For many Malaysians, oral health is only a concern when tooth or gum pain occurs, and regular dental checks are easily dismissed. However, this neglect can lead to a cascade of issues that include a worsening of cavities and gum disease as well as heightened risk for digestive problems.
This might come as a surprise – after all, the mouth and the gut appear to be completely separate. However, Prof Seow Liang Lin, Dean of the School of Dentistry at IMU University, explained, “Bacteria from gum disease can cross the blood barrier and survive gastric juices, allowing it to populate the gut and affect the balance of good gut bacteria that help with digestion. It is medically well-established that patients with gum disease are more likely to have inflammatory conditions of the gut such as inflammatory bowel disease and Crohn’s disease.”
Oral and Gut Health Intertwined
Explaining further, Prof Seow added, “The oral cavity and the gut harbour some of the most dense and diverse microbial communities; they share a common factor, which is the presence of good and bad bacteria that usually exist in balance. However, this balance can be disrupted by many factors, such as the presence of oral bacteria in the gut which releases toxins that trigger inflammation, while suppressing the good bacteria that helps to fight inflammation,” said Prof Seow.
Similarly, digestive health issues can also have an impact on oral health. For example, the backflow of acidic stomach juices in patients with gastroesophageal reflux disorder (GERD) can erode teeth enamel, leading to thinning of tooth structure, irreversible tooth damage and sensitivity.
Moreover, tooth loss has been found to be associated with a lower relative abundance of Faecalibacterium, which secretes short-chain fatty acids believed to have systemic anti-inflammatory effect.
“The relationship between oral health and gut health is more direct than most people realise, and oral health is more important than you think, because it can have an impact on your overall health and wellbeing. The oral cavity acts as a gateway for microbial colonization, shaping the composition of subsequent microbial communities along the respiratory and digestive systems,” said Prof Seow.
“Dental problems such as decay and gum diseases that have gone unnoticed may eventually lead to tooth loss and result in difficulty in chewing. This, in turn, may affect a person’s food choices, such as avoiding meats or vegetables in favour of processed foods that are easier to bite into, and lead to malnutrition or constipation.”
Another common factor affecting oral health is smoking, which disrupts gum health in the oral cavity, triggers inflammatory responses in the mouth and reduces blood supply to the gums, leading to gum inflammation.
Oral Health Redefined
With ongoing research, more connections between oral health and other diseases may be established, but the existing data on gut health is already compelling and a good reminder to make oral health equally important as other aspects of health.
This means getting regular check-ups to detect problems early, when they can still be remedied. For instance, tooth decay can cause sensitivity or pain, and thus prompt a visit to the dentist. However, gum disease can often progress without any pain and symptoms like bleeding are often ignored; over time, the underlying bone structure will be compromised and the tooth become loose; by then, there is nothing that can be done to reverse it, explained Prof Seow.
“The usual advice is to see your dentist at least once a year but it is more relevant to look at your risk factors. If you have been practicing good oral hygiene and have no known issues, annual check-ups might be sufficient. However, the presence of tooth decay or gum disease, or the use of braces or other prosthesis that easily retain plaque, may require more regular attention, perhaps twice a year or even quarterly, depending on your dentist’s recommendation,” said Prof Seow.
As a final word of advice, Prof Seow advocates making your dentist your trusted ally. “Having a regular dentist who is familiar with your history can encourage more open discussion and education on oral care solutions that are relevant and effective for you.”
-THE MALAYSIA VOICE
