I read an article years ago that bad oral hygiene could lead to a host of other diseases, including clogged arteries and heart disease. I didn’t really believe it then and I don’t really believe it now. Nonetheless, The New York Times had an article on why oral hygiene is crucial to your overall health.
A growing yet limited body of research, for instance, has found that periodontal disease is associated with a range of health conditions including diabetes, heart disease, respiratory infections and dementia.
Exactly how oral bacteria affect your overall health is still poorly understood, Dr. Bray said, since the existing research is limited and no studies have established cause-and-effect.
But some conditions are more associated with oral health than others, experts say.
Why do I say this is rediculous? Back in grad school we were taught the mantra, correlation is not causation. In other words, when two things appear together one is not necessarily caused by the other. We know that health is correlated with income and education. The more income and education, the better the health, on average. This from Tulane School of Public Health:
Less education is linked to lower income, which is linked to poorer health. Numerous studies show that people in lower socioeconomic situations experience more obesity, asthma, diabetes, heart disease and other health problems than people in better financial circumstances.
Here is the mechanism that the New York Times reports on why poor dental health is associated with poor health in other ways.
In its early stages, called gingivitis, the gums may become swollen, red or tender and may bleed easily. If left untreated, gingivitis may escalate to periodontitis, a more serious form of the disease where gums can recede, bone can be lost, and teeth may become loose or even fall out.
With periodontitis, bacteria and their toxic byproducts can move from the surface of the gums and teeth and into the bloodstream, where they can spread to different organs, said Ananda P. Dasanayake, a professor of epidemiology at the New York University College of Dentistry.
Supposedly diabetes is caused by poor dental health and poor dental health causes diabetes. The latter is probably more likely than the former.
Of all the associations between oral health and disease, the one with the most evidence is between periodontal disease and diabetes, Dr. Bray said. And the two conditions seem to have a two-way relationship, she added: Periodontal disease seems to increase the risk for diabetes, and vice versa.
But wait a minute: diabetes is also highly correlated with income:
After statistically controlling for other factors, lower income males were 94 % more likely to have type 2 diabetes while lower income females were 175 % more likely to have type 2 diabetes.
The New York Times also reports that poor dental hygiene is correlated with cardiovascular disease:
In a report published in 2020, an international team of experts concluded that there is a significant link between periodontitis and heart attack, stroke, plaque buildup in the arteries, and other cardiovascular conditions.
While researchers haven’t determined how poor oral health might lead to worse heart health, some evidence suggests that periodontal bacteria from the mouth may travel to the arteries in vascular disease patients, potentially playing a role in the development of the disease.
Yet, according to research studies, [h]ousehold income was strongly and independently associated with heart disease. Another article claims [s]tress links poverty to inflammation and heart disease inflammation.
The New York Times article went on to say poor dental hygiene is associated with pregnancy complications and dementia. Yet, it is common knowledge that lower socioeconomic status results in worse pregnancy outcomes. Moreover, the Alzheimer’s Association also states memory loss and dementia are correlated with lower socioeconomic status.
Dental health is also correlated with income and education. People with money tend to take better care of their teeth than those with less income. At the very least, people with less money sometimes decide they do not have the money for dental visits. Numerous studies, including here and here, find that people at the lower end of the income distribution tend to make fewer dental visits and have poorer dental health. The same is true of physician visits. People at lower income strata may decide to forgo health insurance and medical care because they have other uses for the money.
Does poor dental health cause other health problems, including diabetes and cardiovascular disease? Does poor dental care result dementia and pregnancy complications? Anything is possible but what is more likely is dental health and chronic health conditions are all related to socioeconomic status. Also, public health advocates are at a loss to explain exactly why lower income and education result in poorer health outcomes. Their solution is Medicaid expansion or Single Payer health insurance, but those too have not shown to prevent health problems from occurring.