Why Oral Health Matters: How It Affects Your General Health

Gum disease is inflammation that develops in response to bacterial plaque building up around the teeth. It has two stages:

• Gum inflammation (gingivitis): Red, swollen gums that bleed when you brush. At this stage it usually reverses with regular care and professional cleaning.
• Periodontitis: The inflammation spreads to the bone that holds the teeth. The gums recede, the teeth start to loosen and, over time, teeth can be lost.

The most important feature of gum disease is that it often causes no pain. This is why it can progress for years without being noticed. Gums that bleed when you brush are not "normal"; it is a sign that needs to be checked.

Scientific studies show that there is a link between gum disease and some general health problems. Part of this link is not yet fully understood, so it would not be accurate to say "gum disease causes this condition". But what is known is reason enough to take oral health seriously.

Diabetes

The link between diabetes and gum disease works both ways: uncontrolled diabetes increases the risk of gum disease and slows healing, and advanced gum disease can make blood sugar harder to control. This is why regular gum check-ups are especially important for people with diabetes.

Heart and blood vessel health

Studies report that heart and blood vessel diseases are more common in people with advanced gum disease. The reason for this link and how direct it is are still being researched; shared risk factors (such as smoking and diabetes) also play a role. With some heart conditions and before heart valve surgery, cardiologists may ask for sources of infection in the mouth to be checked.

Pregnancy

Hormonal changes in pregnancy make the gums more prone to inflammation; bleeding gums are common. Regular oral care and a dental check-up when needed are important during pregnancy. Planned and extensive procedures are often postponed until after the birth, but do not hesitate to see your dentist if you have pain or an infection.

Before certain medicines and treatments

Some osteoporosis medicines, radiotherapy to the head and neck and some cancer treatments can make healing harder after later procedures such as tooth extraction. Having a dental check-up before starting such treatment helps resolve possible problems in advance. It is best to work together with your doctor and your dentist on this.

Even a single missing tooth can change the balance in the mouth over time:

• The teeth on either side of the gap tilt into it, and the opposing tooth in the other jaw grows longer.
• The chewing load shifts to the other teeth and the jaw joint.
• The jawbone where the tooth was removed shrinks over time; if you want an implant later, an additional procedure may be needed.
• When chewing becomes less efficient, eating habits can change too.
• Gaps at the front affect speech and how comfortable you feel when you smile.

Which solution suits a missing tooth (an implant, a bridge or a denture) varies from person to person. For the options, see the Dental Implants page.

• Brush twice a day for two minutes. A fluoride toothpaste and a soft or medium brush are enough. Brushing hard can damage the gums.
• Clean between your teeth. A toothbrush does not reach between the teeth; use floss or interdental brushes every day.
• Limit sugary and acidic drinks. Having them frequently throughout the day is especially harmful to teeth.
• Stop smoking. Smoking is a major risk factor for gum disease, implant failure and mouth cancer; it can also mask bleeding gums and delay the disease being noticed.
• Take steps if you clench your teeth at night. If you notice worn teeth and jaw pain, have it assessed (see TMJ Disorders).

Even without symptoms, a regular check-up at least once a year is generally recommended; for people with gum disease, diabetes or implants, the dentist may set a shorter interval.

See a dentist without waiting if you have:

• Bleeding gums when brushing or on their own
• Loose teeth or gums that have clearly receded
• Bad breath that does not go away
• A sore in the mouth lasting more than two weeks, a white or red patch, or a swelling
• Swelling in the face or gums, or difficulty opening your mouth
• Recurrent pain and swelling around a wisdom tooth (see Jaw Surgery)
• Jaw pain, locking or tired jaw muscles in the morning

Sores in the mouth lasting more than two weeks are usually caused by something benign, but early assessment is important.