We pay less attention to it than to the rest of our body. We forget to do the revisions and many times we do not visit the dentist until that toothache is unbearable. But the reality is that what happens inside our boca It can put us on the track of situations in our general state of health that we don’t even intuit.
Halitosis, dental sensitivity, thrush, dryness, inflammation and bleeding of the gums, worn teeth… symptoms that we sometimes do not give importance to but that can be the tip of the iceberg of other pathologies. And it’s not just that there diseases that can show their first signs in the mouth. Is that poor oral health can even influence its appearance, development or correct treatment.
In fact, two studies by researchers at the Fred Hutchinson Cancer Center in Seattle, recently published in “Cell Reports” and “Nature,” respectively, suggest a link between oral health and cancer. The two articles focus on an oral bacterium called Fusobacterium nucleatum, which has been linked to colorectal cancer. Non-tumor cells surrounding a tumor can help it fend off attacks by the immune system, resist therapies that attack it, and allow it to spread to other parts of the body. “We have seen that there regions of the tumor that are colonized by bacteria and functionally differ from regions that do not harbor bacteria,” says Susan Bullman, author of the study in “Nature.” “And these bacteria-rich regions have a increased metastatic potential“, Add.
“There is an emerging trend of microbes traditionally associated with oral inflammatory disease being found in association with extraoral and gastrointestinal cancers, highlighting the oral cavity as a breeding ground for pathogenic oncomicrobials,” says molecular microbiologist Christopher D. Johnston, other investigators.
Global cases of oral diseases have increased by one billion in the last 30 years, a clear indication that many people do not have access to the prevention and treatment of these pathologies, according to a recently published WHO report.
Warning signs that should always be consulted
The dryness Persistent oral, periodontal problems (bleeding or receding gums) sores that do not heal, injuries reddish or whitish oral cavity that we do not usually recognize or pain dental. “It does not mean that whenever we have one of these symptoms it is going to be a serious disease, but it is necessary to review it with a doctor to rule it out,” advises Dr. Berta Uzquiza, head of Innovation and Clinical Quality at Sanitas Dental.
For his part, Dr. Miguel Carasol, coordinator of the Alliance for Oral and General Health of the Spanish Society of Periodontics (SEPA) and director of Promosalud dismantles another myth: it is not normal for teeth to fall out with age. When they start to move you have to consult because behind there is a gum recession. «That thing about losing teeth with age is absolutely false. Teeth neither grow nor separate nor curl with age. Behind it there is pathology, which is the loss of gum and bone, “warns the periodontist.
On the other hand, waking up with pain in the area of the temporomandibular joint or in the temple and noticing wear on the teeth could be symptoms of bruxism, a pathology linked to stress that increased notably during the pandemic.
Diseases that warn us from the mouth
The oral cavity can give a lot of information about our general health. Given signs of a systemic disease, the dentist can recommend a visit to the specialist doctor to confirm the suspicions. The best known relationship is that of periodontitis (gum disease) and diabetes, which is bidirectional. Not only does diabetes increase the risk of periodontal disease, but periodontal disease can affect diabetes, complicating glycemic control. “A thickened, dry, very red gum or a tendency to have oral candidiasis gives us an idea that there may be diabetes,” explains Dr. Marta Montserrat, a periodontist at the Friedländer Dental Clinic.
There are also studies that link periodontitis with an increased risk of high blood pressure. Other signs, such as having recurrent thrush or cheilitis, may alert you to a lack of a certain vitamin. And in patients with HIV you can see symptoms such as very recurrent oral candidiasis or sarcoma because the immune system is affected. While in patients with leukemia petechiae may appear in the mouth or bleeding gums, adds Marta Montserrat.
Other signs, such as xerostomia (oral dryness), points out Dr. Berta Uzquiza, “may indicate that we have diabetes or Sjörgen syndrome, an autoimmune disorder characterized by destroying the glands that produce saliva, increasing the risk of cavities.”
Pathologies such as celiac disease “may have their first manifestations in the oral cavity, such as enamel hypoplasia, a deterioration in the quality of the dental structure characteristic of poor absorption of certain vitamins and minerals in the digestive system,” he adds.
