Why is oral-dental health so important?
By A. Minocha MD, author: Guide to Alternative Medicine and the Digestive System
- Orodental space represents the tip of the spear for most things good and bad (food, drugs, toxins, pathogens) that enter the body especially the gastrointestinal tract.
- Ironically, the status of orodental cavity may reflect the overall health including nutritional and immunological status.
- Orodental changes may be cause of effect or what is happening in the body.
Oral cavity is “dirty”. A variety of bacteria are present including pathogens that have potential for local and body-wide repercussions.
- As many as 500 species are encountered and most of them are not pathogenic.
- In the presence of immune dysfunction, the pathogenic bacteria can become pathogenic manifesting in chronic inflammatory periodontal disease and can then affect the entire body.
- Orodental activities, as simple as chewing, flossing brushing and minor procedures like scaling result in release of bacteria into blood circulation, although the bacteremia is usually transient.
- However, the release of bacteria or their toxic product into the circulation have potential to seed another nidus of infection/inflammation setting off a deleterious chain reaction.
Is localized focus of infection anywhere significant
Poor oral-dental health implies a localized focus of infection.
- The word “localized” may be a misnomer since a localized focus of infection need not have localized effects only.
- Not unlike cancer, metastasis of bacterial infection may occur in the form of bacteremia, release of bacterial toxin into the circulation.
- Metastatic inflammation describes the phenomenon wherein bacterial antigen released into circulation interacts with an antibody resulting in immune complexes that can have their own disease processes.
Localized focus of infection: A historical perspective
Concept of localized focus of infection is not new; in fact it is rooted in history of medicine since ancient times
- Hippocrates successfully treated a case of arthritis by performing tooth extraction.
- Dr. C.H. Mayo in 1914 declared in Journal of American Medical Association that “root abscesses and pus pockets connecting them are often the source of acute and chronic rheumatism”.
Localized orodental infection foci
- Much of the research has focused on periodontal lesions and their systemic effects beyond oral cavity
- Caries is also increasingly attracting attention in recent times
- WHO considers caries a global health problem
How does focus of infection including orodental affect body
Diffusion or metastasis of bacteria, toxins and antigens into the body can initiate or worsen a distant and/or generalized illness. Affects can be far away including heart and brain
- Administration of components of normal mouth bacteria (commensal) Porphyromonus gingivalis exacerbates encephalomyelitis in mice.
- An additional concept gaining traction is involvement of RAGE.
The emerging RAGE concept (Anger at cellular level)
RAGE (Receptor for Advanced Glycation End Products ) has been implicated in multiple disorders.
- Signaling through RAGE has been implicated as a nemesis for diverse pathologies including periodontal disease, cardiovascular diseases, complications of diabetes mellitus including diabetic vasculopathy, Alzheimer disease, cancer, and neurologic conditions.
- An excess of AGEs (Advanced Glycation End Products) has been documented in numerous organ systems including brain of patients with autism.
- RAGE are plentiful in gums and are released into circulation when gums are inflamed.
- AGE-RAGE axis has been postulated as the mechanism of a variety of associations of orodental diseases and increased diseases beyond oral cavity including heart, blood vessels and nervous system [Katz et al 2010].
Oral-dental lesions in GI diseases
- Concept of oral-dental lesions in gastrointestinal diseases with far-reaching effects in various parts of the body is well established.
- Examples include inflammatory bowel disease, Behcet’s disease, celiac disease etc.
Effects of poor health on oral cavity
In addition to gastrointestinal disorders, aphthous lesions may occur due to immune dysfunction related to infections, malnutrition, allergies, stress and hematological and malignant disorders. More details in upcoming post.
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