bacteria have been found in areas of cerebral stroke, blood vessel rupture and heart vessel and structure break down. Internet searches will come provide many links to scholarly papers about these conditions.
There have also been some recent suggestions that a person with poor oral hygiene could be more susceptible to rheumatoid arthritis. Pneumonia in the elderly has also been linked to possible oral implications. The reasoning is that pneumococcal bacteria can reside in the oral flora found in the gum tissue. The elderly are less likely to maintain proper oral hygiene procedures. One often reads of an elderly person who falls, breaks a bone then dies of pneumonia. The connection isn’t always automatic; but there is some speculation of the interconnection.
In conclusion, the recognition of the link between a lack of proper oral hygiene and possible general health consequences is being recognized beyond the dental profession. It is a quality of life issue we can all improve
Maintaining good oral health is more than the occasional brushing and flossing. It is a practice that, if neglected, can have serious general health considerations. This article provides basic information on several conditions.