Relationship Between Oral Health and Overall Health

The human body is a system requiring an integrated approach to its well-being, including any necessary treatment to regain its functionality. Similar to how nutrition affects various parts of your body in an interconnected fashion, such as from your gut to your brain, oral health is also a part of the same symphony. Poor oral health can give rise to a variety of health problems, including diabetes, stroke, respiratory infections, heart disease, and pregnancy complications. Some medical conditions, such as diabetes, pregnancy, and high blood pressure, can also affect oral health. 


Oral health impacts your overall health in numerous ways, most commonly through the spread of bacteria and inflammation. Bacteria developing in your mouth can enter the bloodstream and spread to various parts of your body, leading to inflammation and potentially causing or exacerbating health problems. Some health conditions, such as diabetes, can make it more challenging to control oral infections, leading to gum disease and other issues that require prompt attention. 

Oral Health and Heart Disease

A growing body of evidence derived from research suggests a link between gum disease and heart health. Gum disease, or periodontal disease, is a bacterial infection that causes inflammation and damage to your gums and supporting structures of your teeth. Since bacteria from your mouth can enter your bloodstream and travel to your heart, untreated gum disease can contribute to atherosclerosis, where plaque builds up in your arteries, subsequently increasing your risk of heart attack and stroke. In addition, inflammation caused by untreated gum disease increases your risk of blood clots, further increasing the possibility of cardiovascular events. 

Several studies support the link between oral health and heart disease. In one study published in the Journal of Periodontology, researchers found that people with gum disease are nearly twice as likely to develop heart disease compared to those without periodontal disease. Another study published in the American Journal of Cardiology found that people with gum disease had a 53% higher risk of developing cardiovascular disease than those without gum disease. 

Researchers believe that the connection between oral health and heart disease may be due to the spread of bacteria, which leads to inflammation and damage to the blood vessels. Bacteria from periodontal disease can also cause the liver to produce high levels of specific proteins that promote inflammation throughout the body, including blood vessels. 


While more research is needed to fully understand the connection between gum disease and heart disease, maintaining good oral hygiene and seeking treatment for gum disease has been shown to lower the risk of cardiovascular problems. 

Oral Health and Diabetes

An important link exists between oral health and diabetes that is considered a bidirectional relationship. Individuals with diabetes are at an increased risk for gum disease, which in turn can pose a challenge in regulating blood sugar levels. High blood sugar levels often result in dry mouth, causing an increase in plaque deposits and a higher risk of tooth decay. People with diabetes are also prone to developing infections, especially in the mouth. Consequently, those can cause inflammation, gum disease, and other oral health concerns. Individuals with diabetes need to maintain proper oral hygiene habits, visit their dentist regularly, and control blood sugar levels to reduce the emergence of many dental problems. 

A study published in the Journal of Periodontology found that people with diabetes were three times more likely to develop gum disease than those without diabetes. Another study published in the Journal of Clinical Periodontology found a higher prevalence of gum disease and more severe periodontitis among diabetic patients than those without diabetes. 


Several studies have suggested that treating and managing periodontal disease can positively impact glycemic control in individuals with diabetes. A systematic review and meta-analysis published in the Journal of Clinical Periodontology in 2013 concluded that non-surgical periodontal therapy improved glycemic control in individuals with diabetes.

Oral Health and Respiratory Health

Growing evidence suggests the connection between oral health and respiratory health. Maintaining good oral health is not only crucial for a bright smile and strong teeth but also plays a significant role in supporting overall respiratory health. The link between oral and respiratory health lies in the intricate interplay of bacteria, inflammation, and the body's immune response. Harmful bacteria in the mouth, particularly in the form of dental plaque and gum disease, can migrate to the respiratory system through inhalation or aspiration, leading to various respiratory conditions. Additionally, chronic inflammation in the oral cavity, such as periodontitis, can trigger systemic inflammation, increasing the risk of respiratory infections and exacerbating existing respiratory conditions like asthma and chronic obstructive pulmonary disease (COPD). Conversely, respiratory illnesses like pneumonia can harm oral health, as mouth-breathing during respiratory distress can result in a dry mouth, reduced saliva production, and an altered oral microbiome. Therefore, fostering good oral hygiene practices, regular dental check-ups, and promptly addressing oral health issues are vital for a healthy mouth and promoting optimal respiratory well-being.

A study published in the Journal of Periodontology in 2007 found that individuals with periodontal disease were more likely to develop respiratory infections, including pneumonia. The study suggested that the bacteria associated with periodontal disease could be aspirated into the lungs, contributing to respiratory complications.

A recent study published in 2020 in the Journal of Clinical Medicine investigated the impact of oral hygiene interventions on respiratory outcomes in elderly adults living in nursing homes. The study demonstrated that regular professional oral care, including toothbrushing and dental cleanings, significantly reduced the incidence of pneumonia and respiratory-related hospitalizations in this population.


Certain population-based studies have reported that improved oral hygiene practices and professional dental care can reduce the risk of respiratory infections. Taking care of your oral hygiene through consistent brushing, flossing, and dental check-ups can lower the amount of harmful bacteria in your mouth and potentially reduce your risk for respiratory complications.