Oral cancer, continues Uzquiza, can appear “in the form of a sore on the lips or mouth that fails to heal, reddish or whitish lesions with various shapes on the oral mucosa, gums, and tongue.”
To what extent the mouth influences our general health
«The mouth is part of the organism and can be the route of entry for different pathogens that can affect other parts of the body, as well as a priori pathologies far from the oral cavity that can manifest themselves in it. The link between the mouth and general health is undeniable”, says Dr. Berta Uzquiza. According to the 2022 Sanitas Oral Health Study, 7 out of 10 Spanish adults between the ages of 24 and 60 currently have some oral problem, with the pathologies most detected in consultations being cariesthe gingivitis and the bruxism. “Regarding general health conditions, adults with poorly controlled diabetes had a 2.9 higher risk of periodontal disease than those without diabetes. There is a clear relationship between periodontitis and cardiovascular diseases, among other pathologies, and its relationship with Alzheimer’s and the impact on pregnancy and the increased risk of preeclampsia and premature birth are being studied,” adds Uzquiza. In addition, “there is increasing evidence that points to a relationship between certain pathogens present in the mouth and respiratory diseases such as bronchitis and the pneumonia. These bacteria would reach the airways through aspiration, so it is essential to maintain correct oral hygiene and go for check-ups with the dentist,” advises Dr. Uzquiza. When bleeding and inflammation of the gums occur, it is because “there are bacteria in the mouth and they can enter the bloodstream and cause infections further away from the mouth or aggravate a systemic disease”, says Dr. Marta Montserrat, a periodontist at the Friedländer Dental Clinic.
Halitosis, dryness, tooth sensitivity
There are three common problems and none should be taken as normal. In bad breath, Dr. Miguel Carasol believes that a very serious error is produced: thinking that it comes from the stomach. “Nine out of ten cases are due to cavities, gingivitis, periodontitis or poor oral hygiene,” he says. Bad breath that can occur when getting up, which is normal because the mouth dries up, must be distinguished from the rest of the day. “If you use mouthwash, but do not treat the disease that causes halitosis, the problem is not solved,” warns the coordinator of the SEPA Alliance for Oral and General Health. Tooth sensitivity is also not normal. Most often it is due to a cavity or a periodontal disease that destroys the tissue that supports the tooth and leaves the root exposed. And as for dryness, you always have to consult because behind it there may be a systemic disease (diabetes, hypertension) or some drug.
What do we do wrong in the oral hygiene routine?
One of the mistakes we make the most when we brush our teeth and gums is do it very fast. “You have to spend two minutes on it,” says Dr. Marta Montserrat. And another big mistake is rub very hard. «Incorrect brushing, with a very hard bristle or a very abrupt horizontal movement, causes gum recession. Medium-hard brushes and non-traumatic techniques must be used”, explains Dr. Miguel Carasol. And this habit must be repeated after each meal, minimum 3 times a day. At least one of those times, we should use the hilo dental Or interdental brushes. “We can do it before or after brushing, the important thing is to remove the plaque between the teeth,” says Dr. Montserrat. And don’t forget about “change the brush every 3 or 4 months”, adds Berta Uzquiza. As for the paste, it should always have fluoride. In children under 6 years of age, a minimum of 1000 ppm and from that age, 1450 ppm. In healthy people, an annual review with the dentist is recommended; and in patients with pathologies, every 6 months. It’s fundamental give up habits like tobaccowhich “does tremendous damage to the tissues surrounding the tooth,” warns Dr. Carasol.
Electric or manual toothbrush? Do I have to use mouthwash?
Both the electric and manual toothbrushes are effective “as long as the correct technique is used for at least 2 minutes per brushing,” says Dr. Uzquiza. Dr. Montserrat shares the same opinion, stating that although the electric brush removes more plaque per second, if a good brushing technique is used, the manual is just as good.
As for the mouthwash, in healthy people it can be a good ally, but it is complementary, and can never be a substitute for brushing. “What removes the plaque is the brush,” recalls Dr. Montserrat. There are therapeutic mouthwashes, such as those with chlorhexidine, which the dentist can prescribe to treat oral problems caused by bacteria, but be careful not to use it without professional indication because “it can stain the teeth a lot and give food a metallic taste,” warns Dr. Carasol .