Oral health, chronic disease, and longevity

A recent study published in The Journals of Gernontology Series A found an association between poor oral health and frailty in the elderly.  T he study found that elderly people who had poor status in 3 or more measures of oral frailty(# of natural teeth, chewing ability, tongue pressure, difficulties in eating or swallowing, and articulatory oral motor skill)  had greater than 2-fold increases in the risk of various measures of physical frailty including sarcopenia, disability and mortality.

It’s easy to toss these associations aside if we look at them in a vacuum.  Certainly people who haven’t been taking care of their oral health are far more likely to not take care of other aspects of their health.  But this study isn’t an island; there are quite a few other studies that back up the association between oral health and overall health.  Furthermore, there’s plenty of mechanistic studies showing a causal relationship.

Is neglecting oral health common?

I pay pretty close attention to most aspects of my health.  But if there’s one aspect of health and wellness that I’ve neglected over the years, it would be oral health.  For some ridiculous reason, it’s been one of the lowest priorities in my life since I can remember.

It started when I was that kid.  You know, the one that would wet his toothbrush and hide in the bathroom for 10 minutes to make his parents think he was brushing his teeth.  I still, to this day, have no idea why I did that.  Nor do I understand why I thought up until recently that moving a 1/2 oz brush across my teeth for 5 minutes was such a monumental task meant to be feared.

All that’s changed with my enlightening on the factors that promote health and reduce my risk for the chronic diseases of aging.  Diseases that include Cancer, Type 2 diabetes, cardiovascular disease, and Alzheimer’s disease.  If you’re a betting person, you can pretty much put it all down on one of the diseases taking your life.

Most people are under the mistaken impression that these things are pretty much determined by the genetic hand you’ve been dealt.  We now know that what you do with that hand is just as important as the actual hand you’ve been dealt.  To end this poker analogy, the person with the best hand doesn’t always win the game.

Gut health…oral health…It’s all the same mechanism

Once upon a cotton gin, we thought the inside of the human body was basically sterile.  Sure, bacteria slip in from time to time when we get sick, but for the most part our days are spent free of bacterial invasion.  Then, over the course of the last few decades, we found out that wasn’t quite true.

Not only do we have bacteria living as residential helpers in our gut, they seem to slip in on a pretty regular basis.  Then, of course, we have our oral bacteria…and our skin microbiome…Basically, we’re vehicles for bacteria.  The more access they get, the more problems they cause.  For a detailed rundown of how this happens and the consequences of it, check out my synopsis here.

At this point, many people have bought in to the concept that bacteria in your gut can cross a damaged intestinal barrier, get in to the bloodstream, and contribute to the chronic diseases of aging by increasing chronic systemic inflammation.  But what most people aren’t aware of is that they appear to do it from your mouth too.

Image result for old dirty bastard

Taken from: https://lastfm-img2.akamaized.net/i/u/770×0/798712572d104cb39411b4ad986fc8cb.jpg

Evidence for oral bacteria in chronic disease

One of the first lines of evidence in the link between oral bacteria and chronic disease came from studies showing an increased risk of chronic disease in people with gingivitis.  Most recently, specific bacteria in the mouth increasing the risk for stroke.  In the initial model, excess inflammation from the mouth entered the bloodstream and contributed to the systemic inflammatory load.  True, but not the only problem.

Researchers have found bacteria known to inhabit the mouth in the brains of people who died of Alzheimer’s.  Next, the plaques lining the blood vessel walls in people with cardiovascular disease.  And then, the blood and joint fluid of people with rheumatoid arthritis.  Now, the model becomes more complex, with bacteria slipping in to the blood from the mouth and causing damage remotely.

We’ve known that the chronic diseases of aging come with chronic inflammation for years.  There’s even a cutesie little name for it: inflammaging.  Whether the primary cause of this chronic inflammation is from inflamed tissues “leaking” inflammatory cytokines in to the blood or from bacteria slipping across the mouth and gut barriers to damage other tissues within the body is irrelevant since the solution is precisely the same: Maintain healthy tissue barriers.

Time to get a dentist involved

Over the last 10+ years I’ve made a concerted effort to improve this situation.  I began using a Water Pik and brushing my teeth 2-3 times a day.  Reducing to almost eliminating the sugar and refined carbohydrate from my diet is also a step in the proper direction.  Unfortunately, this process only recently began to involve a dentist.

I never knew my gums were really all that inflamed because they’d pretty much always been the way they are and didn’t regularly bleed.  Sure, if I had the Water Pik on too high I’d get some, but I attributed that to having the pressure up too high.  At least that was what I told myself.  The Dentist told me otherwise…

Image result for and the lie detector test determined that was a lie

Taken from: http://s2.quickmeme.com/img/78/788940436268b403a1c069011befbc30d74a3eab8ebd99f619a6f130e2e3f467.jpg

Not only were my gums inflamed, I had periodontal disease.  In fact, I had 30% bone loss, caused by those sugar guzzling bacteria making acid and the chronic inflammatory response eroding my bone.  This inflammation, and the problematic bacterial dickweeds eroding my teef bones had to go.

I’d like to say the process is complete, but it isn’t.  95% of what I need to get done by the dentist is finished, but keeping those mofos in my mouth under control is something that involves effort from me.  My new rotation is Water Pik/brush AM, floss/brush after lunch, Water Pik or floss/brush before bed.  I even throw in some hydrogen peroxide from time to time to drop a surprise bomb.

My mouth is definitely much healthier because of it.  The only negative response I experienced came immediately after I had the built up plaque removed from my teeth.  They were super sensitive, but that’s probably because some of those surfaces hadn’t seen air in a long time.  My dentist also went super-aggressive on her approach, and I’m happy she did.

Now, my teefers feel great.

Conclusion

While the human body is much more complex than a motor vehicle, it often works as a good analogy for people to grasp the importance of maintaining healthy systems to optimize overall health and function.  To optimize your cars performance, you need to maintain the tires, the engine, the brakes, the drivetrain, and every other subsystem that controls operation of the car.  Your body’s no different.

While it’s easy to blow off the maintenance of systems you deem insignificant, everything matters to some extent.  You may view oral health as the radio in your car, but even if you’re right, a radio can mess up the way a car functions.  If it shorts out, the entire electrical system in your car can go, and you’r car becomes a very expensive paperweight.  Why leave your body to the same fate?

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