While the exact mechanisms underlying the oral-respiratory health link are still being studied, it is believed that the spread of bacteria and inflammatory mediators from the oral cavity to the respiratory tract plays a significant role.

Oral Health and Pregnancy

There is a recognized link between oral health and pregnancy, with evidence suggesting that poor oral health during pregnancy may have implications for both the mother and the developing baby. 

During pregnancy, hormonal changes can increase blood flow to the gums. This can lead to greater sensitivity and a higher risk of inflammation, leading to a condition called pregnancy gingivitis, characterized by swollen, tender, and bleeding gums. Poor oral hygiene can exacerbate this condition. If pregnancy gingivitis is left untreated, it can progress to a more severe form of gum disease. Periodontitis is characterized by gum inflammation, recession, and potential tooth loss. Research suggests that pregnant individuals with periodontal disease may have an increased risk of certain pregnancy complications.

Some studies have discovered a link between periodontal disease and adverse pregnancy effects, including preterm birth (delivering the baby before 37 weeks) and low birth weight (less than 2,500 grams). The exact mechanisms are still being investigated, but researchers believe that the bacteria associated with periodontal disease may enter the bloodstream and trigger an inflammatory response, potentially affecting the placenta and fetal development.

Evidence suggests that poor oral health, particularly gum disease, is associated with a higher risk of gestational diabetes mellitus (GDM), a form of diabetes that develops during pregnancy. The chronic inflammation triggered by periodontal disease may cause insulin resistance and the development of GDM.


Poor oral health and untreated dental infections may increase the risk of transmitting certain oral bacteria from the mother to the baby. This transmission can occur through close contacts, such as sharing utensils or during activities like kissing, potentially increasing the child’s risk of early childhood caries (tooth decay).

To mitigate these potential risks, pregnant women should maintain good oral hygiene practices, including regular brushing, flossing, and dental check-ups. Seeking dental care during pregnancy, such as professional cleanings and necessary treatments, is also recommended. Pregnant women should also discuss their oral health with their healthcare providers and dentists to receive appropriate guidance and care throughout pregnancy.

Oral Health and Dementia

Last but not least, a potential link between oral health and dementia exists, although the exact nature of the relationship is still under research. Research shows a link between inadequate dental hygiene, specifically gum disease and tooth loss, and a higher chance of experiencing cognitive decline and dementia. A systematic review published in the Journal of Clinical Periodontology in 2017 concluded that gum disease was associated with a higher risk of cognitive impairment and dementia.

Researchers have also explored a potential connection between gum disease and Alzheimer’s disease. Some studies have detected the presence of bacteria associated with gum disease in the brains of individuals with Alzheimer’s disease. These findings have led to investigations into the role of inflammation and the immune response in the development and progression of Alzheimer’s disease. 


Maintaining good oral health habits, such as regular toothbrushing and dental visits, has improved cognitive function in older adults. A longitudinal study published in the Journal of the American Geriatrics Society in 2012 found that poor oral hygiene was independently linked to a higher risk of cognitive decline.

Tips for preventing gum disease and maintaining good oral health

During your regular check-up, your dentist might provide tips for preventing gum disease, especially if you are at an increased risk. Here is some advice on how to maintain proper oral hygiene and habits that might prevent the development of gum disease:

  1. Proper oral hygiene: brush your teeth for a few minutes twice daily using fluoride toothpaste to remove plaque and bacteria. Use flossing as part of your oral hygiene routine to eliminate food debris and plaque from between teeth and the gum line. Mouthwash is an excellent way to kill bacteria and freshen your breath. 
  2. Visit your dentist regularly: routine dental check-ups and cleanings can help prevent gum disease and detect any issues early on. 
  3. Quit smoking: smoking increases the risk of gum disease and various health problems. 
  4. Eat a healthy and balanced diet: nutrition rich in fruits, vegetables, and whole grains can assist in promoting good oral health. Limit sugary and acidic foods as those can erode tooth enamel and lead to decay. 

References:

Chambrone, L., Guglielmetti, M. R., Pannuti, C. M., Chambrone, L. A., & Artese, H. P. (2007). Evidence grade associating periodontitis to preterm birth and/or low birth weight: I. A systematic review of prospective cohort studies. Journal of Clinical Periodontology, 34(11), 793-804.

Simpson, T. C., Weldon, J. C., Worthington, H. V., Needleman, I., & Wild, S. H. (2013). Treatment of periodontal disease for glycaemic control in people with diabetes. Cochrane Database of Systematic Reviews, 5.

Stewart, R., Weyant, R. J., Garcia, M. E., Harris, T., Launer, L. J., & Satterfield, S. (2012). Adverse oral health and cognitive decline: the health, aging and body composition study. Journal of the American Geriatrics Society, 60(5), 894-901.

Taylor, G. W., Burt, B. A., Becker, M. P., Genco, R. J., & Shlossman, M. (2008). Glycemic control and alveolar bone loss progression in type 2 diabetes. Annals of Periodontology, 3(1), 30-39.

Wu, Z., Nakanishi, H., & Fujita, T. (2017). Periodontal disease and Alzheimer's disease: findings from NHANES III and JMSA study. Journal of Clinical Periodontology, 44(3), 285-294.

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